Tricycle Talks: Buddhism & Psychotherapy

An Interview with Mark Epstein

Tricycle Talks: Now in iTunes

In the debut episode of Tricycle Talks, contributing editor Amy Gross speaks with practicing psychiatrist Mark Epstein on Buddhism and psychotherapy. Epstein emphasizes that there is dukkha (suffering) in every place at every time, and that psychotherapeutic practices can help alleviate this suffering. Epstein's new book, The Trauma of Everyday Life, also explores this topic.

Tricycle Talks is a podcast series featuring leading voices in the contemporary Buddhist world.

Want to hear more of Epstein's thoughts on Buddhism and psychotherapy? Read "What Changes?" Epstein's article in the Tricycle's Fall 2013 Issue.

Download the talk here.

View the transcript here.

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jewelupthesteps's picture

I have so thoroughly enjoyed reading Tom Peppers comments. His voice is a diamond cutter. His courage to speak out is invigorating. Yes he resorted to name calling but no one took the bait which is really inspiring. Keep telling it like it is Tom!

Dominic Gomez's picture

It behooves the Buddhist to duke it out with dukkha rather than give up. One symbol of a Buddha is a fearless lion.

mralexander99's picture

I don't know anything about "psychotherapy" except what I learned from the song by "The Talking Heads" - after listening to this conversation - I am over joyed to finally have some confidence in the purpose of the "so-called therapeutic" world - because all I heard from this tricycle treasure was pure dharma!...I especially appreciate how the analogies of dukkha, mothers and being nurtured relates to The Buddha's insight --- correlated with being free of trying to "fix" anything about myself but, more of a leaning toward a delight in discovering the "traumas" that put me together.........alhamdillilah!?!

sschroll's picture

Hi Mark,

I have no words to express my gratitude for this talk. Such a relief !!!
I have a wonderful Sangha....but there is one difficulty.....the ability to connect with the trauma of every day life. 15 years ago it was easier, but now it's 'be happy!!!!'

beatrice's picture

Thanks for the interview. Loved it and look forward to more. I will certainly read his books.
Being present to self and others is gift.
Namaste'

williamftyler's picture

Question: would not the young prince have a wet nurse even if his mother lived and how traumatized could a 5 day old baby get especially if he was being well cared for?

williamftyler's picture

My female mother friends assure me that losing ones mother after a few days is very traumatic. My male cognative therapist friend assures me it is not. I think I will go with the mothers. Interesting how Moses mom was his wet nurse after he was given to Pharos daughter!

buddhaddy's picture

since the loss of the mother is the subject we are speaking of, how would a mother experience the trauma to her lost child?

wtompepper's picture

Ah, so you are uninterested in the truth--you will choose to believe whatever comforts you. This seems to be Epstein's approach, as well.

williamftyler's picture

Interviewing people with different opinions and then making an informed decision. Sounds reasonable to me and thanks for comparing me to Mark Epstein I take that as a compliment.

wtompepper's picture

Good question. I have another one: Isn't it a little silly to base one's entire interpretation of Buddhist enlightenment on a myth? Particularly on a myth that was the standard narrative of the lives of many spiritual leaders (including at least one of the Buddha's disciples), and was not actually applied to the Buddha himself until several hundred years after his death? Wouldn't this myth tell us more about the ideology of the culture in which it was told than about the actual teaching of the Buddha or about Buddhist thought?

buddhaddy's picture

And i thought that the buddha told us to base our perception of reality on what we learned from individual meditation and mindfulness of the moment, not on what we read or were told.

michaelstumpf's picture

What is the difference,the Buddha taught there's no separation,whether on the cushion or not it's Life,so why isn't possible to bring meditation/mindfulness to the people we read or interact with in the Moment-whatever that IS?

idaleung1's picture

The quote that Robert Thurman read, "i was like a wild child, long lost his mother..." Was especially powerful for me because my father died before I was 1. The resonane was deep. Wonderful interview, looking forward to the book and more in this series.

kcwd50's picture

Like Finder above, I have read Epstein's work (all of his books, and found it very rewarding) but had never heard him speak--really enjoyed the interview and hope Tricycle will do more of this sort of thing.
Agree with Zmnmd that psychotherapy, in its various guises, can benefit everyone, not just the "bourgeoisie". While not a therapist myself, I know individuals who make a real difference in the lives of the poor and marginalized; and, while not poor and marginalized myself, I've experienced great benefit from psychotherapy
.

