INTRODUCTION
Ego is the one affliction we all have in common. Because of our understandable efforts to be bigger, better, smarter, stronger, richer, or more attractive, we are shadowed by a nagging sense of weariness and self-doubt. Our very efforts at self-improvement orient us in an unsustainable direction since we can never be certain whether we have achieved enough. We want our lives to be better but we are hamstrung in our approach. Disappointment is the inevitable consequence of endless ambition, and bitterness a common refrain when things do not work out. Dreams are a good window into this. They hurl us into situations in which we feel stuck, exposed, embarrassed, or humiliated, feelings we do our best to keep at bay during our waking hours. Our disturbing dreams are trying to tell us something, however. The ego is not an innocent bystander. While it claims to have our own best interests at heart, in its relentless pursuit of attention and power it undermines the very goals it sets out to achieve. The ego needs our help. If we want a more satisfying existence, we have to teach it to loosen its grip.
There are many things in life we can do nothing about—the circumstances of our childhoods; natural events in the outer world; the chaos and catastrophe of illness, accident, loss, and abuse—but there is one thing we can change. How we interact with our own egos is up to us. We get very little help with this in life. No one really teaches us how to be with ourselves in a constructive way. There is a lot of encouragement in our culture for developing a stronger sense of self. Self-love, self-esteem, self-confidence, and the ability to aggressively get one’s needs met are all goals that most people subscribe to. As important as these accomplishments may be, however, they are not enough to guarantee well-being. People with a strong sense of self still suffer. They may look like they have it all together, but they cannot relax without drinking or taking drugs. They cannot unwind, give affection, improvise, create, or sympathize with others if they are steadfastly focused only on themselves. Simply building up the ego leaves a person stranded. The most important events in our lives, from falling in love to giving birth to facing death, all require the ego to let go.
This is not something the ego knows how to do. If it had a mind of its own, it would not see this as its mission. But there is no reason for the untutored ego to hold sway over our lives, no reason for a permanently selfish agenda to be our bottom line. The very ego whose fears and attachments drive us is also capable of a profound and far-reaching development. We have the capacity, as conscious and self-reflecting individuals, to talk back to the ego. Instead of focusing solely on success in the external world, we can direct ourselves to the internal one. There is much self-esteem to be gained from learning how and when to surrender.
While our culture does not generally support the conscious de-escalation of the ego, there are silent advocates for it in our midst. Buddhist psychology and Western psychotherapy both hold out hope for a more flexible ego, one that does not pit the individual against everyone else in a futile attempt to gain total surety. These two traditions developed in completely different times and places and, until relatively recently, had nothing to do with each other. But the originators of each tradition—Siddhartha Gautama, the South Asian prince who renounced his luxurious lifestyle to seek an escape from the indignities of old age, illness, and death; and Sigmund Freud, the Viennese doctor whose interpretation of his own dreams set him on a path to illuminate the dark undercurrents of the human psyche—both identified the untrammeled ego as the limiting factor in our well-being. As different as these two individuals were, they came to a virtually identical conclusion. When we let the ego have free rein, we suffer. But when it learns to let go, we are free.
Neither Buddhism nor psychotherapy seeks to eradicate the ego. To do so would render us either helpless or psychotic. We need our egos to navigate the world, to regulate our instincts, to exercise our executive function, and to mediate the conflicting demands of self and other. The therapeutic practices of both Buddhism and psychotherapy are often used to build up the ego in just these ways. When someone is depressed or suffers from low self-esteem because he or she has been mistreated, for example, therapy must focus on repairing a battered ego. Similarly, many people have embraced the meditation practices of the East to help build up their self-confidence. Focus and concentration diminish stress and anxiety and help people adapt to challenging home and work environments. Meditation has found a place in hospitals, on Wall Street, in the armed forces, and in sports arenas, and much of its benefit lies in the ego strength it confers by giving people more control over their minds and bodies. The ego-enhancing aspects of both of these approaches are not to be minimized. But ego enhancement, by itself, can get us only so far.
