Who We Really Are: Buddhist Approaches to Psychotherapy*

Kenneth Porter**

See www.desmoinesmeditation.org & Click above on “More from this Publisher”

In the last 30 years Buddhism has increasingly influenced a new generation of

American psychotherapists. The basic Buddhist concepts of Buddha nature, the
dharma, attachment and meditation have opened up new ways of thinking about
the self, psychopathology, therapeutic process, the goal of therapy, the affective
focus of therapy, the super-ego and therapeutic technique. Using a Buddhist
approach to group therapy we can maintain adherence to the traditional
principles of group therapeutic leadership technique, while exploring the
possibilities for changing group structure through meditation, increasing insight
and empathy in both leader and group members, and deepening access to
repressed material. This approach does not create “a new form of therapy or
group therapy,” but rather might enable us to do better what it is that we already
know how to do.

It is interesting that the history of Buddhism in America, and the history of

psychoanalysis, begin at almost the same moment. Although Thoreau in the
1840’s, and the spiritual movement of the Theosophists and certain Boston
scholars after the 1870’s, had all been interested in Buddhism, its entrance into
the United States is often dated from the arrival of the Zen teacher Soyen Shaku
in 1905 – only four years before Freud’s famous Clark University lectures of
1909. Since then both movements have permeated American society.

But it was in the 1950’s that Buddhism began to enter the American mainstream.
The writers Jack Kerouac, Gary Snyder and Allen Ginsberg embraced Zen
Buddhism with a fervor. With his easy and brilliant writing style, the transplanted
Englishman Alan Watts began to make Buddhism accessible to a wider
audience. And at Columbia University the esteemed (and aged – he was then in
his late 80’s) Zen scholar D.T. Suzuki began to teach the famous seminar that
introduced Buddhism to psychoanalysis. Attended by Erich Fromm and Karen
Horney (as well as the musician John Cage and others), this class led to the
seminal 1957 Cuernavaca conference on Zen Buddhism and Psychoanalysis
and to the book of the same name. This was the first attempt to bring these two
powerful movements together in a scholarly fashion (Suzuki, Fromm and De
Martino, 1960).

In the 60’s and 70’s Buddhism grew in popularity. Starting in 1959 another Zen
master named Suzuki (Shunryu Suzuki Roshi) began to teach in San Francisco,
and his collected dharma talks, later published under the title Zen Mind,
Beginner’s Mind, (Suzuki, 1972) became a classic. In the 70’s two Tibetan
Buddhism teachers, Chogyam Trungpa Rinpoche and Tarthang Tulku, also
began to teach in the United States, and three young Americans, Joseph

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Goldstein, Jack Kornfield and Sharon Salzberg brought back from Asia the form
of Buddhism called Insight Meditation and founded the Insight Meditation Society
in Massachusetts. Starting in the 1980’s came pioneering work in the integration
of Buddhism and psychotherapy – especially the books of Diane Shainberg
(Shainberg, 1983, 1993, 2000), John Welwood (1983, 2000), and Mark Epstein
(Epstein, 1995, 1998, 2001), among many others.

It has often been noted that among many spiritual traditions Buddhism seems to
hold a particular appeal for psychotherapists. This has been attributed to two
causes. First, compared to the other great spiritual traditions, Buddhism contains
a particularly sophisticated understanding of human psychology (the Buddha
having jokingly been referred to as the world’s first cognitive psychotherapist).
Second, the powerful emphasis on love and compassion that permeates all of
Buddhist teaching is sometimes contrasted with what is said to be the harshness
of the Jewish conception of divinity, and with the Christian emphasis on original
sin and guilt, and is said to be in harmony with psychotherapeutic concepts of
healing.

Basic Concepts of Buddhism

For the purposes of this paper we will focus on four basic concepts of Buddhism:
Buddha nature, the dharma, attachment, and meditation.

