Can American Buddhism Thrive Without the Psyche?

Abstract

Buddhist teachings first made contact with psychoanalysis almost one century ago. Carl Jung famously grew interested in Buddhist psychology, with its obvious resonant orientation toward the mind as an ultimate resource. Clinicians from Erich Fromm, to Karen Horney, Wilfred Bion, and many others began integrating the tradition into their analytic work. However, it took another 75 years for Buddhist teachers and spiritual mentors to acknowledge the role of psychodynamic methods and insights for students of the Dharma (Buddhist teachings). Perhaps informed by scandals among revered Buddhist teachers, who seemed to be re-enacting unworked-through trauma histories, and students who brought a full spectrum of developmental struggles, interpersonal traumas, psychiatric illness, and addiction to their spiritual pursuits, contemporary Dharma mentors began to slowly appreciate the need for more active conversation between the traditions. Today, there is widespread awareness, primarily among Western Buddhist teachers, that many Dharma students need both spiritual and psychological support. But still, there remains a struggle to more fully grapple with the impact of developmental interpersonal experience on a student’s relationship to their spiritual practice. In this paper, I will explore through the lens of both my psychoanalytic practice and my role as a Dharma teacher, how Buddhist spiritual care in the West across lineages will continue to benefit from increased understanding of psyche, and how even foundational and widely taught Buddhist methods such as mindfulness and concentration can become sources of distress, or merely ineffectual, when these perspectives are ignored. I will reference clinical vignettes of two long-term psychoanalytic patients and their evolving relationships to the Dharma as a portal into this ever-evolving conversation.

1. Introduction

Whether we enter the realm of healing through psychoanalytic or spiritual care, those of us who bring the psyche and spirit into active conversation across traditions recognize that we are living through a time of profound and complex suffering. I imagine that my colleagues contributing to this journal have felt called to consider how our awareness and integration of contrasting though resonant approaches to the human condition may offer those seeking care a process suited to this moment of layered human struggle and the longing to work through it. I will approach this theme as a psychoanalyst shaped by intersubjective, relational, and depth psychological theories and methods, understanding the psyche as a realm formed by ornate personal and interpersonal histories, as well as shared or collective internal capacities that are often obscured by powerful identification with personal struggle.

As a teacher of Tibetan Buddhist studies and practice, I have also found myself, over the past two decades, in the role of Buddhist spiritual mentor. Drawing on my clinical work, teaching, and spiritual care, this article will explore the continuing evolution of Buddhist practice and psychology in contemporary Western settings, where questions of self and mind—and the contrasting though compatible models and methods for working with these vast internal spaces—continue to call for deeper understanding and reflection. I have been learning about these elusive questions through my own spiritual practice and analytic work with patients. In this article, I will focus on two psychoanalytic treatments of patients exposed to Buddhism who sought help to bridge these traditions so they would not fall into the gap between them. Over time, our work wove together their developmental and interpersonal journeys and its impact on the always evolving mind and self with our shared curiosity about spiritual resources embedded in the mind that would support this whole endeavor.

2. The Beginnings: Buddhism in the West

In the early 1970s, the first wave of Tibetan Buddhism in the West was emerging with all the joyful, unabashed fanfare associated with Woodstock and Ken Kesey’s bus to freedom. This ancient, Indic healing tradition, with its systematic and nuanced psychology, had captured the imagination of Westerners seeking an experience of self and other, unhindered by cultural, developmental, and familial constraints. There was a spaciousness posited in the Buddhist model of mind that seemed to offer immediate relief to its practitioners: a self-state that was at once entirely subjective and inter-dependent.

Unlike the Freudian model of mind with its inherent conflict that can be managed but remains ultimately insoluble, the Buddhist topography proffered a realm of mind free from all psychic ensnarement. This most precious and liberating foundation of mind is referred to as main mind, or a basic consciousness that allows for pure and unobstructed awareness (Tsering 2006, p. 8). I have come to think of this mind of clear seeing as the deepest layer of the psyche, underneath the repressed unconscious. It is a realm of mind thought to be of ultimate psycho-spiritual liberating value in Buddhist psychology. In this way, there is no external source of psychological and spiritual evolution that can be of any reliable value without conscious engagement of this foundational nature of mind.

When I was first exposed to Buddhism as a child, accessing this experience of inner clarity through the restored simplicity of just being, just seeing, and just breathing left an impression that would influence the course of my adult life. In these brief and innocent glimpses into contemplative states, relatively freed from customary discursive and evaluative states, it seemed that there was a way to land more fully in oneself without feeling isolated or alone. When the mind could settle into its most unfettered and spacious condition, feelings of connection within and with others emerged effortlessly. I took note.