Both Western psychotherapy and Buddhism seek to empower the observing “I” over the unbridled “me.” They aim to rebalance the ego, diminishing self-centeredness by encouraging self-reflection. They do this in different, although related, ways and with different, although related, visions. For Freud, free association and the analysis of dreams were the primary methods. By having his patients lie prone and stare into space while saying whatever came to mind, he shifted the usual equilibrium of the ego toward the subjective. Although few people lie on the couch anymore, this kind of self-reflection remains one of the most therapeutic aspects of psychotherapy. People learn to make room for themselves, to be with uncomfortable emotional experiences, in a more accepting way. They learn to make sense of their internal conflicts and unconscious motivations, to relax against the strain of the ego’s perfectionism.
Buddhism counsels something similar. Although its central premise is that suffering is an inextricable aspect of life, it is actually a cheerful religion. Its meditations are designed to teach people to watch their own minds without necessarily believing everything they think. Mindfulness, the ability to be with whatever is happening in a moment-to-moment way, helps one not be victimized by one’s most selfish impulses. Meditators are trained to not push away the unpleasant nor cling to the pleasant but to make room for whatever arises. Impulsive reactions, in the form of likes and dislikes, are given the same kind of attention as everything else, so that people learn to dwell more consistently in their observing awareness, just as one does in classic modes of therapy. This observing awareness is an impersonal part of the ego, unconditioned by one’s usual needs and expectations. Mindfulness pulls one away from the immature ego’s insistent self-concern, and in the process it enhances one’s equilibrium in the face of incessant change. This turns out to be enormously helpful in dealing with the many indignities life throws at us.
While the two approaches are very similar, the primary areas of concern turned out to be different. Freud became interested in the roiling instincts and passions that rise to the surface when the ego is put under observation. He saw himself as a conjuror of the unconscious, an illuminator of the dark undercurrents of human behavior. When not prompted, people reveal themselves, often to their own surprise, and what they discover, while not always pretty, gives them a deeper and richer appreciation of themselves. Out of the dark earth, after a night’s rain, flowers grow. Freud took delight in poking fun at the belief that we are masters in our own houses, comparing his discoveries to those of Copernicus, who insisted that the sun does not revolve around the earth, and Darwin, who claimed that man “bears in his bodily frame the indelible stamp of his lowly origin.” For Freud, the ego could evolve only by giving up its ambitions of mastery. The ego he encouraged was a humbled one, wider in scope but aware of its own limitations, not driven so much by instinctual cravings but able to use its energies creatively and for the benefit of others.
While maintaining a similar reliance on self-observation, Buddhism has a different focus. It seeks to give people a taste of pure awareness. Its meditation practices, like those of therapy, are built on the split between subject and object. But rather than finding uncovered instincts to be the most illuminating, Buddhism finds inspiration in the phenomenon of consciousness itself. Mindfulness holds up a mirror to all the activity of mind and body. This image of the mirror is central to Buddhist thought. A mirror reflects things without distortion. Our consciousness is like that mirror. It reflects things just as they are. In most people’s lives, this is taken for granted; no special attention is given to this mysterious occurrence. But mindfulness takes this knowing consciousness as its most compelling object. The bell is ringing. I hear it and on top of that I know that “I” am hearing it and, when mindful, I might even know that I know that I am hearing it. But once in a while in deep meditation, this whole thing collapses and all that is left is one’s mirrorlike knowing. No “I,” no “me,” just pure subjective awareness. The bell, the sound, that’s it! It is very hard to talk about, but when it happens the freedom from one’s usual identity comes as a relief. The contrast with one’s habitual ego-driven state is overwhelming, and much of the Buddhist tradition is designed to help consolidate the perspective of this “Great Perfect Mirror Wisdom” with one’s day-to-day personality.