1. The Nature of the Self and Buddha Nature. The most fundamental idea in
Buddhism is that all human beings are, at their core, healthy, wise and loving –
brilliantly sane, as one Buddhist teacher put it. This is referred to as Buddha
nature. At the same time, Buddhism famously teaches that “there is no self.” By
this Buddhism does not mean to deny the obvious fact that we all experience
ourselves as having a continuous identity, and that this concept is useful in living
our daily lives. The idea is rather that this everyday idea of identity is not the
deepest, most real experience that we can have of ourselves. We might say that
our identity, as we usually experience it, is composed of a set of mental
constructs, self-representations or self-images, which are actually simply ideas.
Buddhism teaches that on a deep level we may sometimes experience ourselves
in such a way as to reveal this ordinary concept of the self to be not completely
real. Instead, we could experience ourselves as deeply aware, peaceful, wise,
and caring, as not a static object but a process, as interdependent with others –
“inter-being,” as one teacher put it – rather than as independent of others.

Putting these ideas together, we might say that there are fundamentally two
different ways to experience the self – somewhat analogous to, although not
identical with, Winnicott’s well-known concept of the true self and false self. In
one mode, which we could call the social self or the false self, we experience
ourselves as a static set of self-representations, independent of others, in which
deficiency and psychodynamic conflict reside. In the other mode – Buddha
nature – we may experience ourselves as a fundamentally healthy, loving, wise

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interdependent process. It is an interesting and crucial fact, for most of us, that
the capacity to experience ourselves in the mode of our Buddha nature may be a
capacity that is even more deeply repressed than the thoughts, feelings and
impulses of what we normally think of as the unconscious.

2. The Journey of our Lives – the Dharma. The word dharma has many
meanings in Buddhism, but the most fundamental of these is that the universe
and our lives are characterized by order, and that we can live our lives with the
most happiness if we align ourselves with this order. A corollary is that the most
useful way to approach any situation in our lives, especially a difficult one, is not
to consider it as a problem to be solved, but rather to see it as an opportunity to
learn something new about this order and about how to align with it.

3. The Cause of Unhappiness: Attachment. Buddhism teaches that our

unhappiness in life springs from our not understanding how to be happy. In order
to be happy we focus on achieving goals that are basically unstable, such as
wealth, power, beauty, health, prestige, pleasure, or the enhancement of certain
self-images. Buddhism refers to the need for these goals as “attachment.” The
idea here is not that it is wrong or immature to pursue such goals – they are
obviously of value – but that it is a mistake to make them our primary focus, to
base our happiness on them. (Because for us as therapists, educated by object
relations theorists, the word “attachment” has another meaning; it is sometimes
clearer to refer to “attachment” in everyday language as “expectation” or “need”
or “mental addiction.”) Instead of focusing on attachments or addictions for our
happiness, however, we might make our primary focus a more satisfying and
stable goal – for instance, developing the capacity to experience our Buddha
nature through fully feeling and accepting what we are experiencing at each
moment of our lives.

4. Meditation: A Technology for Happiness - Re-training the Psyche. In his

famous initial teaching the Buddha suggested eight different techniques which
could lead to a well-lived life (“the eight-fold path.”) For our purposes the most
relevant of these might be meditation. The most basic form of Buddhist
meditation, mindfulness meditation, is done by focusing our attention on our
breathing, and gently bringing our attention back to our breathing when our
attention wanders.

The theory of meditation is as follows. The potential exists in all of us for our
consciousness to be in contact with the deepest level of who we are. What
interferes are the habits of our brain, our habits of thinking and feeling which tend
to focus our attention on our attachments, our addictions. Meditation is simply a
matter of re-training our brains to focus away from these attachments – the
places to which our minds wander during meditation – to leave the brain free to
contact something deeper and more satisfying. Focusing on our breathing is a
technique to pull our minds away from our mental addictions.

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 Principles of Buddhist Psychotherapy

In the application of Buddhism to psychotherapy we need to be aware of a

number of caveats. First, for the purposes of this article, I am simplifying
Buddhism to a considerable degree. Second, like all the world’s great spiritual
traditions, Buddhism is not monolithic. Just as there are many traditions within
each of Christianity, Judaism, and Islam, for example, so too there are at least
five major traditions within Buddhism that are currently practiced in the United
States. These are Insight (Vipassana) Meditation, Zen Buddhism, Tibetan
Buddhism, Pure Land Buddhism, and Nichiren (Soka Gakkai) Buddhism.
However, within this diversity there is a core of shared beliefs that can allow us to
speak of a common Buddhist approach to psychotherapy.

