Psychotherapy without the Self: A Buddhist Perspective

Psychotherapy without the Self: A Buddhist Perspective

by Mark Epstein

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Immersed in Buddhist psychology prior to studying Western psychiatry, Dr. Mark Epstein first viewed Western therapeutic approaches through the lens of the East. This posed something of a challenge. Although both systems promise liberation through self-awareness, the central tenet of Buddha's wisdom is the notion of no-self, while the central focus of Western

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Immersed in Buddhist psychology prior to studying Western psychiatry, Dr. Mark Epstein first viewed Western therapeutic approaches through the lens of the East. This posed something of a challenge. Although both systems promise liberation through self-awareness, the central tenet of Buddha's wisdom is the notion of no-self, while the central focus of Western psychotherapy is the self. This book, which includes writings from the past twenty-five years, wrestles with the complex relationship between Buddhism and psychotherapy and offers nuanced reflections on therapy, meditation, and psychological and spiritual development.


A best-selling author and popular speaker, Epstein has long been at the forefront of the effort to introduce Buddhist psychology to the West.  His unique background enables him to serve as a bridge between the two traditions, which he has found to be more compatible than at first thought.  Engaging with the teachings of the Buddha as well as those of Freud and Winnicott, he offers a compelling look at desire, anger, and insight and helps reinterpret the Buddha's Four Noble Truths and central concepts such as egolessness and emptiness in the psychoanalytic language of our time.


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What is the relationship between Buddhism and psychology? Can both help a suffering individual? Epstein, a Buddhist as well as a psychiatrist, bridges the gap with a thorough discourse covering meditation and its limitations, narcissism, and the ego, among other issues. In truth, the book is an autobiographical journey based on the author's personal experience and professional expertise, backed up by solid research findings from Buddhist scholars and well-known psychologists. The Buddhist view of emotional life is pondered, as is the psychoanalytic view of mystical experience through Sigmund Freud's eyes. The last section covers the work of British psychologist D.W. Winnicott in joining the two disciplines for daily use through the world of art. Intriguing insights include that the ego rightfully exists and that we have manyfalse selves. The passage on "unintegration," however, may prove difficult to grasp. Ultimately, the author finds that both Buddhism and psychology can foster the willingness to be fully alive through accepting the unknown in ourselves. What is key is how in touch we are with what we are internalizing, even in our confusion. Recommended for larger psychology/religion sections of academic libraries.
—Lisa Liquori

Robert A. F. Thurman

"Psychotherapy without the Self is mandatory reading for anyone seeking to understand today's axial event in psychoanalysis—the encounter of the Freudian and subsequent schools with the Buddhist psychological tradition. Epstein's insights are utterly penetrating, brilliant in uncanny comparisons and clear critical contrasts, altogether illuminating. It is elegantly and wittily written—a real pleasure to read. And don't worry, there is a self, just different from the one that can't be found!"—Robert A. F. Thurman, Jey Tsong Khapa Professor of Buddhist Studies, Columbia University, author of Inner Revolution and Infinite Life

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Psychotherapy without the Self
A Buddhist Perspective

Yale University Press
Copyright © 2007 Mark Epstein, M.D.
All right reserved.

ISBN: 978-0-300-12341-8

Chapter One
Meditative Transformations of Narcissism (1986)

Attempts by theorists of transpersonal psychology to explain the place of meditation within an overall framework encompassing Western notions of the development of the self often see meditation as a "therapeutic" intervention most appropriate for those possessing a "fully developed" sense of self. This approach has been useful in distinguishing transpersonal levels of development from early, pre-oedipal levels, but appears to have sidestepped the issue of how Buddhist meditation practice, for example, could be seen as therapeutic for psychological issues that have their origin in the infantile experience of the meditator. The emergence of object relations theory and the psychodynamics of narcissism have provided a vocabulary more relevant for the discussion of such influences than was Freud's original drive theory that stressed the evolution and persistence of unconscious (Russell, 1986) aspects of libido and aggression. It has been noted that some of those attracted to meditation have demonstrable narcissistic pathology (Epstein & Lie, 1981; Engler, 1983; 1984), but the role of meditation in transforming narcissistic pathology has not yet been explored. By focusing on two particular dynamic structures relevant to narcissism, the ego ideal and the ideal ego, and charting how these psychic structures are affected by the meditative path, it is possible to begin to unravel the complex relationship between meditation and narcissism.


