Relieving Renunciation: An Examination of Psychotherapy and Selflessness in 'Thoughts Without a Thinker' from a Theravāda Perspective
(The following is an academic essay I wrote for school last year, offering ideas about Mark Epstein's Thoughts Without a Thinker, a book that was influential for me. I'm guessing Watts would approve.)
By Dzintars Dzilna
Often painted with broad strokes of renunciation and self-restraint, Theravāda Buddhism can appear to be dogmatic and uninviting, especially to Westerners who are unfamiliar with the tradition. Passages by Theravādin monks such as Dhammasudhi, an early author of Buddhism’s move to the West, use disciplinarian language about meditation that may seem stark and formidable. More recent authors, such as Thanissaro Bhikkhu—a Theravādin monk born and raised in the U.S.—use discourse that is more tailored and appealing to Western audiences, embracing affirmative messages. But the perspective of Theravāda as renunciatory is at least to some degree still reflected in the current dialogue between Buddhism and psychology, which is informing the evolution of Buddhism in the West. Whereas Theravāda is often identified as conservative and rigid in its soteriological practices, Mahāyāna schools such as Pure Land, Zen, and Tibetan lineages are seen as adaptive and dynamic.
As an example of the tension between traditions, Mark Epstein, one prominent author within the dialogue, draws from Theravāda to describe its insight meditation techniques, but his interpretive presentations of Buddhist teachings are typically Mahāyānist in nature. In his Thoughts Without a Thinker, he cites a range of Mahāyānist schools, including Zen, Madhyamaka, and the “Tibetan tradition,” to explain how “nirvana is samsara (sic) [Epstein’s italics]” for example, a claim that Theravāda would categorically deny.  Perhaps more relevant to today’s Western practitioners, Epstein discusses how Buddhism seeks to “work with” emotions and integrate repressed experiences—rather than “renouncing” them.
Mahāyāna presentations of Buddhism might well be effective for explaining the overall tradition’s teachings to Westerners, but do psychology-oriented interpretations adequately consider Theravāda’s relevance? For his part, Epstein presents Buddhist teachings in terms of psychotherapy, in an attempt to show how the practice of meditation—such as Theravāda-based insight meditation—can enhance psychotherapeutic methods and results. Two prescriptive messages stand out. The first, addressed mainly to Buddhist practitioners who have taken up meditation as a path for emotional healing, promotes professional psychotherapy as a way to help overcome unresolved developmental issues. Epstein asserts that Westerners often use meditation as a defense mechanism, to avoid recurrent behaviors such as low self-esteem and estrangement, as well as serious neuroses and pathologies. In response, therapy provides “working-through” that can help practitioners overcome unconscious obstacles which can, in turn, enable one to employ meditation more effectively for further soteriological work. Epstein’s second message, addressed to Western psychotherapists and patients in general, explains how the Buddhist teaching of selflessness offers psychotherapy an opportunity to go beyond its limits of transforming neurotic misery to only a “common unhappiness,” as Freud even recognized. In short, Epstein explains that Buddhism’s selflessness offers an approach for working with narcissism and reification of a self-entity, which lead to psychological suffering.
Beyond Epstein’s descriptions of Theravāda-based insight meditation and the teaching of selflessness common to all forms of Buddhism, one might assume that there is little common ground between Epstein’s prescriptions and Theravāda’s doctrines. But an examination of Epstein’s treatment in terms of Theravādin hermeneutics—especially relying on the language of the suttas as described by Steven Collins’ Selfless Persons, a study of Theravāda literature and the doctrine of selflessness—reveals the tradition’s applicability to the treatments Epstein promotes. Regarding Epstein’s assertion that practitioners seek professional therapy to build emotional stability, for example, Theravāda recognizes the need for a “unitary self” that is capable to receive its dhamma. The tradition even has a system of categorizing “persons” and suttas, effectively diagnosing individuals according to personal temperaments and capabilities, and matching them with appropriate treatments of teachings. With regard to Epstein’s presentation of selflessness, Theravāda prescribes the teaching only to religious specialists: rare individuals who have proper training within the tradition and a supportive cultural and economic environment. Theravāda’s conservative perspective, in fact, serves as a caution of the difficulties involved in explaining the teaching adequately within the Western milieu. Comparing Epstein’s prescriptions with Theravāda perspectives will provide insights to Theravāda’s relevance in the current dialogue between Buddhism and psychotherapy in general. In addition, this analysis will also offer some insights to Epstein’s own assertions about psychotherapy and his interpretation of the teaching of selflessness as applicable to Western sensibilities.
