By Philip Chanin, Ed.D., ABPP, CGP
Board Certified Clinical Psychologist
Assistant Clinical Professor, Department of Psychiatry
Vanderbilt University Medical Center
philchanin@gmail.com

“Our task is to eradicate suffering by eradicating its causes: ignorance, craving, and aversion. To achieve this goal, the Buddha discovered, followed, and taught a practical way to this attainable end. He called this way the Noble Eightfold Path. Once, when asked to explain the path in simple words, the Buddha said, ‘Abstain from all unwholesome deeds, perform wholesome ones, purify your mind.’…the mind is truly purified not by performing religious ceremonies or intellectual exercises, but by experiencing directly the reality of oneself and working systematically to remove the conditioning that gives rise to suffering.” (Goenka, S.N., “Moral Conduct, Concentration, and Wisdom” in An Introduction to The Buddha and his Teachings, edited by Samuel Bercholz and Sherab Chodzin Kohn,1993, p. 97)

The Buddha lived and taught some 2,500 years ago. Western psychotherapists have become increasingly interested in the relevance of the Buddha’s teachings to our modern-day practice of psychotherapy. Patient seek us out for help with their anxiety, depression, relationships, and careers. Fundamentally, patients are often unhappy with their lives and are desperate for guidance. The Buddha’s Noble Eightfold Path and The Karmic Law of Cause and Effect offer wisdom for us to distill to our patients.

According to S.N. Goenka, one of the best-known Buddhist teachers, the Noble Eightfold Path

“can be divided into three stages of training: shila, samadhi, and prajna. Shila is moral practice, abstention from all unwholesome actions of body and speech. Samadhi is the practice of concentration, developing the ability to consciously direct and control one’s own mental processes. Prajna is wisdom, the development of purifying insight into one’s own nature.”

Three parts of the Noble Eightfold Path fall within the training of shila: right speech, right action, and right livelihood:

Right Speech: One who practices right speech, the Buddha explained, “speaks the truth and is steadfast in truthfulness, trustworthy, dependable, straightforward with others…His words are worth remembering, timely, well-reasoned, well-chosen, and constructive.” (Goenka, p. 99)

Patients and couples often come to psychotherapy describing angry and hurtful interactions with spouses, children, and other family members. To put Right Speech into action, patients must be determined to bring a higher awareness and intention to every word that they speak.

As my first meditation teacher Jack Kornfield writes, “The development of awareness in meditation allows us to become mindful enough or conscious enough to recognize our heart and intentions as we go through the day…Practice it with your speech. Pay very careful attention and notice the state of your heart, the intention, as you speak about even the smallest matter. Is your intention to be protected, to grasp, to defend yourself? Is your intention to open, out of concern, compassion, or love? (A Path With Heart: A Guide Through the Perils and Promises of Spiritual Life, 1993, p. 279)

Right Action: “Just as right speech means to avoid causing harm with what you say, right action means avoiding causing harm with what you do. So in place of physically hurting others through your actions, you seek to help and protect them.” (Landaw, Jonathan, and Stephan Bodian, Buddhism for Dummies, 2003, p. 69). Describing one who practices right action, the Buddha said, “Laying aside the rod and sword, he is careful to harm none, full of kindness, seeking the good of all creatures.” (Goenka, p. 99).

Just two days ago I spoke with a patient who described a recent encounter with his girlfriend: “She got in my face, so I threw a glass of wine in her face.” This was not Right Action. Recently I was working with a couple whose conflict developed into a physical altercation. The police were called, the husband spent several hours in jail, and the court and lawyer’s fees totaled $6,000.

Right Livelihood: As Goenka writes, “We meet our obligations to society by the work we do, serving our fellows in different ways. In return for this, we receive our livelihood…Whatever remuneration we are given in return for our work is to be used for the support of ourselves and our dependents. If there is any excess, at least a portion of it should be returned to society, given to be used for the good of others.” (p. 101). As psychotherapists, we can stress to our patients the importance of right livelihood for overall well-being. As Jack Kornfield once said, “Try to meditate after stealing all day.”

Three parts of the Noble Eightfold Path fall within the training of meditation, or samadhi: right effort, right awareness, and right concentration.

Right Effort: Regarding meditation instruction, Goenka writes, “Respiration is an object of attention that is readily available to everyone, because we all breathe from the time of birth until the time of death. It is a universally accessible, universally acceptable object of meditation…When we notice that (the mind) has wandered away, patiently and calmly we bring it back again. We fail and try again, and again…The task requires repeated, continuous practice as well as patience and calmness. This is how we develop awareness of reality. This is right effort.” (p. 103)

Patients come to psychotherapy with very busy minds. They often have great difficulty turning their minds off, even to be able to go to sleep. As Buddhist informed psychotherapists, we can encourage our patients to develop a meditation practice. Many apps are now available that can be very helpful and encouraging, such as Headspace and Calm. We can agree with our patients that meditation is difficult and requires sustained practice and patience.

Right Awareness: Meditation is a powerful practice for learning to live in the present moment. As Goenka says, “The mind spends most of the time lost in fantasies and illusions, reliving pleasant or unpleasant experiences and anticipating the future with eagerness or fear. While lost in such cravings or aversions, we are unaware of what is happening now, what we are doing now. Yet surely this moment, now, is the most important for us. We cannot live in the past; it is gone. Nor can we live in the future; it is forever beyond our grasp. We can live only in the present,” (p. 104). Many of our patients present with sometimes unbearable anxiety, constantly worrying and anticipating the worst. As a patient told me two days ago, “I’m this worry machine. I catastrophize. It’s hard to relax.” Meditation can be a wonderful practice for letting go of negative scenarios and learning to live in the present moment.