Third and most crucial, an approach to therapy informed by Buddhist principles

does not constitute a radically new form of therapy. A conscious fly on the wall in
the office of a therapist who might think of herself as Buddhist might not, most of
the time, observe very much that seems different from traditional psychotherapy.
At times different techniques might be introduced, it is true, and a Buddhist
understanding might be translated into different ways of intervening. But the
main difference would probably be in how the therapist is understanding and
experiencing what is transpiring in the session. A Buddhist approach to therapy
will not necessarily yield “a new form of therapy.”

The primary effect of Buddhism on the practice of group therapy is in the way
Buddhist practice changes the consciousness of the therapist. In my experience
this is in the direction of a greater capacity on the part of therapists to be fully
present in the here-and-now with the patient, to be compassionate, and to be
flexible and creative with their responses – in other words, to do more effectively
what we already know how to do.

This effect of Buddhist practice on the consciousness of the therapist is

illustrated in the recent book Psychoanalysis and Buddhism (Safran, 2003). In
this compilation of articles and dialogues a number of senior psychoanalysts with
decades of experience with Buddhist practice explore in detail the ways in which
their years of Buddhist meditation has refined their capacity to be present with
their patients with greater delicacy, creativity, caring and presence. This idea –
that Buddhist practice can help us as psychotherapists do more effectively what
we already know how to do – extends also to a cognitive understanding of what
we might call certain basic Buddhist principles of psychotherapy. A rough outline
of these different principles of therapy is presented below.

1 .The Self. According to Buddhist thinking, there is fundamentally no

pathology in human beings. What we refer to as psychopathology certainly does
exist, of course, as part of the organization of the social self. But this is a
consequence of our consciousness being cut off from contact with who we truly
are on a deeper level. When we are in fact in the mode of the true self we may

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experience ourselves as without pathology. These are the experiences we may
have while looking at a beautiful sunset, or listening to music, or being engaged
in artistic creativity, or making love, or being engaged in a particularly meaningful
therapy session, or participating in a special moment of athletics. These
experiences, which have been referred to a “flow,” (Csikszentmihayli, 1990), or
are spoken of by world-class athletes as “being in the zone,” are characterized by
feelings of utter calm, of effortless spontaneity, of a sense of oneness with the
world, and a sense of beauty and rightness.

Such experiences of Buddha nature, in a Buddhist conception of psychotherapy,

are considered to be the birthright of all humans. We might think of it in this way -
that our experience is like a kaleidoscope. Whether we are experiencing
ourselves as the social self or as the true self, the same components of our
psyches are present. But in the two states the organization of the psyche is
radically different. It could be the aim of psychotherapy to teach us how to spin
our internal kaleidoscopes in such a way that we have increased access to our
Buddha nature.

2. Psychopathology. In the Buddhist view what is usually considered to be

psychopathology is not thought to be caused by the usual suspects – intra-
psychic conflict (in the structural or ego-psychological models of the psyche),
deficient self and self-object experience (in the self-psychological model), or
pathological internalized object relations (in the object relations model). Rather,
psychological dysfunction is considered to be a result of lack of contact with
Buddha nature. In line with the Buddhist conception of dharma, psychopathology
is in fact not considered to be “pathology” at all, but rather “path,” a distinction
first made, to the best of my knowledge, by John Welwood (Welwood, 1986).
That is, symptoms and dysfunction are not fundamentally considered to be
problems, but rather to be opportunities to learn on the journey of life. To quote
the dolphin researcher and neuroscientist John Lilly, “in life there are no
mistakes, only experiments.”

3. Therapeutic Process. We may best approach the Buddhist

understanding of therapeutic process by contrasting it with the models of
therapeutic process that characterize traditional models of psychotherapy. In
traditional terms, healing occurs either through making the unconscious
conscious, or through the provision of an appropriately empathic self-object
response, or through the correction of dysfunctional relational patterns. In
Buddhist therapy, on the other hand, healing occurs through opening a channel
between the conscious mind and the deepest level of who we are.