Conventional prescription: Therapy as part of meditation
As a basis for both of his prescriptions, Epstein first describes psychotherapy’s strengths and weaknesses, positioning the Western tradition as both a potential benefactor for Buddhist practitioners and beneficiary of Buddhist teachings. As a benefactor, the tradition can help patients by revealing latent traumas, repressed feelings, and repeating behaviors, which can foster grieving, acceptance, and some relief. To its credit, the tradition has moved from examining sexual and aggressive conflicts to recognizing narcissism—which Epstein posits in the language of Buddhism as part of the origin of suffering (i.e., Buddhism’s second Noble Truth)—as an underlying cause of psychological suffering. However, psychotherapy has not been able to develop a final treatment for the underlying problem. Revealing past traumas and repressed emotions can aid in overcoming them, but one is likely to continue to harbor resentment for past mistreatment, and one will also continue to seek ever-elusive satisfaction for one’s narcissistic self-construction. In sum, “psychotherapy may be equally necessary [with meditation], especially to expose [childhood deficiencies] and reduce erotic or aggressive conflict, but the psychotherapeutic dialogue will always come up against the problem of the restless and insecure self. … It has not been able to deliver freedom from narcissistic craving.”
Epstein’s second prescription—Buddhist selflessness, as described below—is to provide psychotherapy a way to help patients with the underlying problem of narcissism. But in order to be able to employ selflessness, a patient or practitioner must first have an ability to “hold” experience and observe emotions and thoughts, without getting caught up by them and playing out one’s repeating, painful behaviors. Meditation is the key, described extensively by Epstein in terms of three practices: concentration; mindfulness; and insight. The first two practices, concentration and mindfulness, provide a foundation of psychological capabilities such as bare attention, openness, impartiality, nonjudgmental awareness, and fearlessness. These capabilities are necessary to enable successful self-inquiry involved in insight meditation, the third practice that employs the teaching of selflessness.
As part of his explanation of concentration and mindfulness meditation, Epstein describes the need for psychotherapy—especially for beginning meditators—effectively prescribing therapy as part of meditation practice. Epstein asserts that Western practitioners often use meditation as a way to hide from dealing with recurrent personal conflicts and disorders: “The psychic pain revealed [through meditation] … and personified by the strong longing is often so central and so deeply personal that meditators can never let go of the wish that the meditation itself would magically heal them.” Epstein also describes how therapy can aid progress in meditation practice. He cites one study of experienced meditators finding that subjects were just as anxious as non-meditators, and had no less internal conflict. Meditators only had a “‘marked non-defensiveness in experiencing such conflicts.’” Epstein concludes that while meditation can help the practitioner be more accepting of internal conflict, “without a therapist’s intervention, there is a very real danger of paralysis.” While meditation instructors can help, they are typically not trained to handle psychological issues, especially serious neuroses requiring professional treatment.
Aside from finding it self-serving for a psychotherapist to recommend psychotherapy, Buddhist proponents and meditation practitioners might also find it literally self-serving, i.e., promoting construction of a sense of self that the doctrine of selflessness is to counter in the first place. The idea of using therapy to reconstruct a personal history and work on one’s individual problems might seem to contradict the Buddhist teaching of selflessness, especially within the context of the Theravāda tradition, which can, for example, object strongly even to the use of “the [Pāli] words attā [i.e., ‘self’], purisa and puggala [both ‘person’] … in any theory which posits a real, permanent self or person as the agent behind action or the subject of experience.”
However, Epstein’s prescription for using psychotherapy could be interpreted in terms of Buddhism’s “two truths,” i.e., conventional truth and ultimate truth. Theravāda and Mahāyāna schools alike recognize the two truths as a pedagogical method for presenting Buddhist teachings. While the traditions vary on their views on ultimate truth, they generally agree that conventional truth includes socially accepted norms and ideas, practiced by “worldly people.” As Collins describes, conventional truth within the Theravāda tradition “speaks of selves, persons, spirits, gods, and so on.” The conventional world is thus the world of householders, for whom religion provides a system of ethics, rituals, prayers, etc. Historically, the doctrine of self-lessness was generally not of concern by practitioners within the conventional world, except perhaps as a symbol to oppose Brahmin priesthood and belief systems, according to Collins. Within the Theravādin laity, one believes in the unitary individual, who has an inherent self-interest; in practicing religion and merit-making, the main hope is for reincarnation into a future time when one is reborn into the time of Maitrī, the next Buddha, to hear his teachings and have enough merit to work on selflessness of nibbāna.