Right Concentration: As Goenka writes, “It takes time to change the ingrained mental habits of years. It can be done only by working repeatedly, continuously, patiently, and persistently. Our job is simply to return attention to our breathing as soon as we notice that it has strayed. If we can do that, we have taken an important step toward changing the wandering ways of the mind. And by repeated practice, it becomes possible to bring the attention back more and more quickly. Gradually, the periods of forgetfulness become shorter and the periods of sustained awareness—samadhi—become longer…Maintaining this awareness from moment to moment, for as long as possible, is right concentration.” (pp. 106-107).

The final two parts of the Noble Eightfold path fall within the training of prajna, or wisdom: right thought and right understanding:

Right Thought: As a result of sustained meditation practice, Goenka says, “The mind has become tranquil at least at the conscious level, and has begun to think about…the way to emerge from suffering.” (p. 112). “Therapies break the hold of past conditioning on present behavior. Meditation tries to alter the process of conditioning per se. As a result, the meditator realizes his or her role as writer-director of these inner dramas and discovers the element of choice in the cutting and editing of perceptions of reality.”

“This responsibility for choices becomes clear…The meditator is able to identify and abort the circular, conditioned mind habits that before had tended to linger and reverberate as ruminations and purposeless obsessions.” (“Meditation and Psychotherapy: A Rationale for the Integration of Dynamic Psychotherapy, the Relaxation Response, and Mindfulness Meditation,” by Illan Kutz, M.D., Joan Borysenko, Ph.D., and Herbert Benson, M.D., American Journal of Psychiatry, 142:1, January, 1985, pp. 5-6)

Right Understanding: There are three kinds of wisdom, or prajna: received wisdom, intellectual wisdom, and experiential wisdom. As Goenka writes, “Received wisdom is not one’s own wisdom—it is borrowed wisdom…Intellectual understanding..is still not one’s own insight…Whereas experiential wisdom…arises out of one’s own experience, out of personal realization of truth. This is the wisdom that one lives, real wisdom that will bring about a change in one’s life by changing the very nature of the mind.” (pp. 112-113)

In Thoughts Without a Thinker: Psychotherapy from a Buddhist Perspective (1995), Mark Epstein,M.D., suggests a distinct similarity in the methods of Freud and the Buddha: To his great credit, Freud discovered the importance of the therapist’s learning to attend, non-judgmentally, to whatever came into the patient’s mind. “There is no evidence,” according to Epstein, “that Freud was influenced directly by Buddhist practices, but the resemblance of his attentional recommendations to those of the Buddha cannot be denied…Freud’s writings on the subject reveal the first essential quality of bare attention—it’s impartiality. (Freud) repeatedly admonish(ed) psychoanalysts to ‘suspend…judgment and give…impartial attention to everything there is to observe.” (p. 114)

Thus, the promise of psychotherapy is learning to pay attention to one’s mind and to one’s every action, on the path to gaining real wisdom—experiential wisdom.

The Law of Karma: Just as the Noble Eightfold Path describes a plan for leading a fulfilling life and alleviating suffering, the Law of Karma helps us understand the constant workings of cause and effect in our lives. Many people have the idea that karma is synonymous with fate, as in, “It’s just his karma.” However, the Buddhist teachings on karma make clear that a fuller meaning of the term involves, in Jack Kornfield’s words, “the way that cause and effect govern the patterns that repeat themselves throughout all life…The Buddhists say that understanding this is enough to live wisely in the world.” (p. 273)

Kornfield goes on to say, “We can understand the workings of karma in our lives by looking at this process of cause and effect in our ordinary activities and by observing how the repetitive patterns of our own mind affect our behavior…These patterns and tendencies are often much stronger than our conscious intentions. Whatever our circumstances, it is old habits that will create the way we live.” (pp. 273-274)

Kornfield continues, “If we are not aware, our life will simply follow the pattern of our past habits, over and over. But if we can awaken, we can make conscious choices in how we respond to the circumstances of our life. Our conscious response will then create our future karma…we must see that karma has two distinct aspects—that which is the result of our past and that karma which our present responses are creating for our future. We receive the results of past action; this we cannot change. But as we respond in the present, we also create new karma. We sow the karmic seeds for new results.” (p. 276).

Thus, Buddhist psychology puts great emphasis on our intentions, in all of our actions. As Kornfield writes, “The intention or attitude that we bring to each situation of life determines the kind of karma that we create. Day to day, moment to moment, we can begin to see the creation of the patterns of karma based on the intentions in our heart…persist in your good intention and observe the kinds of responses it eventually elicits…try responding only when your heart is open and kind. When you don’t feel this way, wait and let the difficult feelings pass.” (pp. 279-280)

As Buddhist inspired psychotherapists, we can teach our patients about the wonderful guidance of the Nobel Eightfold Path and The Law of Karma, as our patients seek to lead more fulfilling lives, with better relationships, less anxiety and depression, and more meaning. The Buddha begins his teachings in the great Dhammapada by saying:

We are what we think.
All that we are arises with our thoughts.
With our thoughts we make the world.
Speak or act with an impure mind
And trouble will follow you
As the wheel follows the ox that draws the cart.
We are what we think.
All that we are arises with our thoughts.
With our thoughts we make the world.
Speak or act with a pure mind
And happiness will follow you
As your shadow, unshakable.