4. The Goal of Therapy. Traditionally the goal of therapy is considered to

be satisfying relationships and productive work. In a Buddhist approach to
therapy we might add the capacity to be and to play. “Play” is used here in the
highest sense of the word, as used by the historian Huizinga in his classic Homo
Ludens (Huizinga, 1950) or by Winnicott (Playing and Reality, 1989). The idea is

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similar to that expressed by the German playwright Friedrich Schiller when he
wrote, “ we only play when in the full meaning of the word we are human, and we
are only completely human when we play.”

5. The Affective Focus of Therapy. In Buddhist therapy there is an overt

focus on cultivating certain positive emotions – for example, compassion,
empathy and forgiveness. This is not done to the exclusion of bringing
unconscious feelings of lust, hurt, grief, anger and hatred into consciousness, but
as an additional deliberate focus. It follows the meditative principle of re-training
the brain so it is more able to contact the deeper level of who we are.

6. The Role of the Super-ego. A Buddhist point of view would be open to

the possibility that the super-ego might ultimately be an antiquated internal
structure. This is not to deny the crucial importance of morality in life, which is
heavily emphasized in Buddhism. (In fact traditional Buddhist practice begins
with an emphasis on ethics rather than meditation.) The idea rather is that the
deepest source of morality might lie not in a psychic structure derived from
internalized parental object representations, but rather in a profound sense of
being in touch with our essence, which might automatically include a sense of
deep caring and respect for others.

According to this approach the super-ego could be viewed as a structure that can
be outlived rather than modified and softened. Of course it could be argued that
what a Buddhist considers to be morality derived from Buddha nature is really
just another way of talking about an unconscious mature super-ego, but from the
Buddhist point of view even a mature super-ego could be considered simply a
mental object, and therefore a potential interference with contact with what could
be an even stronger source of morality.

General Principles of Technique in a Buddhist Approach to Therapy

1. The Practice of Psychotherapy as a Maturational Path for the Therapist.

One of the great secrets of our profession, which we all know but do not talk
much about, is that the quality of our clinical work depends heavily on the
quality of our own personal maturity. So the first principle of Buddhist therapeutic
technique has to be for us to do our own inner maturational work, in whatever
way seems right to us. Ultimately this takes precedence over all else.

2. Presence. Next it must be said that talking about a Buddhist, or for that
matter, any spiritual technique for psychotherapy is to immediately engage in a
massive paradox. For the essence of a Buddhist approach to technique is that
there is no technique at all. That is, in a Buddhist approach to therapy, the
essence of the technique of doing therapy is not to try to “do” anything at all –
that is, not to try to “fix” the patient or “make something better.”

Rather the idea is to “be” with the patient or the group, to be present, without

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trying to fix anyone or anything. This is essentially what the existential analysts
meant by “presence,” what Sullivan meant by “the syntactic mode,” what the
Jewish mystic Buber meant by “an I-Thou relationship,” and what Bion meant by
jettisoning “memory, understanding and desire.” In other words, the technique is
simply to be fully present with the patient or group, which means allowing oneself
as a therapist to fully experience and accept the patient’s and one’s own
experience without the need to do anything. Or as the psychologist and spiritual
teacher Ram Dass (Richard Alpert) said when talking of his own approach to
doing psychotherapy, “the gift you offer another person is just your being.”

3. Cultivating Communion and Catalyzing the Patient’s Contact with her

True Self. In spite of all this, we might still want to know something more about
technique than the simple admonition to be mature and present. What actually is
supposed to happen, we might ask. From a Buddhist perspective we might think
of it this way. The ultimate healing for our patients consists in our helping them to
spin their internal kaleidoscopes, to shift from a false self to a true self mode, to
contact the essence of who they really are, to contact their Buddha nature. The
psychotherapist who is in contact with her own true self, her own Buddha nature,
establishes a sense of authentic contact with her patient, establishes an I-Thou
relationship or what we might call a sense of communion. She then is operating
in a sense as a midwife, and can catalyze her patient’s capacity to contact her
own Buddha nature. We might think of it as the therapist blowing on the spark of
Buddha nature in the patient to allow it to become a flame. This might be
considered the fundamental healing process in the Buddhist approach to
psychotherapy.