In fact, Collins makes a special point to note the indispensable role of developing oneself that was held within early (Theravāda) Buddhist doctrine relative to Buddhist society: “socially and psychologically it was and is necessary that there be both affective and cognitive selfishness in order that that the doctrine of anattā can act, or be thought to act, as an agent of spiritual change [Collins’ italics]” Theravāda uses attabhāva (Pāli) to refer to the lifetime of a person, and it is the convention that the tradition uses “as a means by which its non-personal, category-analytic mode of discourse [i.e., the teaching of selflessness] can be made to come half-way to meet the personalized, self-interested style of thinking and perceiving which is held to be characteristic of all ordinary, unenlightened discourse.” On the level of conventional truth, the tradition recognizes that the personal psychology of the individual appears: “Although the ultimate discovery of the religious life would be the meditator’s ‘realization’ of selflessness, nevertheless on the way to that final goal, the practitioner would find out much about his character.” In Theravāda’s use of attabhāva, the meditative life “teach[es] the monk ‘self-knowledge’” in two ways: One develops a “general awareness of the individual character which is his karmic inheritance, its faults, merits and spiritual potential; and also, he will become conscious, moment to moment, of what actually occurs in the experience of that individual character.” One in training then “work[s] with motivational and perceptual processes as they ordinarily are, that is to say, based on desire.” In this specific context, mental training does not “cut” the stream of desire immediately, but guides it, “like water along viaducts.” If the monk develops intensified self-awareness and uses it to illuminate past experience, it can lead to seeing past “individualities” and “lives.”  Buddhism thus assumes “unitary selves or persons” to receive the dhamma, just as Epstein proposes psychotherapy to lay Westerners so that they can develop psychic stability, for the ultimate goal of employing of the teaching of selflessness.
The application of psychotherapy as preparatory for meditation practitioners might also be validated by seeing Buddhist teachings as therapeutic, effectively giving care to different types of patients. The Tipiṭaka, the Theravādin canon of scripture, includes a wide range of teachings, addressing different types of practitioners—including householders, monks, and specialists—and the tradition includes a hermeneutical approach for organizing the dhamma accordingly. Two postcanonical texts, the Netti Pakaraṇa and the Peṭakopadesa, present the teachings in terms of a “gradual path,” a characterization indicating a moderate and preparatory series of steps. According to Bond, the interpretative approach by the Netti Pakaraṇa and the Peṭakopadesa provides a way to embrace religious needs of individuals at different stations in life, while concurrently including the singular goal of nibbāna encompassing all the teachings: “The notion of the gradual path to nibbāna allowed the [texts] to subsume mundane goals under the supermundane goal and to explain how the truth of the dhamma relates to all people.” Just as psychotherapy classifies individual patients according to their dispositions and personal neuroses, these two texts categorize people into different typologies and classifications, including life situations (“man in the world” (i.e., householder), learner or initiate (monks or “renouncers”), and adept (renouncers who have attained nibbāna)) temperaments (including different types of defilements of desire and view), and abilities. And just as therapy provides appropriate treatments for each type of patient, the “gradual path” texts correlate classifications of people with different types and combinations of suttas, including teachings for countering defilements and promoting moral living (for householders), for “penetration” (i.e., disciplines for renouncers), and for adepts. Though Buddhist teachings explain the “gradual path” as occurring over multiple lifetimes and “eons” of time—as opposed to focusing on one particular “person” as psychotherapy does—each “birth” represents a necessary stage, “stepping stones to a birth in which a person is able to strive for the ultimate goal.”
Ultimate prescription: Selflessness as part of therapy
Epstein’s first explanation of Buddhist meditation gives a detailed overview of its practices and includes his prescription for including therapy within meditation’s setting. But he also explains meditation in the context of Freudian analysis, specifically, “remembering,” “repeating” and “working through,” a process for enabling the patient to recognize past trauma, identify neurotic behaviors and their developmental impetuses, and integrating repressed emotions. Epstein asserts that Freud understood intuitively the value of bare attention and mindfulness, and proposed that therapists develop these qualities as part of their work with patients. Part of Epstein’s strategy in explaining meditation in terms of Freud’s process of analysis is likely to show that meditation practice is in line with—in fact, practically proposed by—Freud’s work, giving it credence and thus enabling therapists to employ it on a professional basis. It demonstrates how bare attention and mindfulness can help therapists be more effective, and can help patients recognize and work with issues. Another strategy is to explain to meditation practitioners how therapy works in a step-by-step process, described with examples and terms from psychology that Epstein clarifies or are familiar to Westerners. Most important, Epstein’s examination elucidates how within a therapeutic setting one could use insight meditation and the teaching selflessness, which might otherwise remain a theoretical, esoteric, and unattainable concept to Westerners. The teaching of selflessness enables one to realize the “ultimate truth” of nibbāna within the Buddhist system vis-à-vis “conventional truth” as espoused with Epstein’s previous prescription of therapy, along with concentration and mindfulness meditation practices.