The wisdom teachings of this tradition, described in the Perfection of Wisdom Sutra (Prajnaparamita), indicate that we are all capable of accessing the mind’s natural capacity for psychic well-being when we accurately experience the self, mediated by the main mind or spacious mind, as relationally embedded (Dalai Lama 2005, pp. 110–11). This teaching, known as anatta in Pali and anatman in Sanskrit, is translated as no-self, a translation that has caused understandable confusion and fodder for spiritual bypassing. It is described as the absence of “the feeling or belief that there is an inherent, ontological core at the center of our experience that is separate, substantial, enduring, and self-identical” (Engler 2003, p. 52).

Informed by the Buddhist model of mind that attributes all affective struggles, and ensuing neuroses, to more surface (and therefore less foundational) mental factors, this teaching on selfhood as fluid and potentially freed from any and all psychic ensnarement, supported by the mind’s natural clarity, has been a source of great optimism and prospective healing for students of Buddhist psychology (Tsering 2006, pp. 29–31). The teachings place a profound trust in the mind’s intrinsic capacities to work through all psychological experiences of suffering. It is one predicated on determination, steadfastness, and ongoing psycho-spiritual efforts, but is nevertheless informed by the conviction that the mind’s natural state is one of clarity and spaciousness.

I was too young to notice during my initial exposure to this tradition, on the heels of the Vietnam war and a major cultural revolution, that some of the early devotees were hungry for this optimism. In part, this was due to the pervasive complex traumas, developmental thwarting, and interpersonal struggles they hoped to free themselves from in their Buddhist practice. Clinicians that were active in these early Buddhist communities made efforts to help devotees consider the importance of a psychological self as a needed subjective home base from which a generative interdependence informed by a more fluid self (no-self) would be more possible and fruitful. Psychotherapist and Buddhist teacher, Jack Engler, later famously wrote that we need to have a self before we can have a no-self, by which he meant that the spacious and freeing experience of an ontological fluid self cannot replace the need for psychological self-cohesion, self-coherence, and a sense of being on a continuum of time. We need to feel that who we are today has something to do with who we were yesterday and who we may become tomorrow, to make use of and withstand our interdependent nature (Engler 2003, pp. 35–38).

Engler was also careful to validate the Buddhist conviction that fluidity of self-hood and a radical challenge to customary states of self as being fundamentally separate from others is essential for mental health and perhaps in ways that had not before been expressed so directly by someone conversant in both traditions, this was not a theoretical matter (Engler 2003, p. 87). The lived experience of anatta was a psycho-spiritual opportunity to be fundamentally freed from avoidable psychological suffering and far more able to enjoy the preciousness and ongoing vulnerability of life without anxiety disrupting this capacity for joyful living. But for reasons that remain relevant today, he was also suggesting that a stable experience of unique and viable subjectivity is foundational to our psychological well-being and necessary for the ontological freedom promised in Buddhist teachings to become a lived reality (Engler 2003, pp. 36–37).

Engler got some pushback for his developmental perspective that emphasized having enough self-hood before challenging it (Engler 2003, pp. 47–49; personal communication). Clinicians who had experienced enormous psychological healing from the practice of these wisdom teachings before entering into their own psychotherapy treatment were disinclined to posit such a linear progression. It is, indeed, revelatory, to discover that no amount of personal trauma can negate this inherent capacity for feeling both rooted in one’s authentic selfhood and capable of radical change, growth, and even transcendence. More recent scientific inquiry into the neurobiology of trauma and the autonomic nervous system by the psychologist Stephen Porges has helped the larger clinical community grapple with this truth–we are wired for safe and authentic connection, to self and other, and our neuroplasticity allows for and supports needed healing. It is what the body and mind push for (see Porges 2011; Dana 2018, pp. 26–28).

3. Selfhood and Mentalization

Some 20 years after my first exposure to Buddhist practice and teachings, I began studying illness narratives as a graduate student of medical anthropology and was gripped by the ornate spectrum of experiences associated with suffering. How we make meaning of personal suffering in ways that either bolster or dilute a generative sense of self, that utilize the mind’s capacity for healing or weave vexing knots, was my entry point into clinical studies. Like many prospective clinicians, I sensed that the mind was endowed with capacities that were too easily ignored and unlived. And, most relevant to this paper, it seemed that the cross-pollination of a psychoanalytic appreciation for personal struggles with one’s experience of mind and selfhood, in conversation with a Buddhist optimism that these struggles are fodder for abiding intra-psychic freedom when turned toward skillfully, was the inroad I had been looking for.

