I first stumbled upon Mark Epstein’s book Going to Pieces Without Falling Apart: A Buddhist Perspective on Wholeness a few years ago. It was the subtitle that caught my attention: “Lessons from Psychotherapy and Meditation.” By the time I discovered it, both of those practices had undergone an explosive cultural renaissance (he was only missing the ayahuasca)—but, curiously, the book had been published in 1999. Epstein, a Harvard-trained psychiatrist and longtime Buddhist practitioner, seemed to have presciently intuited the coming zeitgeist. (As if to prove just how presciently, the book would pop up in an episode of HBO’s Girls.)
But even today, therapy and meditation strikes me as incongruous combination: if the former takes you deeper inside yourself, trying to understand the origins of egoic tendencies and habits, the latter encourages you to set the self aside, to forgo understanding for simple awareness. I made my way through the book, scribbling down its koan-like insights—“The thinking mind remembers itself constantly, not wanting to be forgotten”; “Our own endless and repetitive thoughts squeeze the life out of life, guarding against the loss of self that we fear”—as Epstein made his case for why the two modalities work as complements. As he sees it, if therapy is a key step in understanding and taking responsibility for one’s personal experience, meditation is an equally important process of disidentifying from those experiences, to keep from clinging too tightly to limiting stories of who we think we are (and can still be).
This has been the unifying theme across Epstein’s work. His eighth book on this intersection, The Zen of Therapy: Uncovering a Hidden Kindness in Life, is out this week and acts as a therapist’s diary of sorts. Over the course of a year, Epstein made notes on how his deep understanding of Buddhism and mindfulness informs the psychodynamic process unfolding between him and his patients. What emerges is a compelling portrait of how these two independently therapeutic practices become all the more powerful when joined together. Though the book’s patient sessions end in December of 2019, reading it towards the end of 2021 had me wondering how Epstein’s lessons might help the rest of us cope with all of the turbulence of the two years since.
GQ: All of the sessions in the book take place before Covid-19. How have you seen this interplay of Buddhism and therapy helping people during the traumatic experience of covid?
Mark Epstein: Trauma is not unique to Covid. Covid is just more trauma—it’s a universal trauma, happening to everybody at the same time. That's very unusual. Where Buddhism helps the most [right now] is being able to help people grieve in an unscripted way, not how they thought they should grieve, but how they're actually grieving—like, not being able to go out and see their friends or not being able to have their life returned to them after the vaccines promised them that they were going to be able to go back to the movie theater, being able to roll with the unpredictable nature of things.
What are some ways in which you would counsel people to deal with the unscripted grief?
Well, that's what meditation is practice for. If you take on a meditation practice, where you're just trying to sit with your own mind for 20 or 30 minutes or, or however long, you can see how impossible it is to control anything within your own mind. [laughs] We control so much of our lives and it's a blessing that we're able to control as much as we can. But what meditation does show you is there still an element that is always going to be out of our control. We can resist that, or we can learn how to roll with that. In learning how to roll with it, we are practicing dealing with stuff like Covid, where you really don't know what's going to happen in the next moment. You really don't know what's going to happen tomorrow. You really don't know what twists and turns your mind, your life, and the world is going to take. You have to be able to work with it as it unfolds, and that's what meditation is teaching you. Meditation is training in dealing with uncertainty.
You’ve written that “we are all broken by experience” and that “trauma is an ineradicable aspect of life. We're human as a result of it, not in spite of it.” How do we distinguish between things that are traumatic and things that are just the complications of being alive?
I don't think you have to distinguish between them. When I wrote the book The Trauma of Everyday Life, that's a lot of what I was trying to say. In the trauma world, they make a differentiation between the Big-T Traumas—fires, war, earthquakes, terrorism, death—and then the little-t traumas, that happen when we're growing up: the traumas of our parents either being too interfering or too abandoning, or even the the traumas of things breaking, people getting sick, or of minor losses. I don't think the emotional body differentiates. I think they all feel like trauma.