Transpersonal theorists, in general, have preferred to portray the meditative path as beginning with an already developed sense of self, as progressing onward from where conventional Western personality theory leaves o. This approach asserts that Eastern psychologies pay relatively little explicit attention to the infantile components of the personality and that the transformation that they promise consists primarily of proceeding beyond the limitations of an already cohesive self. First delineated by Wilber (1980) in his descriptions of the "pre/trans fallacy," made explicit by Engler (1983; 1984) in his comparison of psychoanalysis and Buddhism, and finally codified by Wilber (1984a; 1984b) in his recent papers, this view is expressed most succinctly by Engler in his statement, "... you have to be somebody before you can be nobody" (Engler, 1983, p. 36). Such an orientation has proven to be an effective balance to the heretofore prevailing psychoanalytically influenced view that mystical states in general fostered a regression to pre-oedipal levels of fulfillment, yet it has, I believe, obscured inquiry into the question of whether Buddhist meditation practices could, in any way, aid in the resolution of infantile, narcissistic conflicts. When conceived as an either/ or perspective, the pre/trans rationale does not easily allow for the examination of the infantile matrix or developmental roots of the spiritual experience, nor does it readily demonstrate how inherent narcissism is engaged and continually addressed throughout the meditative path. In classifying Buddhist meditation practice as an "ethnopsychiatric discipline" (Engler, 1983), one must be open to the possibility that such practices may be confronting primitive psychological conflicts with an eye toward resolving them, not through "analysis," but through experiences in meditation that ultimately allow such conflicts to be transmuted.

Engler indicates there is a sizable proportion of individuals with demonstrable narcissistic pathology who seem to be drawn to meditation. He also describes their tendencies to form transferences to their teachers, often paralleling those described by Kohut (1971) in the treatment of narcissistic personalities. Yet he seems to feel that it is an anomaly of Western culture that individuals with narcissistic vulnerabilities tend to gravitate to the spiritual disciplines. I suspect, however, that this tendency is not unique to this culture and that its existence suggests an underlying thrust of the spiritual disciplines toward the resolution of narcissistically tinged issues (Masson, 1980).

This is not to assert that those individuals functioning at a clinically defined borderline level of personality organization (Kernberg, 1975) could withstand the rigors of intensive meditation practice. Indeed, the available evidence suggests that they cannot (Epstein & Lie, 1981). In this respect I agree with Engler's conclusions regarding a "prerequisite level of personality organization." Yet his conclusions could also imply that the meditative experience, in a developed form, does not address infantile issues, that the ego must be "well integrated" and "intact" and its development "normal" for the meditative experience to unfold. Such a view might foreclose the use of the therapeutic potential of the meditative experience, or ignore the infantile origins of the attraction to spirituality, and neglect the narcissistic residue that may persist throughout the meditative path.

To assert that infantile issues can persist in their influence in the meditator's psyche even after he or she has successfully traversed the early developmental spectrum is not to contradict the major theorists of personality development, all of whom assert that the infantile residue "reverberates throughout the life cycle" (Mahler, 1972, p. 333). Those who have addressed narcissistic issues tend to agree on the essential point that the memory of the infant's blissful symbiotic union with the mother creates an ideal in the individual's psyche which inevitably becomes compared with his or her actual experience (Mahler, 1972, p. 338; Jacobsen, 1964, p. 39; Kohut, 1966, p. 246; A. Reich, 1960, p. 311; Guntrip, 1969, p. 291; Chasseguet-Smirgel, 1975, p. 6). This ideal is narcissistic at its core because it is rooted in a time when all of the infant's needs were immediately satisfied and when its self was not differentiated from that of its caretaker. Just as this narcissistic residue reverberates throughout the life cycle, affecting goals, aspirations and intimate interpersonal relationships, so it can be seen to reverberate throughout the meditative path, where psychic structures derived from this infantile experience must be, at various times, gratified, confronted or abandoned.