Having brought Buddhist perspectives into my analytic studies, I found myself considering that our relational nature was clearly emphasized in both traditions, but our first years of interpersonal and intra-psychic development were only explored in the analytic tradition. This difference was most striking in discussions of mind and selfhood. Through the lens of many developmentally oriented analysts (see Beebe et al. 2005; Stolorow et al. 2000; Stern 1985; Winnicott 1992), the mind and its ensuing capacities are first informed by the mind of a caregiver and their capacity to hold the evolving mind of an infant. We begin this life in a purely experiential state, but without awareness of having a mind that, potentially, if things go well enough in our primary relationships, holds and filters everything it takes in. In this way, we are wholly dependent on the spaciousness of our caregiver’s mind to help hold our developing mind. In its earliest stages, the mind is exquisitely vulnerable without enough psychic structure to be utilized for the good but hard work of conscious awareness.

The British psychoanalyst Peter Fonagy, in particular, has made stalwart efforts over the last 30 years to bring this truth to the psychoanalytic community. In his research on mentalization, he describes the process by which we become aware we have a mind that mediates our perception and experience of the world. It is a developmental achievement, largely informed by the capacity in the caregiver to offer sufficient affect attunement, to convey awareness of the growing infant’s internal world and somatic experience (Fonagy et al. 2002, p. 3). His wise suggestion that the mind is not a genetic given dovetails with my wish to propose that the main mind of Buddhist psychology may also be dependent on interpersonal experience to bring it forward as a felt and lived psychic reality.

For Fonagy and his colleagues, a mentalizing capacity allows for the experience of selfhood to emerge. As a growing child begins to mentalize their affective arising, it helps them to both regulate affect and cull subjective meaning from it. This whole process begins to weave together a felt sense of an agentic and unique selfhood (Fonagy et al. 2002, p. 5). It is an intra-psychic and interpersonal process that ongoingly supports both the capacity to access interiority and personhood, and to recognize the interiority and personhood of others: something that has also been extensively explored and confirmed by mother/infant research, attachment research, and relational and intersubjective clinical work (see Beebe et al. 2005; Stolorow et al. 2000). This larger clinical community has become a chorus of voices conveying that the mind and self are formed in a relationship. In this way, we are by our very nature, relationally embedded.

In contrast, as described in the original Buddhist teachings of mindfulness offered in the Satipatthana Sutta, there is a conspicuous presumption of mind as sufficiently developed and ready for the arduous challenges of sensitizing the mind to all arisings without customary habituated reactivity (Anãlayo 2007). In Buddhist psychology, we come primed with a sturdy mind endowed with all the psychic structures needed for full psycho-spiritual liberation that allows us to access an experience of self as fundamentally dynamic, free from any fixed or unchanging elements. The mind comes prepared to recognize the truth of ontological “no-self”, and to access the wisdom to live out this psychic truth.

4. Monastic Mentalization

When I first began exploring these clinical and psychoanalytic perspectives on the mind’s formation in a primary object relationship and bringing this into conversation with Buddhist teachings of mindfulness, I was fortunate to be working with a seasoned Buddhist teacher. He is a revered Tibetan monk who welcomed my many questions about his personal history. Sensing my interest in him as both a spiritual mentor and someone who had a complicated early life, my teacher began telling me more about his childhood and primary relationships.

The first few years were not easy—he and his family lived with few conventional resources in rural Tibet—but they were idyllic compared to what would come later. He described a relative steadiness in his caregivers, and a pervasive cultural message mediated through this caregiving, that feelings and personal experience were not to be over-emphasized. It seemed that the combination of this steadiness and the under-emphasis on subjectivity helped him survive the many traumas he would face as a six-year-old: the sudden invasion of his country and ensuing flight to an Indian refugee camp, where tragically, his four siblings, three under the age of six, all died from illness. When he was seven years old, he was sent to a monastic school where he lived with other Tibetan refugee children, who like him, had experienced head-spinning loss.

Listening to these evocative and painful memories transported us both back in time and to places and tumultuous conditions I could only imagine. My teacher was clearly impacted, describing moments of shock, and the sense of being haunted by loss for many years. Devastating memories of his older brother, just 8 years old, suddenly dying right in front of him, were most pronounced. There were also recurring dreams of his mother whom he did not see again after being sent away.

But right alongside the palpable thud of pain and tenderness of these memories and images was another realm of feeling that would quickly emerge. In a poetic reverie that seemed ethereal, genuine, and protective, my teacher described a felt sense that we could choose to not become overly identified with our suffering. Of course we would be impacted by loss, but it lacked ultimate power to dilute our basic well-being.

“Watching my brother die, it affected me very much,” he said softly, as if to emphasize he was not lapsing into total denialism, and that he was not on the run from the direct experience of affect. He then went on to suggest that because the mind is ultimately endowed with the powers to essentially curate our experience, we could use the mind to reliably bring us back to well-being without getting too ensnared in suffering.