4. Emphasizing the Healthy Growth Edge. It is critical, in this approach to

therapy, to always emphasize the aspect of the patient that is growing, rather
than to focus primarily on what we usually call pathology. This does not mean
that as therapists we will not point out and interpret dysfunctional emotional,
cognitive or behavioral patterns, but only that the emphasis is always placed on
health. This also suggests an emphasis in psychotherapy on compassion and
empathy, though not to the exclusion of dealing with conflict and aggression.

This approach is familiar to many of us through the principles of self-psychology

(or in family therapy through the concept of “re-framing”), and we may often at
times include it in our therapeutic armamentarium. What characterizes the
Buddhist approach, and can be deeply transformative, is a commitment on the
part of the therapist to make identifying healthy motivation the priority, no matter
how “pathological” the presenting clinical material may appear to be. (Of course
therapeutic judgment may dictate departing from this injunction when clinically
indicated, as in the case of dealing with sociopathy or severe acting-out.)

5. Being Willing to Rest Peacefully in Not Knowing. According to the

Buddhist approach, the greatest source of our ability to help our patients will
originate in our Buddha nature, our deepest source of wisdom and compassion.

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Over-attending to the conscious mind only interferes with our access to this
knowledge – hence Theodor Reik’s famous advice to listen with the third ear
(Reik, 1964). What is required is a capacity to be comfortable with confusion,
what the poet John Keats famously referred to as “negative capability” – “when a
man is capable of being in uncertainties, mysteries, doubts, without any irritable
reaching after fact and reason” (Keats,1959).

6. Being as Flexible as Possible in the Practice of Therapy. This requires

trusting our intuition, taking chances, always being willing to change our minds,
always being willing to not know how psychotherapy works. We could be like
Michelangelo (at age 87!): “I am still learning.” This also means being able to
admit mistakes without considering them to be problems (Dogen, considered one
of the greatest Buddhist teachers, stated: “my life has been a continuous series
of mistakes.”)

7. Using Active Techniques to Facilitate Contact with Deeper Experience

and Letting Go of the False Self. These might include introducing meditation,
emphasizing breathing, and the use of special techniques such as gestalt work or
Eugene Gendlin’s focusing technique (Gendlin, 1996). The idea here is that the
barriers to directly experiencing the true self may be so habitual and rigid that
active intervention on the part of the therapist may be needed and welcomed by
the patient. It goes almost without saying that all such active interventions are
freighted with transference implications which must be carefully attended to by
the clinician.

A Buddhist Approach to Group Psychotherapy

First it is important to note again that a Buddhist-oriented group therapeutic

approach may not differ in fundamental ways from a traditional psychodynamic or
interpersonal approach (Rutan and Stone,1984, Yalom,1985). The theory,
content, process and technique may not differ radically from what we are used to.
Buddhist group therapy, therefore, to the extent that such a thing has been in the
process of being invented by a number of therapists in the last decade, is not “a
new form of group therapy.” In this sense it differs from certain innovations that
have appeared on the group therapy scene in recent decades, such as gestalt
group therapy, transactional analysis, redecision group therapy, and cognitive-
behavioral group therapy, to name just a few, all of which do seem to constitute
fundamentally new (and often, quite powerful and helpful) approaches to our
clinical work.

So at least in our present state of knowledge, a Buddhist approach to group

therapy does not necessarily lead to a radically new approach to group process
or group dynamics. Good group therapy is good group therapy, and the basis of
a Buddhist approach to running groups is to be a good group therapist. Along
these lines, no therapy group, no matter what its orientation, can be successful

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unless its leader adheres to the basic principles of good group therapy
leadership. These are, to review (Porter, 1994):

1. Attending to individual needs by giving primacy to the here-and-now,

interpreting the unconscious, and encouraging the expression of feelings in
words in a way that is useful for both the individual and the group.

2. Attending to group needs by maintaining the therapeutic frame, always

making the group the agent of change as much as possible, stimulating group
interaction, and educating the group to the therapeutic process.

3. Balancing individual and group needs appropriately.

4. Dealing with resistance by according it priority, recognizing its often

unconscious nature, allowing anxiety to be optimal rather than maximal or
minimal, and dealing with resistances in order of severity.

5. Dealing with transference by using the group as an instrument, using

optimal timing, and recognizing the need to deal with transference using a variety
of approaches (insight, supportive, self-psychological, relational) according to the
needs of the patient at any given moment.