The first step of the Freudian process, the “remembering” phase, involves either the patient uncovering past traumatic events, or the therapist’s observing the patient’s present behavior to uncover sources of pain that are not tied to specific events. In the latter case, Epstein explains that most people have neuroses as adults not from an individual traumatic experience in childhood, but from a consistent occurrence or absence experienced while growing up—for example, neglect by parents—that can lead to the individual unconsciously perceiving a flaw in him or herself. Epstein calls this flaw the “basic fault” (using the phrase as originally coined by Balint) and describes how it can lead to issues like low self-esteem and alienation.
In the “repeating” phase, the therapist observes, analyzes, and helps identify the patient’s unconscious “basic fault” and resulting conflicts. Patients with developmental issues often reproduce them in present behavior, i.e., they try to “repair or deny the original deprivation”—but they usually remain unaware of the repeating behavior and of the underlying issue. By observing—and not interfering—the analyst can enable the patient to reveal behaviors and attitudes that repeat, and then can identify them for the patient as necessary.
Last, the “working through” phase is for allowing, accepting, and integrating disaffected content. Revealing otherwise latent deprivations and associated emotional conflicts can enable their transformation. However, the patient can also develop resentment and desire for reparation in finding the “basic fault” and repeating behaviors. As the patient realizes that one’s needs and obstacles of the past were not met—and irrevocably cannot be met—he or she often has a sense of deep outrage which obscures the patient’s observing mind. “This very outrage is the hallmark of what has come to be called narcissism: The vain expectation and selfish insistence that one’s sense of hollowness should somehow be erased.” In this sense, “working through” is limited in its ability to provide final and lasting relief.
By “remembering” past traumas and recognizing repeating behaviors, one can identify and acknowledge—in Buddhist terminology, become aware of—issues that one otherwise denies, creating the opportunity to adapt appropriately. But one has not solved the underlying cause, only a relative symptom. While Freudian analysis enables working through of disaffected emotions to a certain degree, it is limited in providing ultimate relief precisely because the self-construction is still intact. One's narcissism will continue to manifest: “As long as the thinker is implicitly accepted, there will always be some narcissistic attachment to the injury that is uncovered in therapy.” Instead of catering to a narcissism that projects a self as substantialized agent to be healed, Buddhism provides a method for questioning the substantiality that is projected: “In stripping away people’s cravings to have to be something, the insight practices actually allow meditators to function in the everyday world unencumbered by the need to protect the false sense of ‘I’.”
Epstein describes how Buddhism’s “secret weapon” of selflessness “is to look for the sense of I that is hidden behind the disclaimed actions and emotions.” Citing “the Tibetan tradition,” Epstein explains that the practitioner is to use the state of “injured innocence,” i.e., when insulted, outraged, etc., to identify and examine one’s beliefs about self as an existing entity. Once one reaches “the bottom of one’s own outrage” within the Freudian “working through” phase of the psychotherapeutic framework, selflessness can be employed with insight meditation: “One can shift the perspective from how outraged one feels to who it is who feels it, and thereby appreciate what the Buddhist psychologies consider the relativity of the narcissistic emotions [Epstein’s italics].” After cultivating concentration and mindfulness, insight meditation takes the next step: becoming aware of the non-reality of the self. Rather than reacting to outrage of past traumas or neglect, one investigates the feeling of identification accompanying the experience, and the nature of the self-entity “I” that seems to be injured.
The process for questioning the agency of a self-entity can be destabilizing, Epstein explains, but this is precisely part of realizing relief from painful emotions due to narcissistic reifications: “Rather than encouraging a consolidating self sure of its own solidity, the Buddhist approach envisions a fluid ability to integrate potentially destabilizing experiences of insubstantiality and impermanence.” For its part, psychotherapy can help by providing a “sensitive and supportive environment” for “bringing out the subjective sense of ‘I’.” But Buddhism’s technique of insight meditation takes the next step by “uprooting the conviction in a ‘self’ that needs protecting.” One becomes aware of self-representations, reifications of identities that are “constructions out of a reaction against just what we do not wish to acknowledge. We tense up around that which we are denying, and we experience ourselves through our tensions.”