My teacher, an obviously brilliant man who sensed that he could disarm skeptical Westerners with humor, looked me dead in the eye during one such conversation—perhaps sensing my skepticism—and said with a wonderfully innocent smile, “If we can be miserable for no good reason, why can’t we be happy for no good reason?”

I laughed and had to admit he had a point.

But even with the levity and sweetness of his humor and optimism, there was a tender residue I think we both felt: the presence of younger parts of himself that had been carefully sequestered over the years being invited forward. There was the misery of premature loss, and the quiet relief of having two minds holding this history across many differences but with a shared trust in healing.

After telling him a little about the psychoanalytic notion of how the mind develops and the role of the unconscious and how it houses—perhaps safeguards—parts of our experience until they are ready to come into consciousness with more emotional support and increased intra-psychic capacity, he seemed curious. “You’re talking about Freud and Jung’s ideas?” he asked. I nodded. “Tell me more!” he implored, asking me about Jung’s purported schizophrenia and Freud’s cocaine addiction. “Were they crazy?” he asked. I laughed again, suggesting that perhaps like many visionaries, they may have been some combination of profoundly insightful and a little nuts.

“Maybe they needed the Dharma,” he suggested, shrugging his shoulders so as not to cause offense.

“Probably would have helped,” I conceded. Of course I wanted to push back a bit, bring the conversation into balance, also suggesting that perhaps, when personal suffering was acute and complex, something more than Buddhist responses might help. The mind, while precious, is also profoundly vulnerable and existentially reliant on others.

That conversation would have to wait.

5. Charbel

Some years later, I gave a presentation at a NYC psychoanalytic institute on my clinical work with children informed by Buddhist psychology. In the audience was a middle-aged Lebanese man whose career in academia contributed to our current understanding of mirror neurons in childhood development. He was a psychologically oriented scientist with a feel for a child’s psyche. He was also interested in Buddhist meditation, having been exposed through a college class on the philosophy of religion that integrated mindfulness practice and readings from the sutras. Having been in a prior long-term treatment with a seasoned analyst who was kind and parental, he was curious about another treatment where contemplative approaches might be integrated in some way.

After he contacted me for a consultation, we began a three-times-per-week analytic treatment. In those early months, Charbel told me more about his complex history. After his family fled the Lebanese civil war in 1975 when Charbel was ten years old, they settled in a middle-class New Jersey suburb. His parents were both well-educated, but in the US, were ineligible for the professional jobs they held back home. They scrambled to support Charbel and his two younger sisters, managing somehow to create a home that looked stable from the outside.

Nevertheless, the pressure clearly bore down on his parents. His mother developed a rapidly worsening relationship to painkillers prescribed for a back injury, and his father was well-meaning, but distant and overwhelmed. He remembered him looking out their kitchen window in the evenings, lost in himself and some hidden grief Charbel could never access. His younger sisters were good playmates, but the age difference eventually deepened his feelings of alienation, and at school with his American classmates who seemed to belong in ways he did not, Charbel began to experience chronic feelings of separateness and isolation. Through the combination of his intellect and strength of character, Charbel found his way through, attending a selective liberal arts college and eventually earning a doctorate in neuroscience.

But intimacy with friends and partners, while longed for, remained elusive and vexing. There was a sense of being haunted by an entrenched and radical isolation he could not break out of, a state of belonging nowhere that caused him endless despair. When his younger sister developed cancer in her early 40s and died two years later, leaving behind a young daughter and husband, he fell into a depression and decided he needed therapy.

6. Ben

Six months later, another patient contacted me for a consultation. He was a long-term practicing Buddhist in the Tibetan tradition who was actively involved in a traditional religious community where the teachers were monastics, and the students were mostly Indian-born Tibetans and a small group of deferential Westerners.

In that first meeting, Ben, a 70-year-old Caucasian man with a gentle smile and hunched shoulders, described a lifetime of sudden and catastrophic loss. When he was 12 years old, his mother died in a car accident, leaving him in the care of a severely depressed father. His older brother showed signs of serious mental illness and was diagnosed with schizophrenia, but the father failed to get him treatment. Their home quickly became a place of utter chaos that terrified Ben and his siblings. Shortly after leaving home, he married young and soon noticed that his wife also showed signs of mental illness but refused care, leaving Ben to somehow keep her and their two young children safe.

Years later, his daughter had a sudden cardiovascular event when she was 31 and died, leaving behind a shell-shocked husband and a two-year-old daughter. Two months after his daughter’s death, his wife developed cancer and died within six months.