6. Dealing with counter-transference by allowing it to be conscious and

deciding when to simply use it as data and when and how to selectively express
it.

7. Dealing with primitive group processes, such as scapegoating,

regression, and projective identification.

This being said, where a Buddhist group therapy may differ is in the more subtle,
but nonetheless critical aspects of the work: the structure of the group, the overall
approach of the therapist to clinical material, the effect of the approach on the
consciousness of the therapist, the effect on the atmosphere of the group, and
the effect on the level of clinical material available for productive therapeutic
work.

In 2001 I started two “meditation training groups” for psychotherapists, intended

to explore the possibilities for integrating meditation, spirituality, and group
process. I called the groups “training groups” and the interaction “group process,”
and I further called the approach “spiritual” in a general way, as it incorporated
understanding and study from years of spiritual practice that I had done in many
different spiritual traditions. Nonetheless, much of what I did was highly informed
by my own 15 years of specifically Buddhist study and meditation practice, and
the groups can serve as a model for what may happen when a traditionally-
trained psychotherapist introduces a spiritual perspective into the practice of
group therapy.

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The model I used evolved over time, largely in response to input from the
members of the groups. The present model is 15- 20 minutes of meditation at the
start of the group, 5 minutes to discuss technical issues of meditation, and about
an hour of group process. The groups end with one to two minutes of closing
meditation. At the present time there are 4-5 members in each group. After about
a year both groups spontaneously (and independently – within about 4 months of
each other) decided to change their contract and become formal therapy groups
– a development which had not been consciously in my mind when I started the
groups. This seemed to be the result of a sense of depth and emotional
connection that had developed among the members of each group. The clinical
examples in this paper are drawn from these two groups.

Here are some ways in which a therapy group run according to Buddhist
principles might differ from what we have come to know as traditional group
therapy, based on my experience with these two groups.

1. Structure of the Group. As I mentioned, groups might begin with a

period of meditation. It seems important that this not be so short as to be
meaningless, but not so long as to substantially interfere with group process
during the remainder of the session. An initial period of 15-25 minutes seems
best, at this stage of my experience.

2. Leadership Technique. In leading these two groups I tried to adhere as

much as possible to the basic principles of Buddhist psychotherapy technique
outlined above: being present, cultivating communion, emphasizing the healthy
growth edge, resting in not knowing, trusting intuition, focusing on positive affect,
questioning the super-ego, and being willing to use active techniques. This
seemed to affect both my own consciousness and the atmosphere of the group.

3. The Consciousness of the Leader: Increased Empathy and Insight.

Much of the effect of bringing a Buddhist approach to group therapy seemed to
spring from the effect of the spiritual perspective on my own consciousness. In
the groups which I have led from this perspective, I have found, without
particularly trying, that I tend to have a greater degree of empathy and intuitive
understanding than usual. This seems to take the form of a greater ability to
spontaneously “get” where a person is, a deeper degree of compassion, and
greater access to creative responses. I attribute this to the effect on me of the
“mental set” with which I approach the group, the effect on me of the initial period
of meditation, and also the effect on me of years of practice of Buddhist
meditation.

Clinical example #1

(All clinical examples have been discussed with and approved by members of the
relevant groups in so far as this was clinically possible.)

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One group was initially characterized for about 6 months by seemingly relentless
attacks on me as the leader. With the exception of one time when I responded
angrily to provocation, I was surprised to notice in myself a more flexible than
usual capacity to maintain a sense of equanimity and empathy in the face of a
very high level of aggression. Although it was of course not the point of the
experience, I noticed that the capacity to hold aggression without acting it out
became a maturational experience for me as a leader, and ultimately set a tone
that allowed the group to transform into a deeper and stronger container. From
my point of view, my Buddhist training seemed to have deepened my own
capacity for compassion and non-judgmental presence.

4. The Atmosphere of the Group: Increased Honesty and Compassion.

Similarly in my experience the groups themselves have seemed characterized by
an increased dimension of giving and receiving difficult feedback with empathy
and compassion. This has also been true in most of the one-day or two-day
training groups I have run at the Eastern Group Psychotherapy Society or the
American Group Psychotherapy Association annual meetings using this
approach.