Admittedly, the path utilizing meditation is a culmination of a significant undertaking, including the preparatory development of concentration and mindfulness, i.e., “mental faculties beyond those that are conventionally accepted as adequate for ‘normal’ functioning.” But just as therapy is a careful and sustained effort, one can cultivate meditative practices to move from emotional reactivity to enabling examination of the “agency of an emotion, mov[ing] from a self-referential perspective to a position of openness.”
Describing the process of utilizing the teaching of selflessness in the context of “integration,” “sensitivity,” and “openness” can seem like a far cry from Theravāda’s historically more renunciatory language. For example, Harvey observes how the “tone” of the Theravādin teaching of selflessness is of stark denial: “Anything subject to the ‘three marks’ [i.e., impermanence, suffering, and selflessness]” should be “dropped like hot bricks.” Epstein himself recognizes the contrast in Psychotherapy Without a Self, a collection of his essays published before and after Thoughts Without a Thinker, in an allusion to “some Buddhist circles” that hold the view that “emotions are ‘defilements’ and that the enlightened person is ‘cleansed’ of them.” He calls such Buddhists “fundamentalist,” noting that their antidote to afflictive emotions is to “extinguish” them.
Collins provides several descriptions and examples of how Theravāda practice sides on eschewing emotions, rather than “integrating” or “working with” them. For example, the practice of careful attention includes the “attempt to avoid producing” the disturbances that “‘assail’” the practitioner. The monk is to “seek solitude, and to avoid ‘disturbances’ both without and within.” Within the two-truths pedagogic, one is to train in realizing ultimate truth by impersonally analyzing all types of experience—including body, form, emotions, thoughts, beliefs—to see that there is no self to be found in any experiential manifestation. In ultimate reality, the specialist sees that “whatever is recognizably contentful is to be seen as impersonal and not to be desired.” With regard to past “‘individualities’” and past “‘lives,’” the practitioner comes to understand that “memory of a sequence of such lives does not give experience of a real, reincarnating individual self or soul.” Just because one remembers past events as a “person” does not mean there was a person—a unitary, separate, and generally unchanging entity—experiencing them. In fact, concern for the past and future is “castigated as a form of ‘not paying careful attention’ and is a manifestation of the ‘the conceit “I am”’.” Collins cites a Sarvāstivāda text that says the ability to see former lives “is not for verification of karma, rebirth, and so on, but the increase of disgust for saṃsāra.” The “streams” of sense pleasures are to be “cut,” “crossed over” and discarded. Collins also points out that within the context of the practice of the specialist, Theravāda does not emphasize memory of former lives, which stands in contrast to the importance that memory has for Western psychology in understanding personal identity.
The Theravāda tradition holds the teaching of selflessness to be so challenging—requiring continuous practice, social and economic circumstance, etc.—that it is attainable, practically speaking, only by the religious “specialist,” who is typically a practicing monk. Collins notes how even most monks do not advance far enough in their involvement with the teachings and practice of the doctrine of selflessness to realize the path. Indeed, according to Sharf, historically most monks in Southeast Asia did not practice meditation—much less employ the teaching of selflessness—before the modern period, focusing on scriptural study instead. In fact, the introduction of meditation by the Theravāda tradition to laity is a very recent phenomenon. According to Gombrich and Obeyesekere, “The widespread practice of meditation among the laity is the greatest single change to have come over Buddhism in Sri Lanka (and indeed in the other Theravādin countries) since the Second World War.” Among Sharf’s arguments why meditation was not offered more broadly seems to be precisely because of the psychological instability that the teaching of selflessness can bring: “Buddhists traditionally held that meditation was a risky business that should be undertaken only under proper supervision, i.e., within the confines of the saṃgha.”
Indeed, using Gombrich’s ethnographic examination of Theravādin monks and laity in Sri Lanka as a proxy for Theravādins elsewhere, practitioners focus largely on studying Buddhist scripture and/or merit-making, instead of pursuing the teaching of selflessness: “It is doctrinally impossible entirely to abandon the self-restraint ideal, but it has been pushed right into the background, … [for example,] monks … are tacitly sanctioned in a course of merit-making like the laity.” While restraint is held in the highest reverence by followers, only rare monks and laity actually renounce worldly ties and pursue the practice of insight meditation and the teaching of selflessness.