I was staggered by the magnitude of unrelenting trauma Ben had lived through. But I was also aware that, like my teacher, Ben seemed to know that he had to find a way to tolerate his personal pain, and mine the Buddhist tradition for every possible healing resource available to help him cope with as much forbearance and equanimity as possible. In those first months of treatment, Ben and I felt our way into the ambience of his early home, which was already a place that felt fraught and burdened before his mother’s death. He suffered feelings of edgy guilt for not finding a way to help his older brother who was forever wreaking havoc at home and at school. His poor father, his poor brother, he said, hanging his head with a weighty sorrow that nearly made him collapse.

Ben felt that somehow, even before he found the Dharma, he had managed to cope, with a stalwart determination to find his way through. Even with the many obvious challenges of parenting, being a father to his two daughters was a source of great joy. From the very beginning, they were remarkably different creatures endowed with distinct and vibrant personalities, an awareness that filled him with a sense of awe and gratitude. This reinforced his sense that each one of us carries within us something uniquely loveable. But when his younger daughter died, he began to feel that he should never have been born: like Charbel, he belonged nowhere. Perhaps he did not deserve to belong.

Approximately one year into our treatment, Ben began to suffer a swampy bleak depression that frightened him. Without the consuming responsibilities of work and caregiving, the losses emerged with full force. Living was agony.

While I could feel Ben’s understandable terror of getting lost in this grief, pulled into a potentially deadening psychic undertow, I was also struck by his capacity and courage to feel this experience directly. Like Charbel, it seemed that he had been offered too little psychic holding from his caregivers, and that more often he was on his own surviving life rather than navigating it with another mind helping him titrate, identify, and recover from his many formidable experiences.

Given this history, I was struck by Ben’s admirable ability and willingness to be open to this undertow of grief, to let himself consciously feel the depths of agony and to risk letting me be there with him.

7. Charbel and the Unfound Mind

As my work with Charbel continued, his interest in Buddhist teachings and meditation deepened. With the precision of a scientist, he carefully read the Abhidharma and several commentaries on this third century text of Buddhist psychology and systematic philosophy, attempting to better understand the Buddhist model of mind and the challenging practice of mindfulness. He read the Sutra on the Close Applications of Mindfulness and other early Pali discourses on the nature of mind.

Like many Western students of this tradition, Charbel was curious about the potential impact of these challenging teachings and methods. He understood the basic premise that included stabilizing awareness (Skt. shamatha) and cultivating insight (Skt. vipashyana) through a method that allows perception to become increasingly sharpened and spacious, without habituated efforts to either grasp onto or reject the arisings of the mind (Wallace 2011, pp. 3–5).

Yet, he was also struck by the complexity of these teachings, rightly sensing that they were far more elusive and psychologically provocative than typically acknowledged by his teachers. Over the years of his studies and practice, he had tapped into occasional meditative experiences during which he was able to observe the workings of his mind, to watch the arising of isolation, the emergence of terror that followed, and the rage that came in to protect against this terror of aloneness. These moments helped him to imagine that there was a dynamic nature to what usually felt both sudden and vexingly permanent.

But then the whole process would evaporate or dissolve into a sense of simply not being able to do it. Sitting with this defeat, Charbel felt kicked out of an enviable mental space and quickly consumed with a more distressing sense of not trusting the method or the contents of his mind to make any good use of it.

While Charbel found some ephemeral meaning in these spiritual endeavors, even with the difficulties he faced, they were not sufficient to spare him several more years of feeling radically alone and somehow not of the same world others belonged to. As we discussed what might be layered into his spiritual explorations, more of his early life emerged, before the obvious stress of leaving his birth country. In these conversations, he described the sense of being on a conveyor belt, with the cultural and familial expectations of life creating reality. By the time he was eight or nine, there was an increasing despair that nothing was holding him—his mind was afloat, like a “floating cranium.” In this way, everyone in the family felt siloed, as if “no one’s mind was available, or real”.

These feelings also arose powerfully in his transference, where Charbel began experiencing me as being “of some other world, some place where mental life was only simulated.” At other times, I clearly did not care and was only conducting therapy for the benefit of my research. He started to resent my Buddhist affiliation, suggesting that I used it to not feel into the depths of his self-doubt and disorientation, and that I preferred to keep him feeling well, rather than risk closer proximity to his personal hell realm. It was in these sessions with Charbel that I began to feel and understand the immense compassion offered in staying with another person’s suffering before moving toward reflection, insight, and recovery. He was asking me to not rush toward wellness and skip over the truth of his private agony of aloneness.