Clinical example #2

By their second year both groups contained four women and one man. Each man
seemed, for a period of time, to be experiencing an angry and unsatisfying
stance toward a woman in his life. Although in each case it was abundantly clear
that the woman in question was contributing in major ways to the relationship
difficulty, it was also clear to both groups that the man, without fully realizing it,
was caught in a behavior pattern that was making things worse for him. The
women in each group were able to give very direct feedback to the men, relating
it in some instances to here-and-now interactions in the group. In both situations
what was striking to me was the exceptional capacity of the group to be both
direct and empathic, and the striking ability of the men to receive the feedback
totally non-defensively, and to rapidly integrate it into their daily lives. Here too
the group atmosphere allowed for a striking degree of compassion and empathy
that seemed related to the Buddhist principles of psychotherapy technique with
which I had attempted to lead the groups.

5. Increased Depth of Material. What has been striking in both groups has
been the rapid access to very deep, sometimes primitive material, that seems at
times to be emerging from the first year of life, and that has included
transferential interactions with me. This has had very positive (and at times
challenging) effects.

Clinical example #3.

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The group referred to in the first clinical example was at first one of the most
difficult I have ever led in 32 years of leading groups, and then evolved into one
of the most successful. It started as a group of ten women and myself that met
for the first time the week before September 11, 2001. The weeks following 9/11
many members were not able to attend. As members began to trickle back, a
hostile and mistrustful attitude toward the group and toward me began to evolve.
Several women developed intense, angry and painfully suspicious relationships
with me, which ultimately led to their leaving the group. I had the fascinating (and
frustrating) experience as a leader that whatever I said or didn’t say was wrong. I
seemed never to be able to help the group come together as a safe, trustworthy
environment. In retrospect I realized a number of things. First, of course, the
presence of ten women and one male leader certainly made for a very
challenging transference situation. Second, as I learned from both this and the
other similar group which I ran, ten members turned out to be too many once the
groups unexpectedly turned into therapy groups. But probably most important,
the combination of September 11 and the meditation ignited a regressive
firestorm that took months to burn out.

When the dust settled, what I came to understand was that the environment of
New York City merged with the environment of the group in the experience of the
group members. As we have come to know (Scheidlinger, 1974), the group is
often, and especially in times of crisis, experienced as the mother of early life, as
is society as a whole. On September 11 a massive attack of male aggression
tore apart the containing (maternal) fabric of society in New York City. Hence the
City itself, as well as the fragmented therapy group (which was unable to fully
reconstitute itself for weeks) was experienced as unsafe. I, on the other hand,
was experienced primarily as either the castrated father who was unable to
protect the integrity of the group, or as the aggressive male who was identified
with the attackers. In line with this, many women in the group began to
experience me as a replica of a traumatizing father.

Eventually a number of women dropped out of the group, which then gradually
settled into a productive work mode. With the addition of a new male member,
the group continued working on very deep material, as members began to deal
with profound feelings of anger and hatred toward their mothers. I supported this,
pointing out the enormous maturational value of being able to experience intense
hatred without self-judgment, repression, projection or acting-out. One woman
successfully freed herself from a lifelong and crippling dependency on her mother
by using her hatred as an engine of separation, and then eventually began to
develop feelings of compassion and forgiveness for her. A second woman went
through an analogous process embodied in a painful separation from a beloved
but disappointing analyst, and then went on to explore the corresponding
psychodynamics with her actual mother.

In summary, in this group it seemed that the spiritual orientation of the group and
the practice of meditation allowed the group to move to a very primitive

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regressed level very quickly. Specifically, the meditation seemed to give patients
quicker and deeper access to unconscious material, and my own background in
Buddhism seemed to allow for greater empathy and attunement of therapeutic
process than I had experienced in the past.

When external events deepened the process more rapidly than the container of
the group could hold, the process did become unstable. But the pressure of the
traumatic events seemed to allow the group eventually to become a cauldron for
transformation into a new and stronger container. What was quite fascinating was
to see that once the group became more stable, it evolved from one of the most
difficult to one of the most profoundly successfully groups which I have ever
encountered, able to work on a surprisingly deep level with very productive
results.