12stepbuddhist's picture

I remember mentioning the cost of psychotherapy to Dr. Epstein when he visited our Zen Center several years ago to discuss his book at the time, Thoughts Without a Thinker. I've personally clocked over 11 years of steady psychotherapy as a Buddhist, and as a recovering addict. I find that psychotherapy is a very useful tool but that it's up to me to understand how it fits, and doesn't fit with my Buddhist and my recovery practice. One way that it's been helpful is to prevent me from "spiritual bypassing," that is skipping the hard work necessary to actually make progress as a meditator. A spiritual bypasser might say, "There's no progress to be made and no self to make the progress," but, as has been said, you have to be "someone" before you can be "no one." There are no shortcuts, or if there are, they've eluded me in over 30 years on the path. I know, there's no path.

bizen's picture

I found your comments very helpful. I am one who does psychotherapy and find it beneficial to be reminded of the self -work that needs to happen there. Apples to both the client and myself.

Briansilva02's picture

I enjoyed the talk. It would be helpful to know the length of a talk in minutes so I can make sure I start it when I have time to listen uninterrupted.

littlestbird's picture

39:48. I downloaded the mp3 using the link so I could add it to my media player.

James Shaheen's picture

This will soon be a podcast, as will all future Tricycle Talks, so you'll be able to know how long each talk is. We're almost there, just waiting for Apple to accept the series and post it!

Many thanks for you comment.

earthdancing's picture

Oh, please make the podcast available elsewhere besides just in Apple's system!!! There are more of us in the world who DON'T use Apple than do (and most of us do not want to be forced to install Apple software on our machines).
Thank you.

linlukpetersen's picture

A great talk from a great teacher. Thank you. It would be helpful for future talks to be able to go back and replay and also to know how long the talk is going to be.

James Shaheen's picture

See my comment above—you'll be able to go back and forth when the podcast is available!

Dominic Gomez's picture

Shakyamuni zeroed in on the 4 sufferings that all human beings undergo (not just GenX-ers who fret about missing busses): birth, aging, illness and death. A much larger perspective on the workings of life than those of us today can wrap our smallish minds around?

Jacinthe Connor's picture

Wonderful interview. Many thanks to all of you. I've very much appreciated Mark's works and would some day love to hear more about his thoughts regarding certain treatment modalities in considering the physiological/emotional connections in trauma and repercussions in adulthood: therapies such as EMDR or Somatic Experiencing. My albeit limited experience has led me to observe the usefulness of these adjuncts in helping one to "live with" indeed, easing the ability to "make room" for the experience and acceptance.
Much gratitude for the work Mark.

zumacraig's picture

You said it. Live with...live with destitute poverty? Live with unutterable suffering that has clear systemic causes, that could be addressed immediately if we took anatman seriously?

zumacraig's picture

To what end are these modalities successful? I could never do these therapies with a straight face and those that do are working very hard at deluding themselves and their clients. That was my experience as a county mental health worker.

The causes of poor folks' ills are so clear and immediate. However, these convoluted therapeutic systems, among other things, keep us from seeing them. Both client and therapist. My favorite part of it all was the pressure on our little staff that served 3 large counties to manage psychotic folks, cure addiction, prevent abuse, prevent suicide and end homelessness. Oh, and document it all numerous times over on computer and paper in measurable ways.

colacino's picture

Thank you for this interview. Transcript will be appreciated for foreigners like me :)

Joanna Piacenza's picture

Greetings!

So glad you enjoyed it. We'll work on a transcript for you.

Joanna Piacenza
Web Editor

colacino's picture

Very kindly!

Thank you for the transcript!

jackelope65's picture

Psychotherapy, acupuncture, buddhism, etc have become unaffordable to most people, despite their wonderful results. We must disassemble the greatest parts of our war machines making reasonable care accessible to most people.

wtompepper's picture

They haven't "become unaffordable," they always were unaffordable for most people. Psychotherapy and Buddhism have always functioned as an ideology of the ruling class, making them more satisfied with their lives of idle luxury--and these kinds of therapy and of Buddhism were always only for the elite. This is nothing new.

No need to worry, though. If you can't afford them, they wouldn't work for you anyway. It's hard to become a better adjusted more contented bourgeois if you're poor. The rest of us need to get over idolizing and idealizing these oppressive ideologies, yearning to be accepted into them, and just practice Buddhism without the expensive retreats and celebrity teachers. Read a book of serious Buddhist teachings with a group of friends you can trust, and don't bother with the smells-and-bells or the $200/hr rent-a-friend.

keith.haas's picture

Although I agree with some of these statements, I have to say I can't agree with the statement that "If you can't afford them, they wouldn't work for you anyway." As a clinical social worker serving some of the poorest and most marginalized, underserved individuals in our community, I can safely say that EMDR, Somatic work, as well as many other modes of psychotherapy have served these people very well. Certain forms of psychotherapy may be packaged/marketed in a way that seem "bourgeois", but that doesn't mean that, at their core, they can't benefit us all in some way, regardless of socioeconomic status.

wtompepper's picture

This is exactly the problem. What the poor get is pseudo-scientific nonsense like EMDR, and "Somatic work," meant to make them more content with their alienated lives. There's not much to say so someone who can take nonsense like EMDR seriously, but, unfortunately, in an age in which intelligence is seen as an impediment to being a good therapist, most new therapists tend to believe in such silly things, and don't have the education, interest, or intellect to understand the critiques of it published by the aging members of the profession. With all their talk of "empirically validated treatments," MSWs today don't have sufficient understanding of the scientific method or of statistics to comprehend that EMDR has never been "scientifically" tested, doesn't actually work even according to the poor tests it has been subjected to, and is just a form of hypnotic suggestion, which works only on the most "suggestible" of clients, who would be better served going to a faith healer or the local psychic, where they'd get the same results cheaper.