The concept of the ideal is not limited to the psychology of narcissism, however. One of the distinctive characteristics of Buddhist psychology (particularly in the Theravadan tradition) is that it clearly postulates an ideal personality, the arahat, that represents the fruition of meditation practice (Johansson, 1970; Goleman & Epstein, 1983), as well as an ideal state, that of nirvana, where reality is perceived without distortion. The ideal personality is conceived of as one in whom even the potential for the arising of unwholesome mental factors, such as greed, hatred, conceit, envy or doubt, does not exist. It represents a personality cleansed of the kinds of mental states accepted as inevitable by Western psychology-cleansed by virtue of the repeated experience of the enlightened state. In order to actually reach this goal, the meditative path, as well outlined in traditional Buddhist texts, must be traversed. From the perspective of the psychodynamics of narcissism, in order for this ideal to be reached, there must occur a transformation of those psychic structures that embody the individual's internalization of the ideal. In other words, meditation must inevitably affect those aspects of the self that derive from the infantile experience of the ideal so that the Buddhist ideal may be realized. It is not just that the promise of nirvana speaks to a primitive yearning and motivates some people to undertake meditation, but that the actual practice provides a means whereby those narcissistic remnants that inevitably persist are seized and redirected. The manner in which this occurs can be explained, once the psychic structures involved are described more fully.

Ego Ideal/Ideal Ego

The two representations of the ideal that inherit the energy of the infant's primitive narcissism (Grunberger, 1971) have been termed the ego ideal and the ideal ego (Hanly, 1984). They both derive from the infant's experience of undifferentiated, symbiotic fusion with the mother that predates cognitive structures mature enough for conceptual thought, but, once established, each assumes separate and distinctive functions within the developing individual's psychic economy. The ideal ego is "an idea which the ego has of itself" (Hanly, 1984, p. 254), an idealized image of what the ego actually is, a secret, tenaciously guarded, deeply held belief in the ego's solidity, permanence and perfection. The ego ideal is that towards which the ego strives, that which it yearns to become, that into which it desires to merge, fuse or unite. It is as if the original fusion with "mother and the sensori-physical surround" (Wilber, 1984a, p. 89) splits into two archaic, disjointed remnants, one embodying the ego's memory of its own perfection and the other embodying the memory of the perfection in which it was once contained. These two remnants diverge, at times contradict each other, and assume separate functions thereafter. They essentially constitute what has been termed the "dual orientation of narcissism" (Andreas-Salome, 1962).

The fundamental difference between the two terms "ideal ego" and "ego ideal" is that the former connotes a state of being whereas the latter connotes a state of becoming.... The ideal ego is the ego insofar as it believes itself to have been vouchsafed a state of perfection-it refers to a positive state even if this state, in reality, is an illusion. In fact, the ideal ego is a self-image that is distorted by idealization but it may be experienced as more real than the ego itself. The ego ideal refers to a perfection to be achieved, it refers to an unrealized potential; it is the idea of a perfection towards which the ego ought to strive. (Hanly, 1984, p. 253)

The ideal ego, according to Hanly (1984), is the source of abstract ideas that the ego has about itself as perfect, complete, immortal and permanent. It is the wellspring of vanity and self-righteousness, the "source of an illusory ontology of the self" (p. 255) and the equivalent of a "wishful concept of the self" (Sandler et al., 1963, p. 156). It is given form when the ego gains the capacity to observe itself, when it senses its own presence (Federn, 1952, p. 60), yet its formation is "built up out of denials" (Hanly, 1984, p. 266) of many of the ego's attributes. Sustained by the on-going denial of what Federn (1952) has termed a "sense of unreality" or "estrangement" (p. 61) that arises when the "preceding state of perfect wholeness" (p. 269) is forever lost, the ideal ego does not permit inquiry into potentially contradictory aspects of the ego's true nature (Hanly, 1984, p. 260). The self, as experienced by the ideal ego, is not the constantly changing series of "fused and confused" self and object images that Jacobsen (1964, p. 20) described in her pioneering study of object relations theory, but is, instead, "an identification of the self with a part of the self which then becomes the 'true self' idealized by narcissistic investment" (Hanly, 1984, p. 255).