Summary and Conclusions

We have reviewed the history of Buddhism in America in the last 100 years,
some basic concepts of Buddhism (Buddha nature, dharma, attachment and
meditation), and some basic principles of Buddhist psychotherapy regarding the
self, psychopathology, therapeutic process, the goal of therapy, the affective
focus of therapy and the super-ego. We discussed the basic principles of
Buddhist therapeutic technique, which include the need for the therapist to do her
own maturational work, be present, cultivate communion, emphasize the healthy
growth edge, be comfortable with not knowing, be open and flexible, focus on
positive affect, question the super-ego, and be open to the use of active
techniques. We explored the application of all this to group therapy, reviewing the
basic principles of traditional group therapeutic leadership technique, and then,
using examples from two Buddhist-oriented therapy groups which I have led,
reviewed how bringing a Buddhist orientation to group therapy might change the
structure (by adding meditation), change the overall technical approach of the
leader, change the consciousness of the leader (in the direction of greater insight
and empathy), shift the atmosphere in the group (toward more honesty and
compassion), and deepen group members’ access to repressed material.

Overall what I have emphasized is that a Buddhist approach to group therapy

does not create a radically new “form of group therapy,” but may substantially
enhance our capability to do better what we already know how to do as group
therapists.

A final word needs to be added. I have described how a Buddhist approach to

group therapy might enhance the effectiveness of our usual clinical work. This
has emphasized certain aspects of the Buddhist tradition that make it especially
helpful to the practice of psychotherapy. Meditation and Buddhist practice
develops the therapist’s capacity to be present in the here-and-now, to be
compassionate, to be attuned to healthy potential, to question the super-ego, to
be flexible and intuitive, and to contact, and encourage contact with, the true self.

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But there is nothing exclusive in the Buddhist tradition that uniquely qualifies it,
among other spiritual traditions, to be privileged in enhancing our therapeutic
effectiveness. One could write an equally compelling paper, for example, on “A
Christian Approach to Group Therapy,” which might emphasize the usefulness of
prayer, purging, mercy and forgiveness; or a “Jewish/Kabbalistic Approach to
Group Therapy,” enumerating techniques to contact and activate the sephirot; or
a Hindu/Yoga approach, focusing on the use of asanas and pranayama, the
activation of kundalini shakti, the opening of chakras, and the path of service and
union with the Divine; or a Moslem/Sufi approach, a Taoist approach, or a
Shamanistic approach, to pick just a few of the many intriguing possibilities from
among the world’s great spiritual traditions.

Indeed, I believe that in the conduct of the therapy groups which I described, I
never once mentioned the word “Buddhism,” and that the members of those
groups, should they happen to read this paper, would be a bit surprised to know
that they had been participating in a “Buddhist-oriented psychotherapy group.” In
part this is because, as I mentioned earlier, the groups were not run exclusively
according to Buddhist principles, but also incorporated many other spiritual
traditions which I had happened to study. It may also be in part because
psychotherapeutic technique does not require (and in fact may even eschew)
making glaringly explicit the theoretical framework with which one approaches
the clinical work.

Be that as it may, my point is that Buddhism is just one of the many great spiritual
traditions which our species has developed, and hopefully it may serve to
facilitate, along with many other influences, the development of an ever more
wise and compassionate twenty-first century philosophy and practice of group
psychotherapy.

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________________________________________

*This article was published in Group, Journal of the Eastern Group

Psychotherapy Society, vol. 28:4, pp. 53-70, Dec. 2004, and is reprinted here
with permission of the author.

** Kenneth Porter, M.D., is a spiritually-oriented psychiatrist and psychotherapist

practicing individual, couples, and group psychotherapy in New York City. He is a
teacher of Buddhist meditation at the New York Insight Meditation Center, Past-
President of the Association for Spirituality and Psychotherapy, and long-term
student of Kundalini Science and of the Diamond Approach of A.H. Almaas. He
can be contacted at rokeisland@aol.com.

My thanks to Ken Porter for submitting this essay for publication on the
www.desmoinesmeditation.org website. Contact Charlie Day at (515) 255-8398
or charlesday1@mchsi.com to submit material or discuss meditation, Buddhism,
sitting groups, retreats, or meditation experiences.

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