But this perspective is notoriously difficult to integrate, the consolidation with the personality hard to achieve. Even the Buddha was said to have trouble. The legendary story of his life is illuminating in this regard. Born a prince, he grew up in a family that did everything it could to protect him from confronting old age, illness, and death. He married and had a son, but caught his first glimpses of an old person, a sick person, and a corpse at the age of twenty-nine while riding in the countryside beyond the palace walls. These images so unnerved him that he left his loving family to go on a spiritual quest in the wilds of the Indian subcontinent. After years of self-examination, meditation, and ascetic practices, he broke through his selfish preoccupations and saw how he was contributing to his own suffering. Awakening followed quickly thereafter.
Before his enlightenment, the Buddha did battle with a fearsome and wily god named Mara, who represented his ego. Mara tried to sway him from his path by appealing to his latent desires for sex and power. He flattered the Buddha and promised him that he could be a great ruler if he but abandoned his quest, sending his daughters to seduce him and his armies to engage and distract him. The Buddha never relented and achieved his breakthrough despite Mara’s valiant attempts to dissuade him. But even after the Buddha’s enlightenment, Mara remained a force to reckon with. He continued to whisper to the Buddha about all the fame and fortune he deserved, about the pointlessness of his personal sacrifice. The Buddha had to deal with his own ego even after his enlightenment. This is an aspect of Buddhist thought that dovetails nicely with psychotherapy. Relaxing the ego’s grip makes the experience of pure awareness possible, but the experience of pure awareness makes it clear what work still needs to be done on the ego. After the ecstasy, it is said, comes the laundry.
This is described very clearly in a famous Buddhist fable. An aged Chinese monk, despairing at never having reached enlightenment, asks permission to go to an isolated cave to make one final attempt at realization. Taking his robes, his begging bowl, and a few possessions, he heads out on foot into the mountains. On his way he meets an old man walking down; the man is carrying a huge bundle. Something about him suggests wisdom to the troubled monk. “Say, old man,” the monk says, “do you know anything of this enlightenment I seek?” The old man drops his bundle to the ground. Seeing this, the monk is instantly enlightened. “You mean it is that simple?” he asks. “Just let go and not grasp anything!” But then he has a moment of doubt. “So now what?” he asks. And the old man, smiling silently, picks up his bundle and walks off down the path toward town.
The message is clear. Awakening does not make the ego disappear; it changes one’s relationship to it. The balance of power shifts, but there is still work to do. Rather than being driven by selfish concerns, one finds it necessary to take personal responsibility for them. In Buddhism, this engagement with the ego is described as both the path to enlightenment and the path out of it. It is traditionally explained as an Eightfold Path: Right View, Right Motivation, Right Speech, Right Action, Right Livelihood, Right Effort, Right Mindfulness, and Right Concentration. To counter the persistent and insidious influence the ego has on us—called “self-grasping” in Buddhist thought—one has to be willing to work with it on all eight levels: before awakening and after.
The Eightfold Path was one of the Buddha’s original organizing principles. He spoke of it in the first teaching he ever gave and referred to it often thereafter. Buddhism has morphed and developed in the twenty-six hundred years since the Buddha taught in ancient India. It spread through India, moved to China, Southeast Asia, Indonesia, Tibet, Korea, and Japan, changing form and evolving many different schools of thought as it made its way through time and space. But the Eightfold Path has remained a constant. While Right Effort, Concentration, and Mindfulness refer primarily to meditation, the other branches do not. Right View and Right Motivation speak to the role of insight in countering the ego’s insistent demands, while Right Speech, Action, and Livelihood describe the importance of ethical restraint in thwarting the ego’s selfish impulses.
The eight branches of the Eightfold Path make up the chapters of this book. While they are as old as Buddhism itself, when informed by the sensibility of Western psychotherapy they become something more. A road map for spiritual and psychological growth, they are also a way of dealing with the intractable and corrosive problem of the ego. While no single therapeutic approach has a monopoly on truth, in a world increasingly dominated by the Western regard for individual ambition, the dangers of an unbridled ego need to be acknowledged. This is not the approach our culture generally takes, but it is something we can all use. To move our psychologies to a better place, we must look at the hold our egos have over us.