If Theravādin practitioners do not, practically speaking, employ the teaching, this raises the issue of whether Epstein’s prescription of selflessness is viable for Westerners, especially within the milieu of psychotherapy. Can Western psychotherapy employ the teaching successfully? Does it actually provide the relief that Epstein proposes? Is one not required to “renounce the world” to realize selflessness? While Epstein cites results as described by Mahāyāna schools, descriptions of outcomes by his patients, as well as his own personal experience to support his prescriptions, his book serves to introduce it to his field of psychology as part of an ongoing dialogue, rather than to immediately prove its efficacy. As Buddhism moves to the West through accounts such as Epstein’s, psychology and neuroscience are currently engaged in examining Buddhist practices, especially meditation, to investigate efficacy in terms of scientific inquiry. This is likely to play a significant part in authenticating or disproving claims such as Epstein’s for the Westerner. Epstein might be psychologizing the religious tradition through a reductionism that does not examine it on its own cultural, historical, and soteriological terms, and critics such as Sharf suggest that religious settings are the “proper domain in which to situate [and authenticate] the Buddhist rhetoric of experience.” However, perhaps in this way Western science is co-opting the teachings and is examining them on its own terms.
With its historically conservative norms, Theravāda might question such means and results of development of Buddhism in the West. With its focus on scholarship and tradition, Theravāda serves to admonish Western Buddhist advocates and teachers of the care and skill necessary to present Buddhist teachings—and the rigor and consistency necessary with which to practice them—especially one that is so radically different to conventional thinking. There is significant opportunity of misinterpretation and misappropriation when such a teaching is presented to readers or students without requisite background and training. It is especially challenging to adequately explain the teaching in terms of another tradition, e.g., psychotherapy. To wit, ABCNews.com recently (October 2009) featured Epstein in an eight-minute video interview called “Can Buddhism and Psychology Co-Exist?” with the subhead: “Meet a doctor who thinks you can better understand the self by destroying it [italics added].” The conversation demonstrates how Buddhist teachings such as selflessness can be misunderstood, especially when repackaged for into sound bites for mass consumption:
Interviewer: What you’re trying to do is kind of tricky. How do you bridge the gap between psychiatry or psychology where you explore the self, build the ego, and Buddhism, where you’re, in a sense—and this may be overly strong—trying to annihilate the self?
Epstein: Well, you don’t have to annihilate the self from the Buddhist point of view. You just have to investigate it. And as you investigate it, you find that it doesn’t exist in the way you thought that it did. So exploring the self psycho-dynamically, exploring the self Buddhist-wise, you come upon the same thing, which is, the self is very elusive. The more you look for it, the more you think you can touch it, the more it moves away.
Like the Theravāda convention of attabhāva, Epstein’s response seems to be an attempt to meet the conventional viewer half-way: He does not want to deny the sense of a self that is overwhelmingly accepted by conventional thinking, but he suggests that under observation, the self is difficult to find. The implication is that there is no actual self to be found in the first place—but because he does not explicitly state it, the interviewer is left to reify his own belief:
Interviewer: I think of myself as a pretty concrete thing.
Epstein: Everybody does.
Interviewer: I am who I am, I’ve accumulated years of experience and education, me, out there, operating in the world. So you’re telling me, the self that I wake up with and go to bed with every day is not as real as I think it is?
Epstein: The self you wake up with and go to bed with everyday is real, but you think that it’s more real than it actually is. That’s what I’m telling you. You think it’s really real when it’s really just real.
While “real” and “really real” could be interpreted in terms of the two-truths pedagogic, it creates what seems to be a shell game of terms—for which the interviewer asks clarification:
Interviewer: So how do we take it down a notch from “really real” to just “real”?
Epstein: By trying to find it as it actually appears to you—by looking for it, either in therapy or in meditation. By actually discovering that it is much more elusive, much more evanescent than you thought it was. Then it puts you into a state of confusion, and that state of confusion is very healing.
The “confusion” Epstein notes is likely the destabilization that one experiences when questioning the agency of the self-entity construction through insight meditation, which—through thorough training and cultivation of concentration and mindfulness—can ultimately lead to “healing” or relief from painful emotions based on narcissistic reifications. However, to a viewer who has no understanding of the teaching, his comments only seem to continue the shell game by asserting that “confusion” is equivalent to “healing.”
Epstein later adds a helpful explanation about how meditation and therapy develop “willingness to look without judgment at our minds, at our experience, at our emotions, and to develop that capacity to not push away what we don’t like, and to not cling to what we’re attached to.” But by the end of the interview, the viewer is effectively left with some scant advice about introspection and an association of Buddhism with both personal self-destruction and confounding psychobabble. While the video segment might lead some to read Epstein’s more thorough and counseled treatment of the teaching of selflessness provided in Thoughts Without a Thinker—and a bald denial of self itself could be quite useful in shocking one into exploring the non-existence of one's cherished object of belief—it is likely to mislead others away from opportunities the tradition offers. In either case, the segment serves as an example of how Theravāda’s conservative approach can be applicable for a measured development of Buddhism in the West.