The kind of therapy someone like Epstein does is a different animal altogether, designed to make affluent but unhappy people stop thinking, and to produce a new kind of activity that can give them some self-indulgent enjoyment in life--so they don't have to think about things like the mass suffering of the poor that enables their affluence, or the inevitable dissatisfaction that comes from a live of idle oppression of others. They's be better off reading Hegel's on the master-slave dialectic, or just trying to grasp the truly constructed nature of their unhappy "selves" so they can work to change the social system--instead, they are invited to wallow in unexamined emotions, to take masochistic pleasure in the illusion that they are discovering their "true self." Just bread and circuses.

keith.haas's picture

If EMDR is not scientifically valid and empirically supported, then why is it advocated as a treatment of choice by the VA and Dept. of Defense, as well as the American Psychiatric Association? Are you saying that the many psychologists, LPCs and other mental health professionals in these institutions are also lacking in their understanding of the scientific method? I would concede that traditional psychoanalysis (multiple sessions a week) is impractical and not necessarily helpful to most people, especially those who are poor or marginalized, but your view of therapy is significantly limited to severe stereotypes if you think that therapy isn't able to help poor and marginalized people do better for themselves. Yes, psychotherapy is not going to directly impact the social determinents of health, i.e. poverty, racism, oppression and marginalization, but it does have the ability to help people become healthier individuals who are then able to go on and advocate for themselves and address those larger systemic issues. I can recount many instances in which an individual came to therapy struggling with the effects of trauma (some of which was related to poverty and minority status), only to successfully benefit from therapy and go on to effectively take part in the body politic. If you look beyond the stereotypes of psychoanalysis and snake oil therapy, you might find there are many of us out there doing therapy with a keen eye toward empowerment and social justice in the work that we do.

celticpassage's picture

I guess for similar reasons as to why nurses in certain states are stilled trained in therapeutic touch although it has no scientific validity.

wtompepper's picture

Why would the Dept. of Defense possibly advocate a treatment that is cheap, short-term, and gets them off the hook for dealing with all the veterans traumatized by combat experience? Hmm. I can't imagine. Why would the "scientists" they pay to prove this short-term inexpensive treatment works design poor studies, and then misrepresent the results? Couldn't happen. Certainly, the pentagon would never be involved in promoting capitalist ideology at the expense of civilian lives...or, wait...

Really, read the research. Read the explanations of the "mechanisms" by which EMDR is believed to work. Anyone stupid enough to buy these pathetic explanations would believe anything. They may even believe that they are helping the poor people they are oppressing, by using pseudo-scientific "therapy" to delude and confuse them and make them into obedient capitalist subjects.

MSW programs and clinical psychology programs today weed out anyone smart enough to see how absurd something like EMDR is, so that nobody will be left to question the institutionalized production of ignorance, delusion and suffering called psychotherapy.

Patricia.I's picture

Does a practice need a "scientific" explanation for it to work, or do YOU need such an explanation?

Have you ever tried EMDR, Tom?

wtompepper's picture

Nothing needs a scientific explanation in order for it to work. Many things work without our understanding why. That's not the issue. The point is that EMDR does not work. And there is ample scientific evidence that it does not. The bizarre "explanations" of why it supposedly should work only make it more ridiculous that so many people claim it is "empirically validated."

keith.haas's picture

To question the research is one thing, to say it doesn't work is another. You simply cannot make such a broad claim. It may not have worked for you, or for those you were trying to help ( it seems as though you did not believe in it when you tried, which would have a negative impact on it's effectiveness). The simple fact is it has helped countless people, whether or not the theoretical underpinnings are sound. If you have conducted a RCT, then I am open to hearing more. Otherwise, keep your claims to your own personal experience.

zumacraig's picture

As a former psychologist I will say that the research on EMDR is absolutely flawed. Any change shown as a result of it's use is almost statistically insignificant. With most of this research, including CBT, any immediate change (however defined) is can be correlated to basic empathic responses to the participant. In other words, listening to a person and acting like you care is what 'helps'. It is not, and has never been, the therapy flavor of the day whether it be RBT, CBT, EMDR, DBT...