The ego ideal, on the other hand, embodies an individual's aspirations. It is derived from the boundless experience of infantile narcissistic omnipotence, in which there is no distinction between self and other and the entire universe is experienced as a part of oneself. First brought into existence by the "violent end to which the primary state of fusion" (Chasseguet-Smirgel, 1975, p. 6) is brought, the ego ideal is characteristically projected outward either onto significant others into which an individual tries to merge or into moral attributes which the individual tries to live up to. Yet, as Freud (1914, p. 116) first stated, "That which he projects ahead of him as his ideal is merely his substitute for the lost narcissism of his childhood-the time when he was his own ideal." Unlike the ideal ego, whose function it is to assure the self of its own inherent perfection, the ego ideal is associated with a yearning to become something that at its root is an internalized image of a lost state of perfection. The ego ideal, says Chasseguet-Smirgel, a French psychoanalyst responsible for much of the repopularization of the concept, represents "a narcissistic omnipotence from which (the individual) is henceforth divided by a gulf that he will spend the rest of his life trying to bridge" (1975, p. 7).

Hanly (1984, p. 256) described the usefulness of these concepts in elucidating personality structure by comparing the relative strengths of ego ideal and ideal ego in various types of personality organization. His essential thesis is that relative strength of ideal ego and weakness of ego ideal predominate in borderline, narcissistic and neurotic disorders and that only as the personality matures does ego ideal begin to eclipse ideal ego in the psychic economy. This schemata assumes special importance as the fate of ego ideal and ideal ego in the meditative path is examined.

Attempts by psychoanalytic theorists to analyze mystical phenomena have traditionally resulted in interpretations that view meditation as a narcissistic attempt to regain an ideal infantile state. From early investigations of mystical ecstasies (Jones, 1913, 1923; Schroeder, 1922; Alexander, 1931; Federn, 1952) to Freud's well-known evocation of the "oceanic feeling" as a "restoration of limitless narcissism" (1930) to more contemporary attempts at describing mystical union (Rose, 1972; Ross, 1975; Lewin, 1950; Bonaparte, 1950; Masson, 1974, 1980), the essential point has always been a variation on the idea that mysticism in general and meditation in particular represents an attempt to merge ego and ego ideal, an idea first proposed by Jones (1923) and fully amplified upon by Grunberger (1971) and Chasseguet-Smirgel (1975). "Mysticism ... corresponds ... to the need for the uniting of ego and ideal via the shortest possible route. It represents fusion with the primary object, and even when the latter is represented consciously by God, it is nonetheless, at depth, an equivalent of the mother-prior-to-the-loss-of-fusion" (Chasseguet-Smirgel, 1975, p. 217).

With regard to the Buddhist path, this interpretation is but a half-truth, and, as such, it is revealing, incomplete and misleading. Such a formulation, while asserting that meditation strengthens the ego ideal, neglects both the fate of the ideal ego and the practices that affect the ideal ego. As psychoanalyst Joseph L. Thompson, writing under the pseudonym Joe Tom Sun in 1924 and the first analyst to appreciate this dimension of Buddhism, pointed out, "Buddha taught that the ego was not a reality, that it was non-existent, that it was an illusion" (Sun, 1924, p. 43), that the ideal ego, as a potent force in the psyche, must be surrendered.

The analytic view, traditionally, has been that meditation constitutes a regression to an infantile narcissistic state, a shortcut in the ongoing attempt to gratify the ego ideal. It is correct in pointing out that the potential for such gratification does exist through meditation, but, by failing to recognize the confrontation with the ideal ego that is also required, it has not recognized that restructuring of both ego ideal and ideal ego is demanded by the meditative path. On the other hand, transpersonal psychologists may not have recognized sufficiently the persistence of narcissistic structures in those undertaking meditation, and so may have overlooked the fate of those structures from an analytic point of view.


Excerpted from Psychotherapy without the Self by MARK EPSTEIN Copyright © 2007 by Mark Epstein, M.D.. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Meet the Author

Mark Epstein, M.D., is a psychiatrist in private practice and clinical assistant professor of psychology at New York University. His previous books include Thoughts without a Thinker, Going to Pieces without Falling Apart, Open to Desire¸ and Going On Being.

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