 Theravāda is a single, representative school of Nikāya Buddhism, also known as Hīnayāna Buddhism. “Hīnayāna” is Sanskrit for “low vehicle,” a pejorative term in the context of Mahāyāna (“great vehicle”) Buddhism. Hīnayāna Buddhism is thus sometimes described by Mahāyānists as a “lesser” tradition in terms of various factors, including its renunciatory language.
 Mark Epstein, Thoughts Without a Thinker (New York: Basic Books, 1995), 18. Generally, Theravāda would not teach that “nirvana is saṃsāra,” rather, saṃsāra is that which is renounced to attain nirvana (saṃsāra is the Sanskrit term for the karmic cycle of rebirth).
 Epstein draws from a range of theorists, including Michael Balint, Wilhelm Reich, and D. W. Winnicott, but predominantly from Sigmund Freud.
 “No doubt fate would find it easier than I do to relieve you of your illness. But you will be able to convince yourself that much will be gained if we succeed in transforming your hysterical misery into common unhappiness. With a mental life that has been restored to health you will be better armed against that unhappiness” (Sigmund Freud and Josef Breuer, Studies on Hysteria, trans. and ed. James Strachey (New York: Avon Books, 1966), 351).
 Sutta is Pāli for an individual sermon by the Buddha (Sanskrit: sūtra).
 Dhamma is Pāli for the doctrine or teaching of the Buddha (Sanskrit: dharma).
 “The Second Noble Truth … is that the cause of suffering is craving or thirst. The Buddha describes two types of craving, each of which has a counterpart in psychodynamic thought. The first, the craving for sense pleasures, we can grasp immediately. … The second, what the Buddha called the craving for existence and nonexistence, is what we would today call narcissistic craving: the thirst for a fixed image of self, either as something or as nothing. It is the craving for security wherever it can be found: in becoming or in death [Epstein’s italics]” (Epstein, 1995, 61).
 Ibid., 6.
 Without mentioning them by name, Epstein is describing here the Buddhist meditation practices widely known as samatha and vipassanā (Pāli), which correlate to “concentration” and “insight.” Epstein effectively categorizes “mindfulness” as samatha, although some Buddhist texts classify it as vipassanā (see Tse-fu Kuan, Mindfulness in Early Buddhism: New Approaches Through Psychology and Textual Analysis of Pali, Chinese and Sanskrit Sources (Abington, U.K. and New York: Routledge, 2008), 142).
 Epstein, 1995, 136.
 Ibid., 135.
 Steven Collins, Selfless Persons (Cambridge; New York: Cambridge University Press, 1982), 87.
 Buddhist philosophy might point out, however, that calling conventional norms “truth” must be posed within the context of the two-truths system. From the point of view of ultimate truth, “conventional truth” is not actually “truth” by itself, but rather a stepping stone to realize ultimate truth, i.e., soteriological liberation.
 Collins, 154.
 Ibid., 12.
 Pāli for nirvana.
 Collins, 152.
 Ibid., 160.
 Ibid., 163.
 Ibid., 251.
 Epstein asserts that psychological issues are rooted in one’s past development—i.e., childhood—and that psychotherapy and meditation can help identify them. And yet, he does not provide an interpretation of the Buddhist process of looking at “past lives”—an act ascribed even to the Buddha during the night before his enlightenment (although Epstein does make reference to “remembering of childhood” in “the Tibetan Buddhist tradition,” but he does not explain it further (Epstein, 1995, 174)). I cannot help but think that this act is at least analogous to psychotherapy’s process of looking at childhood experiences of a patient, where childhood effectively represents a series of “past lives.” This kind of understanding would require interpreting past moments or past experiences within one’s current lifetime as “past lives,” but Buddhism provides precedent for this in its teaching of dependent origination. This teaching, which is fundamental to all Buddhist schools, accounts for a person’s experiences from both one life to another (i.e., after death leading to a new birth), but also within the same lifetime, i.e., moment to moment, day to day, year to year, etc. At each moment a new “person” arises, based on past momentary “persons” and all other causes and conditions (e.g., previous actions, current environment, etc.) that lead to its arising. The examination of past lives in Buddhism is seen to provide insight into dependent origination—i.e., the nature of cause and effect—specifically, the pattern of how ignorance, desire, and aggression lead to suffering, and how to undo that process in one’s current life, in future lives, and in relationships with others. I would suggest that this is precisely what psychoanalysis seeks to provide: a method for examining one’s “past lives” to recognize the psychological patterns that one has, and the causes and conditions—e.g., trauma, neglect, latent behaviors, etc.—that lead to painful patterns. Collins recognizes how “memory-of-former-lives” is part of the stock tale of the Buddha’s enlightenment, although he notes some suttas say it is “by no means necessary for every person’s enlightenment” (Collins, 189).