Anecdotally, it's quite obvious that nothing has ever 'worked' when it comes to counseling/therapy. If it did, we'd actually see the success. The truth is that treatment, is just that, a band-aid, not a cure. The treatment for suicidal ideation is being locked in a building and talking about it until you say it's over. That's it. Nothing magical or amazing. The PhDs and MDs just want it to seem that way.

Same with meditation. It's not some magic 'getting in touch with the true self' or 'seeing things as they are'. It's relaxation response. Alas, TM and Tricycle, among others, have found a way to sell a basic human capacity. It's like selling us bottled water.

wtompepper's picture

Anyone who is interested could easily do this research. I have done it, spent months on it, and am sure of what I am saying. A comment board like this is not really a place to present such research, but it exists in the academic journals. And no, I would never use such cheap charlaton's tricks on people in need of help. If you have, the shame is yours.

I have no doubt there are many stories of success with EMDR. But there are even more stories of such success with faith healing and exorcism, and I wouldn't try those either. No doubt in fifty years, people will look back on EMDR with the same disbelieving horror we now consider lobotomy with. If only the practitioners making money doing it would live long enough to answer for their fraud, or be forced to admit their utter stupidity.

By the way, Keith, it. Is outright unethical for an MSW to insist that one must rely only on personal experience and ignore all research. Why don't you follow your own advice,and offer some published scientific evidence that EMDR has helped "countless people"? You merely assert it is true because you want it to be. Where's your proof? Mere anecdote? The proof of my claim canbe found with a psychinfo search,but social wokers can only point to what they heard at a training workshop.

I really do pity anyone subjected to a therapist stupid enough to believe in EMDR,or stupid enough to say that research proving something doesnot work doesn't justify saying it doesn't work.

keith.haas's picture

Honestly I'd be willing to carry on this conversation in another forum, but it has obviously outgrown this one. I would have no problem providing research showing the effectiveness of EMDR, and would welcome the opportunity to rebut every single statement in your last reply. You are clearly passionate about your position, and I am open to learning from it. Skepticism is healthy and necessary. It's just the vitriol and contempt that I don't understand. If you know of a more appropriate venue to carry on this discussion, please let me know.

wtompepper's picture

These arguments have been made in the professional journals. One cannot repeat them in a comment on a discussion board. A good place to start is Lohr, Olatunji and Devilly, "Threats to Evidence-Based Treatment of Trauma," International Review of Victimology, 2008. There are many others, and they are easy to find.

But there is no point in arguing with anyone who is stupid enough, or dishonest enough, to advocate EMDR. It is like argiong against a psychic or an astrologer. The response is always like yours, Keith, or like Patricia's: those who want reasoned argument and scientific evidence are evil oppressors, we know it works because of our deeper emotions and superior intuition. If it doesn't work, it is the fault of the client, who is blamed for being "resistant'" and skeptical. This is the same kind of argument psychics make. There is also money involved here--both the money being made by the EMDR therapists, and the money to be saved by the insurance companies and defense department if they can claim that waving your fingers in front of someone's face and reading from a script for 12 sessions can cure all ills. Arguments rarely win against profits, and those who control the money are keen to ensure that those in charge of licensing institutions and graduate training in psychology are either stupid, willing to say whatever they are told to get ahead, or both. The only hope is to educate the general public not to participate in this pathetic attempt to exploit their suffering for profit.

Reasoned argument always seems like anger to those attached to their illusions--but if you can't conceive of why somebody might get passionate about attempts to exploit the suffering of others, then you are probably just another self-serving con artist. A small group of intellectually limited con artists have a strangle-hold on therapy licensing institutions in the U.S., and have the ability to dictate what must be done to "help" the suffering, and to prevent any serious research into what might actually help people. This is a situation that people should get passionate about--you can be court ordered to undergo these kinds of therapy, and it is like being court-ordered to go to a faith healer. And anyone trying to do anything else can be prosecuted for not following the dictates of these licensing boards run by morons. So, yes, this is an issue that should evoke some passion--unfortunately, it rarely does.

earthdancing's picture

From your remarks here, you sound rather angry at the entire mental health profession. Your language is quite vitriolic; I am impressed by the calm responses given despite the provocative nature of your comments.

Patricia.I's picture

Keith, there is no argument here for you to "rebut", just a set of assumptions which, when questioned, are defended with name-calling.

mahakala's picture

"Tom Pepper" strikes again!

mpoliver's picture

Exactly, Siddhartha sat alone under a bodhi tree when he had his great awakening, he did not pay someone for retreat, he did not buy the latest book on Buddhist based psychotherapy, he just sat with his self there under a tree and vowed to not leave until he awakened, I believe we should do the same.

Good talk on the nature of dhukka in everyday modern life though, thank you.

zumacraig's picture

Please see my comments above in response to these naive responses to tpepper.

bardo's picture

Just ordered the book...THANKS!!!