Looking at me became increasingly difficult for Charbel. Often, he lapsed into silences that seemed to keep us both on guard, as if we were both siloed, and our minds frozen. In the throes of these sessions, my thinking often felt stunted, as if my mind had ground to a halt or was amorphous in ways that would fail to offer either of us the required holding and containment. After one of these challenging sessions, sitting with the ripple effects of having been pulled into a space where minds were collapsed, I eventually came to appreciate that Charbel also needed me to loosen up and use my mind more spaciously and to be truly present and non-coercive with my mind, perhaps in the way that a Winnicottian good-enough caregiver might be: attuned and in a relationship with him, but also not over-exerting. And then, only then, I would generously try to hold and eventually digest more of what he was clearly struggling to formulate and metabolize: that he needed me to open my mind more fully, to patiently and respectfully notice how psychically on his own he had been, perhaps from the very beginning.

“You Buddhists!” he blurted out, before I had come to this awareness. “You will drive people crazy!”

I nodded, knowing what he meant. In the Buddhist model of mind, there was a problematic skipping over of the earliest developmental stages of mind, something I had considered early in my clinical studies, but may not have sufficiently grappled with. While it was a theoretically relational system, describing how embedded our minds are in the dynamic mosaic of conditions that influence us, still, there was no acknowledgement that utilizing the mind for its most freeing intra-psychic work required first having been found safely held by the mind of another (e.g., see Ogden 2022). There was no Dharma of early childhood.

Charbel began to describe the impossibility of his meditation practice, and the sense that when he sat down on his cushion, he would disappear and become too amorphous. The floating cranium sensations would return in full force. He was learning the foundational practices of Buddhist meditation—mindfulness of body, feelings, mind, and all phenomena—but more often felt they were a trap, and sometimes he felt it with me, too. He felt that he was drifting away, even as I clearly wanted to keep us both in the room. Why did I assume he could use his mind to think about anything? Why did I appeal to his mind to keep him with me when his mind was nowhere?

He asked me this, staring into me.

“You are right,” I said, struck by an insight that is central to our ability to do the hard work of therapy. “Why am I asking you to reflect when no one has been reflecting you into being?”

He nodded. We both sighed, as if surviving a treacherous birth.

In the months ahead, slowly and circuitously, we moved into a new stage in our work. What changed was that we both understood Charbel’s need for more unhurried time to discover his mind, and that when the task was too elusive, I would not withdraw my mind from his struggle. When I was unsure how to help him, or what he most needed from me, I would not retreat into confusion or fear of inadequacy, but would stay present, authentically. In this way, we were learning together that our minds needed a truly collaborative space, in the service of helping Charbel find his own mind, and discover its contents, but this time without pressure to know or tolerate what he discovered until he was ready to do so (see Benjamin 2018).

8. The Suffering of Rejected Affect

As Charbel was moving into a new and enlivening time in his life and in our therapy, Ben’s suffering worsened. He was loath to over-emphasize his distress, acutely aware of how much pervasive suffering existed in the larger human family, but admitted that he no longer wished to be alive. He was recently re-partnered and dedicated to his girlfriend, so he would not act on these feelings, he reassured me, but they were overwhelming him, like a repetitive tsunami in which he was constantly drowning.

He described a recent conversation with his Buddhist mentor. His teacher, a revered elderly Rinpoche, had listened patiently as Ben described his despair and the sense of being engulfed by grief. He said that the loss of his beloved daughter was a thudding pain that would not settle.

With a gentle smile, the Rinpoche nodded empathically, but then replied softly, “This, again,” as if to say, “you hold onto this grief instead of letting it go. It is gone, let it be gone.”

I sighed, and as I did so Ben put his head back and bellowed, “I am making this worse!”

Unbeknownst to Ben, I was filled with a quietly pained indignation. I knew this Rinpoche, had learned from his trenchant writing and teachings, and could easily imagine the wildly confusing combination of kindness, compassion, and refusal of trauma with which he would have responded.

Giving myself a moment to take in the encounter Ben described, I may have slightly shaken my head “no,” as I again sighed with exaggeration. Ben first took this to mean that I agreed with the Rinpoche and must be tired of endlessly hearing about his despair and oceanic grief. Surely this was all more “self-grasping,” an ego-centric position that would not budge. He felt that he was letting his teacher down, and me.

“I’m sorry,” he said, awash with shame.

“Actually,” we looked at each other with the deepest fellow-feeling I had experienced with a patient, “I will admit that it frustrates me, because as much as I respect your teacher, I hear him pulling away from the truth of what you’ve been through, and how you feel. Of what is arising in your heart and mind and needs to be cared for. He is not letting you feel devastated. And how could you be anything but? You lost your beautiful child. You are feeling undone by grief. Not forever, perhaps, but for now, and for as long as you need. Of course, I can’t know, but what I imagine is that your teacher is protecting himself from this pain when he could be opening to it with real compassion. Courageous compassion. You have nothing to apologize for.”