This kind of advice does not apply only in the West. While psychotherapy has never been a strong tradition in the East, this does not mean that people in Eastern cultures are not subject to all of the same conflicts and defenses as Westerners. There are certainly many people in Buddhist cultures who have used meditation to evade themselves, who have never really confronted the tenacity of the ego’s grip. I was told recently about one such person, a hermit who, after meditating in a cave in the mountains of Nepal, heard that the Dalai Lama would soon be passing through his remote area. The Dalai Lama, in the tradition of Tibetan Buddhism, is the most highly regarded spiritual figure in the culture. He is considered a pure expression of enlightened wisdom, and any chance to be in his compassionate presence, let alone to meet with him, is virtually irresistible to those who revere him. This hermit had mastered many of the classic meditations designed to quiet the mind and calm anxiety. Villagers brought him food to keep him healthy, but other than these rare encounters he had been alone for four years in deep states of meditation. He somehow arranged for a personal meeting with the Dalai Lama and emerged from his self-imposed retreat for the encounter. He asked the Dalai Lama for advice on what to do next.
The Dalai Lama, who fled his native Tibet in 1959 when the Chinese invaded, has spent much of his adult life in dialogue with the West. I visited his place of exile in the foothills of the Indian Himalayas in 1977 before I started medical school and returned for six weeks on a research grant before I graduated in 1981. I have had the opportunity to hear him teach on many occasions since. When he speaks about meditation, he often makes a distinction between practices that quiet the mind and those that utilize the mind’s intelligence for its development. Many people, in both the East and the West, believe that shutting down the ego, and the thinking mind, is the ultimate purpose of meditation. The Dalai Lama, rather forcefully, always argues that this is a grave misunderstanding. Ego is at once our biggest obstacle and our greatest hope. We can be at its mercy or we can learn to mold it according to certain guiding principles. Intelligence is a key ally in this shaping process, something to be harnessed in the service of one’s progress. The Dalai Lama’s advice to the hermit seemed to spring from this place.
“Get a life,” the Dalai Lama admonished him.
This monk, from a poor Nepalese village, was shaken by the exchange. It went against all his preconceived notions of what a monk should do. The Dalai Lama was not negating the value of the hermit’s meditations, but, like the old man in the Buddhist fable, he did not want his student to stop there. It was time to pick up his bundle and return to town rather than resting on the laurels of his spiritual attainments.
The hermit had a sister who had been taken in the sex trade. The Dalai Lama’s advice motivated him to emerge from his cave and begin providing education and health care for local village women. An acquaintance of mine helped to fund some of this work, and he was present when someone reminded the Dalai Lama of this pivotal exchange.
The Dalai Lama chuckled. “Oh, yes,” he said proudly. “I told him, ‘Get a life.’”
The Dalai Lama’s advice, while cryptic enough to fit with his role as a Buddhist master, comes from a place of age-old wisdom, as relevant in the West as it is in the East, as helpful today as it was in the time of the Buddha, as true for us as it was for the Nepalese monk.
We all have a life, but we are not always aware of how precious it is. And we all have an ego, but we do not always take enough responsibility for it. Our sufferings, or our doomed attempts to avoid them, all too often keep us mired in obsessive attachment, greed, worry, or despair. There are those, like the hermit in Nepal, who are attracted to spiritual pursuits because they seek a means of escape from life. They view enlightenment as a way out. But this attempt to leapfrog over the ego is counterproductive. There is no getting around it. If we wish to not perpetuate suffering, we have to take a hard look at ourselves. Making one’s life into a meditation is different from using meditation to escape from life.
