At my best, I see psychotherapy in the same light. Many people who come to therapy are disgusted with themselves for one reason or another, much as the Buddha was in his own time and in his own way. This disgust can take many forms: shame, fear, anxiety, or feelings of unworthiness are common expressions of it, but the possibilities are endless. Some people even develop what is called a “reaction formation” and seem the opposite of disgusted. They come across as prideful or conceited and unwilling to admit their faults or self-doubts. But these individuals are often just propping themselves up, creating a false front to mask their vulnerabilities, and somewhere inside they are troubled because they know they are not being real.

Buddhist thought has been helpful for me with this because the Buddha’s first noble truth—that life is tinged with a sense of pervasive unsatisfactoriness (or suffering)—takes it as a given that there is always some way that we feel unseen, unknown, or unrecognized.

Psychoanalysis has explored many of the most obvious parental failings that contribute to such feelings but, in trying to find the source, or the cause, of personal uncertainty, it has encouraged people to overly blame their families of origin rather than taking on the responsibility of reaching out to establish whatever kinds of connections are actually possible in life.

The Buddha’s teachings run counter to this tendency to find fault. He normalized feelings of inadequacy and threw responsibility back onto the individual to sort them out. He taught mindfulness as a method of probing the self and found that impartial attention to moment-to-moment experience yields surprising but predictable insights into the self’s

contingent and relational nature. These insights, which precipitate spontaneously out of concentrated attention and mindful reflection, make abundantly clear that our habitual efforts to defend ourselves against our intrinsic groundlessness make things even worse.

But, as important as it is to understand the sources and details of one’s pain, understanding is rarely enough. My patients come to therapy wanting the burden of their accumulated experience lifted. Yes, they want to make sense of their lives, but that is not usually their fundamental or exclusive aim. First and foremost, they are trying to get over their accumulated trauma in order to feel less fearful, isolated, forlorn, helpless, alone, anxious, or depressed. They might not be able to say it so clearly, but they are reaching for things

beyond thought, trying to make contact with essential capacities that have been sacrificed in their efforts to adapt, adjust, comply, cope, or conform.

Winnicott, and here the parallels to the Buddha are difficult to ignore, believed that “being” precedes “doing,” and that its recovery is the route back to our original nature. He felt that “being” is everyone’s birthright, but that it is something of a lost art, that compliance often robs people of it, that creativity depends on it, and that therapy can serve as a means of rediscovering it if a therapist is sensitive to the need and does not let their male element, in the form of intrusive interpretations, however erudite they may be, interfere. The Buddha, to my mind, thought along the same lines. He said that our original nature is obscured by our cravings and our frustrations, that the ego that emerges in healthy emotional development, while necessary for some things, also blocks us from our underlying and inherent freedom. “Be here now,” my old friend Ram Dass used to proclaim, making it sound as if it were the easiest thing in the world.