We sat together in silence.

After a few minutes, he whispered, “Thank you,” and cried quietly for the rest of the session.

9. Dependency and Freedom

After this session, and many others where we explored Ben’s guilt and shame for feeling shattered by loss, I sat with the layered feelings that had been stirred in our work and throughout my years in a Buddhist community similar to the one that had both loved and struggled to help him. Like Ben’s teacher, my teacher—a wonderfully sensitive and kindly person—had also suffered severe and complex early trauma that was not formulated as trauma. In our discussions over the years, more often, the many harrowing losses of country, family, and health were described as experiences over which we have no control, and that belong solely to the past, with no discernable link to the present, as if they were so ephemeral as to be more of a mirage than a lived psychic reality. Such memories—admittedly painful ones—can settle in the psyche so profoundly that they can no longer wield destructive power.

In the early years of my psychoanalytic work, it often saddened and frustrated me to hear what sounded like a protective refusal of complex suffering, and an absence of needed affect regulation in early primary relationships. It was not an obvious example of spiritual bypassing so much as a culturally, developmentally, and spiritually informed perspective that was always deferential to the powers of the mind to transform suffering into our “natural state” of equanimity and clarity. In this way, suffering was approached as more of an alchemical ingredient meant to be mixed with the most powerful intrapsychic resources of intelligence, wisdom, and compassion. With the trust and understanding that when this arduous psycho-spiritual interaction took place with sufficient patience and optimal support from mentors and spiritual community, the suffering would invariably be transformed.

As a clinician steeped in a tradition that was, indeed, historically too problem-saturated and perhaps too phobic about our capacity for greater and more abiding states of happiness and well-being, I could appreciate the wisdom and value of trusting that our traumas and personal suffering do not have the inherent power to uproot our capacity to enjoy life, or to cull meaning from our struggles that becomes a liberating source of sustenance (in ways akin to existential psychoanalysis, but with a contrasting model of mind). Yet, it was also apparent that in many senior teachers with comparable trauma histories, there was obvious residue of unworked-through personal suffering and loss. Whether managed through a more benign propensity to dissociative theoretical musing and humor, or more problematic struggles with addiction or boundary violations with students, these experiences of loss were not fully transformed with the Dharma alone.

One primary gift of a psychoanalytic process, it seemed to me, was the opportunity to reclaim the psychological truth of our dependency needs and to feel our way back into our original vulnerability and shared need for the presence of other minds to hold us psychically. Of course, this dependency requires maturation over time, but it is a noble process by which freedom from avoidable suffering, and freedom from intra-psychic suffering resulting from unavoidable pain, can be more reliably accessed.

For Ben, and so many other devoted Buddhist practitioners and teachers who had endured the pain of loss, war, illness, and other conditions over which they had no power, I wished for a deepening respect for our reliance on the readiness of another person’s mind to hold what might be too much to hold on one’s own. And that if we could tolerate the truth of this reliance, this dynamic dependency, perhaps one’s own mind and ensuing sense of self would feel truly resourced with an authentic readiness to hold even the most unforeseen changes to come.

10. Conclusions: Moving the Wheels of Dharma

For my Buddhist clinical mentors before me, this central and missing understanding of the mind’s development and its relationship to a felt sense of self that is prepared for the arduous journey of life and death has been obvious: so much so that in the early years of my analytic career I imagined becoming an analyst to the Lamas, Geshes, and Rinpoches (Tibetan honorifics), offering them a place where their histories and minds could be cared for with the compassion and insight they sought to offer others. It seemed to me that if Western students were maturing in our spiritual endeavors and practicing the wisdom and compassion we had been training in, we would offer it more readily to our teachers by recognizing and responding to their suffering.

But the resistance I would face in lifting up the interpersonal imprint on the mind, and the vulnerability of the young mind, or the older mind that had never received sufficient emotional and psychological care from others, was far more formidable than I anticipated. Then came years of treating Ben and others like him, who brought agonizing psychological pain to their Buddhist teachers only to be encouraged to use their practice to garner insight, and eventually, “to let it all go.” Often, teachings of no-self, or anatta, were layered into these spiritual directives. When stories of personal pain were described by students, teachers were listening to tales of “self-grasping,” where an always-changing and fluid self-hood was being reined too much into one-dimensional narratives of suffering. In this way, Buddhist teachers were offering spiritual teachings about the truth of our dynamic nature, the impermanence of all phenomena, in response to stories of psychological pain in need of attuned and compassionate recognition (Engler 2006, pp. 24–28).