This book is a how-to guide that refuses a quick fix. It is rooted in two traditions devoted to maximizing the human potential for living a better life—traditions that have only begun to speak to each other. Although the conversation is just starting, it is clear that Buddhism and Western psychotherapy have much in common. They each recognize that the key to overcoming suffering is the conscious acknowledgment of the ego’s nefarious ways. Without such consciousness, we remain pushed around by impulses and held in check by unrecognized defenses. But when we are able to see the extent of our own fears and desires, there is something in us, recognized by both Buddha and Freud, which is able to break free. Taking responsibility for what is going on inside of us gives hope.
I had the unusual—and I would say fortunate—experience of discovering Buddhism before I knew very much about anything else, certainly before studying Western psychology or deciding to go to medical school to be trained as a psychiatrist. Buddhism spoke to me personally from the start. The very first verse of the Buddha I ever read (in a college survey class in my freshman year) was about training the anxious mind. I felt an immediate attraction to it, as if the words were written just for me. Soon I found myself in the bowels of the university library digging out ancient Buddhist texts buried deep in the library’s stacks. Many of these books had not been checked out for years, but this made them seem all the more special to my eyes.
There was a map of the mind in those ancient texts that seemed relevant to me. This map charts a path whereby the mind can be developed, where qualities like kindness, generosity, humor, and empathy can grow out of a willingness to question one’s own instinctive attractions and aversions. The inner peace of a calm mind, the satisfaction of creative expression, the solace and joy of enduring relationships, the gratification of helping and teaching others, and the liberation of seeing past one’s own selfish concerns into other people’s welfare began to seem like realistic goals, goals that an engagement with Buddhism might make more achievable. I wrote an undergraduate thesis on this ancient Buddhist map that continues to inform my work to this day. I met my first meditation teachers before my twenty-first birthday and “sat” my first two-week silent retreat shortly thereafter. Although I struggled with meditation—for something so simple, it is remarkably difficult—it came alive for me in that first two-week course, and I have returned to these retreats dozens of times since. Every retreat has shown me something interesting about myself and reinforced my initial enthusiasm. Meditation is a real thing. If you do it, it actually has effects!
Like many people, I was drawn to Buddhism because of the promise of meditation. I wanted a way of quieting my thoughts, of accessing inner peace. And I was drawn to the possibility of bringing my mind to its full potential. I must have already known, even as a college student reading Buddhist verse for the first time, how easy it was to get in my own way.
This personal discovery of Buddhism was very important to me. It led me from meditation into a greater exploration of the Buddha’s teachings. I came to appreciate that meditation, while important, was not the be-all and end-all of the Buddhist path. The point of meditation was to bring its lessons to everyday life: to be able to live more fully in the moment, to stop undermining myself, to be less afraid of myself and others, to be less at the mercy of my impulses, and to give more generously in the midst of a busy and demanding day. In my years of work as a psychiatrist, I have come to see that these can also be goals of psychotherapy.
Until recently, I have avoided too much direct talk of Buddhism in my therapy. I have tried to bring it in less explicitly: in the way I listen, for example; in the way I ask my patients to approach their own shame and dread; and in my efforts to show people how they are perpetuating their own suffering. I make no secret of my Buddhist leanings and am happy to talk of them when asked, but I rarely have offered up meditation as a direct therapeutic prescription. I have watched as mindfulness has taken hold in the field of mental health as a therapeutic modality in its own right, but I have stayed on the sidelines, wary of what has always seemed to me to be people’s exaggerated expectations of this single aspect of Buddhist thought. I have preferred to work in the old-fashioned analytic mode, artificially blinding myself, as Freud liked to put it, in order to focus on the dark spot in front of me. There are much more inexpensive ways to learn about meditation than to pay a psychiatrist’s hourly fee, after all.
But what if I am wrong? This thought occurred to me in the middle of my own weeklong silent meditation retreat some years ago. What if I am depriving the people I care about of that which has given me so much help myself? In my efforts to avoid being too prescriptive, was I keeping my patients too much in the dark? What if I were to be more explicit about what I had learned from the dharma, as the Buddha’s teachings are called? What would I say? How could I talk to my patients, many of whom were not at all conversant in a Buddhist sensibility? The teachings of the Buddha had helped me enormously. Could I give advice about Buddhism without alienating the people I was trying to aid?