 Ibid., 160.
 George D. Bond, “The Gradual Path as a Hermeneutical Approach to the Dhamma,” Buddhist Hermeneutics, ed. Donald S. Lopez, Jr. (Honolulu: University of Hawaii Press, 1988), 33.
 Bond, 36.
 “In my view, the origin of the basic fault may be traced back to a considerable discrepancy in the early formative phases of the individual between his bio-psychological needs and the material and psychological care, attention, and affection available during the relevant times. This creates a state of deficiency whose consequences and after-effects appear to be only reversible. The cause of this early discrepancy may be congenital, i.e., the infant’s bio-psychological needs may have been too exacting... or may be environmental, such as care that is insufficient, deficient, haphazard, over-anxious, over-protective, harsh, … indifferent [et. al.]” (Balint, 22).
 Epstein, 1995, 198.
 Ibid., 210.
 Epstein, 1995, 217.
 Ibid., 154.
 Ibid., 209.
 Ibid., 211.
 Epstein, 1995, 94.
 Ibid., 220.
 Ibid., 45.
 Ibid., 19.
 Ibid., 155.
 Ibid., 217.
 Peter Harvey, The Selfless Mind (Surray, U.K.: Curzon Press, 1995), 43.
 Mark Epstein, Psychotherapy Without the Self (New Haven: Yale University Press, 2007), 99.
 Ibid., 157.
 Collins, 142.
 Ibid., 139.
 Collins, 114.
 Ibid., 164.
 Ibid., 189.
 Sarvāstivāda was a Nikāya school that, when extant, had been a contemporary of Theravāda.
 Ibid., 189-90.
 Richard F. Gombrich and Gananath Obeyesekere, Buddhism Transformed: Religious Change in Sri Lanka (Delhi: Motilal Banarsidas, 1990), 237.
 Robert H. Sharf, “Buddhist Modernism and the Rhetoric of Meditative Experience,” Numen 42 (1995), 256. Saṃgha is Sanskrit for community or group, typically of monastics.
 Richard F. Gombrich, Precept and Practice: Traditional Buddhism in the Rurual Highlands of Ceylon (London: Oxford University Press, 1971), 325.
 Sharf, 270.
 Dan Harris, “Can Buddhism and Psychology Co-Exist?” online video, ABC News Now, October 27, 2009, http://abcnews.go.com/video/playerIndex?id=8926421.
 As noted by Philip Stanley, personal communication.
Balint, Michael. The Basic Fault: Therapeutic Aspects of Regression. New York: Brunner/Mazel, Inc., 1979.
Bond, George D. “The Gradual Path as a Hermeneutical Approach to the Dhamma.” Buddhist Hermeneutics, ed. Donald S. Lopez, Jr., 29-45. Honolulu: University of Hawaii Press, 1988.
Collins, Steven. Selfless Persons. Cambridge; New York: Cambridge University Press, 1982.
Dhammasudhi, Phra Sobhana. Insight Meditation. London: Committee for the Advancement of Buddhism (London), 1968.
Epstein, Mark. Thoughts Without a Thinker. New York: Basic Books, 1995.
———. Psychotherapy Without the Self. New Haven: Yale University Press, 2007.
Freud, Sigmund and Josef Breuer. Studies on Hysteria. Translated and edited by James Strachey. New York: Avon Books, 1966.
Gombrich, Richard F. Precept and Practice: Traditional Buddhism in the Rural Highlands of Ceylon. London: Oxford University Press, 1971.
Gombrich, Richard F. and Gananath Obeyesekere. Buddhism Transformed: Religious Change in Sri Lanka. Delhi: Motilal Banarsidas, 1990.
Harris, Dan. “Can Buddhism and Psychology Co-Exist?” Online video. ABC News Now, October 27, 2009. http://abcnews.go.com/video/playerIndex?id=8926421 (accessed December 17, 2009).
Harvey, Peter. The Selfless Mind. Surray, U.K.: Curzon Press, 1995.
Kuan, Tse-fu. Mindfulness in Early Buddhism: New Approaches Through Psychology and Textual Analysis of Pali, Chinese and Sanskrit Sources. Abington, U.K. and New York: Routledge, 2008.
Sharf, Robert H. “Buddhist Modernism and the Rhetoric of Meditative Experience.” Numen 42 (1995): 228-283.