This is not to suggest that nothing has changed over the decades. Today, there is widespread awareness, primarily among Western Buddhist teachers, that many Dharma students need both spiritual and psychological support. In contemporary and more secularized Buddhist communities, teachers are often influenced by a culture where psychotherapy is normative and the notion of a psychological self (in distinction from an ontological no-self) is a lived truth. It is probably not uncommon for such Western teachers to have been in their own psychotherapy or analysis, and to have appreciation for the impact of personal suffering on every aspect of life, including spiritual life and practice. My sense is this increased awareness has been helpful to students of the Dharma, as a way to appreciate that Buddhist psychology can offer profound healing, but like all healing paths, it does not have all the answers at all times (Eigen 1998, p. 219).

Nor am I suggesting that in order for the Dharma to thrive in the West, it needs to become something altogether novel, unanchored by its history and lineage. As a practitioner of two complex healing traditions steeped in their socio-cultural origins, I have come to appreciate the importance of understanding the origins and evolution of any healing path. Without this sense of history and context, we are likely to dilute the depths of our healing work and settle for simplified versions of nuanced and challenging methods and teachings that require struggle and patience before they can be integrated and lived out.

Perhaps the Dharma may stand a better chance of evolving and maturing in the West with an increased appreciation for the influence of the developmental and interpersonal journey on the mind and its relationship to self in all Buddhist lineages. The psyche, which holds our personal and interpersonal history, alongside remarkable structures for healing, is a reality that requires recognition and care. It has been more than a century since Buddhist teachings first made contact with psychoanalysis and it has been just over 50 years since psychodynamic therapists began efforts to advocate for our psychological interiority to Buddhist teachers and communities. The conversation has been rich and multi-faceted, including voices across Buddhist paths and psychoanalytic schools of thought. I am a beneficiary of this cross-pollination, having received my clinical training from analysts for whom our spirituality is as relevant to psychological healing as sound and multi-faceted clinical work.

My wish for future students of the Dharma and for their Buddhist mentors is simply to bring to their spiritual endeavors a respect for the reality of our personhood and subjectivity as housed in the psyche and that it carries our history, alongside our longing to experience life with fresh eyes, unhindered by past suffering. With Ben and Charbel, our work included efforts to mine their Buddhist practice for its healing potential. This spiritual tradition is replete with extraordinary methods for contacting depths of love and compassion for oneself, and potentially for countless others. In this way, it can be an invaluable resource for people with complex trauma that saddles them with a distorted perception of their own deepest value. For clinicians, it can also offer methods that nurture the very open-heartedness and presence of mind that are called for in psychoanalytic work but often insufficiently supported by analytic training.

What I hope for is that this combination of increased appreciation for the personal and interpersonal nature of the mind and self, alongside reverence for Buddhist healing methods that can unlock profound personal freedom, will help Dharma teachers and practitioners identify and disentangle certain spiritual teachings from particular developmental and psychological suffering that requires specific and attuned psychological care. Charbel needed to discover his own mind, and to trust that I could keep my mind with him, before he could practice and enjoy the fruits of mindfulness. Ben needed to know that he could feel bereft without lapsing into a too-rigid or distorted experience of himself and that the agony of loss can be met with respect without amplifying its impact or reifying a grieving state of selfhood.

Even my teacher, through many years of experience with students who brought ornate psychiatric and psychological difficulties to him with the expectation that he and his spiritual care could provide them everything needed for their well-being, has come to recognize that the Buddhist tradition is vast and exquisitely illuminating, but does not address all aspects and causes of suffering. His humility and willingness to recognize this truth have been a blessing to me and many others. Through my relationship with him, and my analytic work, I have come to appreciate that it is difficult to cultivate reverence for any healing path while also recognizing its limitations. We know this through our most intimate relationships, where the respect and love for another human being live right alongside awareness of what cannot be accessed. When we grow in a relationship, we grapple with potential and limitations instead of pushing this arduous process and reckoning into the unconscious.

Perhaps this is what Western Buddhists are now facing: the opportunity to grapple with what the Dharma does not offer and to deepen their relationship to what it can. In this way, there is an opportunity to grapple with the reality of the psyche, both its remarkable capacity for transformation and transcendence and the suffering it carries in need of multiple modalities and responses across traditions. It seems to me this is ultimately what builds character—to stay and work through challenges and limitations faced in our spiritual practice and communities, and to let the psyche be an active part of that process.

If we all need a sense of belonging, to our own unique personhood and to an experience of our own mind that is spacious and flexible enough to withstand the challenges of unexpected suffering, then perhaps those of us who care for others are wise to remain humble in the face of suffering. In this way, we can, with patience and receptivity, consider the full spectrum of clinical and spiritual resources that might become needed inroads to the nourishing and psychically essential place of rest within our self, a place of belonging that we can trust.

Pseudonyms were used for all clinical references to protect privacy.