Much of the time, when I do offer advice, it is overtly welcomed but covertly rejected. People appreciate my attempt to help them, but they have many reasons not to do what I suggest. Paradoxically, this has freed me up a little. I worry less about it now because I know that people will not listen if they do not want to. But still, I am aware of how alienating it can be to come across as any kind of an “expert.” A patient of mine, sober now for twenty years, told me something recently that confirmed my cautious approach. When he’d first come to see me, he said, back when he was still drinking and using drugs, I’d suggested only once that he go to AA. It was very meaningful for him that I said it only once.
“You let me find it on my own,” he told me, and this made it all the more consequential for him.
As my patient implied, the desire to help all too often has untoward consequences. If I had been too insistent on his sobriety, my patient might well have kept on using just to frustrate me.
I have not always been so on point, however. I was recently reminded of another event from the early days of my practice, one in which I offered advice but came across as way too much of an authority. I learned from this experience to be very careful with even well-meaning advice. It can boomerang if the therapeutic relationship is not well established. A young man came to me after his own two-week silent meditation retreat. Rather than becoming calm and peaceful on the retreat, however, his mind had become anxious and unglued. He was extremely intelligent but his thinking showed faint traces of what psychiatrists call “thought disorder,” signs of an incipient process not necessarily visible to a layperson. I met this young man for a single session, in consultation, because his parents trusted me, as someone knowledgeable about Buddhism, to help their son. As well intentioned as I might have been, I was abrupt in my response to him. I was tired at the end of my day and spoke more impulsively, because of my fatigue, than I should have, or would have ordinarily, I hope.
“You might have an underlying bipolar illness,” I told him, “surfacing under the spell of the retreat. It would be good to treat this right away rather than let it impact your whole life.”
I remember pulling literature about manic-depressive illness off my shelf and showing it to him, explaining that if you had to have one psychiatric illness, this was the one to have because there were such good treatments for it and it did not have to wreck your life.
“Lots of very accomplished creative people have it,” I told him reassuringly.
The evidence to support my intervention was slim—this man functioned well enough in his regular life and had come apart only in the silence and sensory deprivation of the retreat—but this did not stop me. My advice did not go over well. He was offended, and he left. The next day his mother called me, and she was furious.
“How can you make that diagnosis based on one visit?” she lambasted me.
She was right. I apologized but never heard from them again.
Twenty years later, I ran into this patient’s mother at a party. She came over to me and reminded me—unnecessarily—of what had happened all those years ago.
“You have children now, right?” she asked me. “You know how devastating it can be to hear that anything is wrong with them? I was mad at you for a long time.”
I knew exactly what she was saying. I apologized again and asked how her son was.
“Well,” she said, “I told him I was going to see you tonight. ‘He could have been right, Mom,’ he told me. He’s had more trouble on those retreats since then, but he’s starting to come to terms with it now.”
Might I have been able to help this person if I had come across as less of an expert all those years ago? Even if I was right (and I was secretly glad to know that I had not been completely off base), being right is not the point in this profession. Being useful is. I do not want any advice I am offering to be as counterproductive as this session had turned out to be!
This book is my attempt to be useful. Its advice can be used by anyone—each in his or her own way. As the Buddha made clear in his own advice on the matter, the Eightfold Path is there to be cultivated. Just as no artist makes work identical to any other, no person’s development will look or feel the same as anyone else’s. We are all coming from different places and we all have our own individual work to do, but it is safe to say that a willingness to engage with the principles of the Eightfold Path will, at the very least, give wise counsel in a confusing world. As hesitant as I have been to offer meditation as the solution to anyone’s problems, rethinking the Eightfold Path has allowed a Buddhist perspective to merge with my psychotherapeutic one. The bottom line is this: The ego needs all the help it can get. We can all benefit from getting over ourselves.