The natural inclination is to defend ourselves against the feelings, to dissociate from the emotional impact, to wall the traumatized feelings off, to shut them away. The only problem is that it doesn't work that well, because the feelings don't go away, they stay lurking. We know that from post-traumatic stress. You see that in incest and child abuse. Walling the painful emotions away, they don't go away, they’re lying in wait to rise up and make trouble. In our most intimate relationships, they tend to show themselves, they get in the way.
So I think it's helpful to train oneself to face the uncomfortable disassociated feelings, in order to metabolize and digest them, to rob them of their power over us. Again, that’s one of meditation’s great powers and one of the things that's therapeutic about it. It lowers us into our traumatized selves slowly, so that we learn how to be with ourselves in a complete way.
This is such a thorny subject, so I want to be careful how I tread, but to ask a rather flippant question: are there some traumas that just don’t need to be worked through?
I think there are many, many, many, many smaller traumas that will never get worked through. Whether they should be or they shouldn't be, they won't. So therefore I don't think that they have to be. But it might be surprising, which ones come up and therefore, do have to be. I've gone on a number of one-week, two-week, 10-day silent mindfulness retreats. And it's very surprising what comes up, what you feel bad about. For as many of the traumas that don't have to be dealt with, I think you have to be open to the ones that just show themselves randomly.
The beauty of meditation and therapy is that they are unscripted. So you really never know what's going to come up for someone when they come into the therapist’s office. If they really are free associating, if they put the agenda down from what they think they should be talking about, and just let themselves follow their own minds, all these little traumas—if you want to call them that—all these little stuck places, all these little scars from experience, can be talked about and, in some way, resolved so that the mind becomes clear. The mind wants to be free, and the heart wants to be open. Therapy and meditation are both there to try to serve that function. Meditation and therapy, when it works in this way, let you not take yourself so seriously.
I ended the book with a quote from the psychoanalyst Michael Eigen talking about how the point of therapy is to become partners with the capacities that constitute us. I think that's the other way of looking at it. We stop taking ourselves so seriously, but we actually inhabit ourselves more fully. We become partners with the capacities that constitute us. Hopefully, after all this meditation and therapy, I'm more me—but I’m taking myself less seriously. Bringing those two concepts together, that's that's what I'm trying to do.
You write we have “violent nostalgia for things that went wrong in our childhood.” Why do we cling to or feel nostalgic for the things that went wrong?
That’s from this other psychoanalyst Adam Phillips. He’s talking about how the idea of “violent nostalgia for what went wrong” is often directed at the mother. He's really hitting where our culture has gone with all of that stuff. Because of the psychoanalytic influence, we're trained to think that what happened to us in our early years has formed us completely, and that any pain that we have, any anxiety that we have, any sense of emptiness, or low self-esteem, is because we must not have been held or handled or acknowledged or seen enough when we were children. Way too much is put on, what did the mother do wrong? Those of us who are drawn to therapy are all hoping that by uncovering that thing that went wrong that we will somehow be healed. That’s asking way too much of psychotherapy, and it’s using the theory way too much to blame the parents—the mother usually.
One of the things that I'm trying to say in in drawing from the Buddhist side, is that no matter how good our upbringing is, no matter how good enough our mothers are, no matter how satisfactory our early development, it's still really hard to be a person all alone in the world, with an ego that's trying to get control of so many things that can't be controlled. It's very uncomfortable, even when I got everything, enough money, enough love, no illness. We all still think, instinctively, that we have to be completely self-sufficient and all okay, in ourselves. It's not all on our early experience. It's part of being a human being that we suffer this way. The Buddha was hip to that and tried to give us an outline of what to do about that. You can take that on and train your mind. There's a freedom working within that wants to assert itself, if you give it a chance. You have to learn how to get out of the way and let it emerge within you.
I want to ask you about the proliferation of mindfulness. In this book, you write, “meditation threatens to become cosmic dermatology rather than ongoing self-examination that is its own kind of higher education.” Can you draw out the distinction between those two ways of practicing?
I'm worried because meditation, and mindfulness in particular, has made such a difference in my life, but so many promises are being made as it's become more and more commercialized. It can never live up to all that's being asked of it. The American consumer who's suffering wants a quick fix, something that will work like Ambien works. You take it and forty-five minutes later, you're asleep. People are looking to meditation and mindfulness, like, why isn't it bringing down my blood pressure? Why don't I feel relieved of my eating disorder, or relieved of my anxiety? It can’t work for everything.
It's a refuge that you can turn to throughout your life, at different times for different reasons, and it helps a little bit. It's a supportive thing that can actually help give a meaning and structure to a life. You can have an immediate breakthrough, and it can show you something right away. When that happens, that’s great, it’s such a gift. But then people think that they're all fixed, and then it's a big disappointment when they find out that they're not. Then people just get frustrated too soon, rather than actually slogging through the day-to-day aspect of what an untrained mind feels like. When I was 18, I was reading a passage from the Dhammapada, this collection of Buddhist verses, that says, “The untrained mind is like a fish thrown on dry ground, flapping all day.” My mind still feels that way often when I'm meditating.
This whole quick-fix mentality makes me think about a patient you discuss in your book. You write that you want her to be willing to suffer, in the sense of her having an ability to hold her uncomfortable feelings. I think a lot of people feel like we've maybe over pathologized suffering and mandated happiness, to the extent where we can no longer handle uncomfortable feelings. Do you feel like that’s a valid read on where we are now?
I like how you’re framing it. I might say that we've gotten disdainful of suffering. The Buddha's first noble truth is that there's always something uncomfortable, even if you're living a charmed life. Inevitably, the specter of old age, illness, loss, death, it's part of reality. The big Buddhist teaching—but it lines up with a psychodynamic understanding—is the wisdom of no escape. There's always something that's going to be hard to face, but we do better if we train ourselves to be with it, rather than walling ourselves off from it. That's the whole thing.
I was trying to get at in the section on aggression: love and hate—or even kindness and anger—are actually connected. If we're pretending to be someone who doesn't get angry, then we're living a superficial life. Who doesn't get angry? Then we're being run by the false self instead of being real with ourselves. In doing that, dissociating ourselves from the uncomfortable aspects of our emotional experience, we're also limiting our ability to love. I think that’s the whole point of both psychotherapy and meditation: to encourage our loving nature.
Can you draw that out? What’s the connection between anger and love?
For a young child or an infant, anger and desire, anger and need, anger and appetite, frustration and love, they’re not differentiated yet. An infant who needs his or her mother or father, is just like a ball of energy that’s attacking. They're not seeing their parents as a separate being, they just want the breast or the bottle, the comfort, the help.
At first, the parent tries to be there totally for the child, but at a certain point—after a year of this or whatever—the parent has to start to disappoint the child a little bit. They make them wait. It’s a process of gradually disappointing the child in a tolerable way, so that the child has some kind of frustration, but the frustration doesn't become overwhelming. They're not left alone for too long, where they just get despairing. But they start to learn how to comfort themselves. They start to see that the parent is a person in their own right, who they can be mad at, but then the parent still comes through for them. That’s the critical thing. There’s a little bit of anger, like, Oh, really? I have to wait here to be fed? But then, I guess that's because you have another child or you have a husband or a wife. It’s a feeling of regard—the psychoanalyst D.W. Winnicott calls it “concern”—for the other grows out of one's anger being held or handled in a good enough way, so that it doesn't come overwhelming, but instead evolves into empathy.
That’s sort of the point of the last quarter of the book that therapy is doing that for people. It’s holding the anger of the aggression that everyone has: why isn't the world responding to me the way I need it to? Therapy is holding that in a way that that a parent has to hold it for a baby. Therapy is holding that for a grown up, so that they start to develop some kind of compassion or kindness—that's the subtitle of the book. Kindness for the uncertainty, for the traumatic underpinnings that we're all subject to.
This interview has been edited and condensed.
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