Advice Not Given

by Mark Epstein

  None of my three patients felt they were doing it right. One wanted to know how long to do it for, as if the length of time were the important thing. She had heard that twenty minutes twice a day was the minimum to get a good effect. She was sure she couldn’t sit still for more than five minutes, so I told her five minutes was fine and we figured out how to set the timer on her iPhone so she would not have to peek at the clock. Another person felt defeated by how tense her neck felt. She wanted the relaxation benefits right away, the stress reduction, and she was frustrated when the meditation did not provide it. She felt her tension more acutely when meditating and became convinced she was a bad meditator. Although I told her there was no such thing as a bad meditator, I do not think she believed me. The third person dropped into a peaceful and quiet state initially and then could not reproduce it in the following sessions. She saw no value in periods that were not of the sublime character she had first tasted and began to disparage herself. I was familiar with all of these reactions, having had them myself, and worked as patiently as I could to counter my patients’ newfound convictions. I wanted the meditation experience to support, not to erode, their self-esteem.

  In thinking about my patients’ requests in light of these experiences, I began to understand one reason for my long-standing reluctance to introduce meditation directly into therapy. People often hope that meditation will be the answer to their problems. They look to it as a kind of home improvement project, as a way of fixing a broken aspect of themselves. They let their regrets about the past and their hopes for the future condition their approach to the present moment. In therapy, we have developed ways of countering these kinds of unrealistic expectations. Therapy is hard work and the payoff does not come immediately. Therapists guard against promising too much and become skilled at showing people how their hopes for a magical cure can obstruct their investigation of themselves. Many people become frustrated with the slow pace of therapy and leave. But those who stay are rewarded by what can become a deep and meaningful relationship. People do not have to pretend to be other than who they are in therapy. They do not have to apologize for themselves but can be honest and revealing in an ongoing way. This can be a great gift and is at the heart of what turns out to be therapeutic for many people.

  Right View was the Buddha’s way of proposing something similar, his way of encouraging people to be realistic about themselves and the nature of things. Right View asks us to focus on the incontrovertible truth of impermanence rather than trying to shore up a flawed and insecure self. Turning meditation into another thing to strive for is counterproductive. Setting up too concrete a goal for oneself—even a worthwhile goal, such as to be more relaxed, less stressed, more peaceful, less attached, more happy, less reactive—is to subvert the purpose of the meditative process.

  When the Buddha taught Right View, he was trying to help with the most painful aspects of life. The microcosm echoes the macrocosm, he said. When we observe the moment-to-moment nature of our experience, the way it is constantly changing, we are also seeing a reflection of the transience and uncertainty of the greater whole. In this world, there is no escaping old age, illness, and death; no way to avoid eventual separation from those we love; and no way of insulating ourselves from time’s arrows. Right View is a kind of inoculation against these inevitabilities, a way of preparing the mind by using its own intelligence so that it does not need to defend itself in the usual ways. The Buddha found that a simple acknowledgment of the reality of things could help life become more bearable. Acknowledging impermanence is a paradoxical injunction; it is counter to most of our instinctive habits. Ordinarily, we look away. We do not want to see death, we resist change, and we pull ourselves away from the traumatic undercurrents of life. We use what therapists call “dissociation” to protect ourselves. In dissociation the ego pushes away that which threatens to undo it. We banish what we cannot handle and soldier on as if we are not as fragile as we actually are.

  But the Buddha was like a contemporary behaviorist who teaches people to carefully go toward the things they fear the most. What we face in meditation is a mini version, or a magnified version, of what we do not want to face in life. A brief experiment with meditation can make this clear. Try closing your eyes. Let your attention go where it chooses. Make no effort to direct it. Most likely, before too long, you will find yourself lost in thought. Pay attention to what those thoughts are, though, even if this is difficult. It is rare that we are having new and important thoughts; most often we are just repeating things to ourselves we already know. What will we do later? What will we have to eat next? What tasks do we have to take care of? Who are we angry with now? Who has hurt our feelings lately? We just repeat these thoughts endlessly, with a minimum of variation. All too often, the present moment slips away from us without our even noticing. We are divorced from it, just as we are separated much of the time from our own bodies. We live primarily in a disembodied mental universe, interrupted periodically—these days—by a need to check our phones to see if we have any messages. As in touch as we might want to be with others, we are very practiced at being at a slight remove from ourselves. But if we try to counter these habitual tendencies, the mind’s ability to drop its defensive and dissociated posture can be a real surprise.

  Meditation begins by asking us to rest our minds in our bodies, as we rest our bodies on a cushion or in a comfortable chair, and to pay deliberate attention to, rather than ignore, the shifting sensations of the physical organism. These sensations can be subtle, but by spending time with them we start to see two important things. First, the inner experience is changing incessantly. When we are lost in thought, we are protected from this knowledge, but when we dislodge ourselves from our usual mental preoccupations we cannot help but see. Second, it becomes clear how easily we are driven out of the present moment by our own likes and dislikes. When something uncomfortable happens, we move away. When something pleasurable comes, we try to enhance it. We do not let the moments pass easily; we are subconsciously engaged in an endless tug-of-war with the way things are.

  To get a sense of how meditation works with this, close your eyes again. Just listen to whatever surrounds you. Sound is a good object of meditation because we generally do not try to control it as much as we do other things. People often have a more difficult time settling into their bodies than they do paying attention to the sounds that appear naturally. Just listen and try to let whatever sounds are around pass through you. Listen in 360 degrees, to the sounds and to the silences that interrupt them. Notice when your mind identifies the sound as a car or a baby or a bird or the television, when the concept of what is making the sound replaces the actual physical sensation of the sound striking your eardrum. Notice when you like something and when you do not and how this changes the way you listen. We tend to move away from a continuous direct experience of our senses into a mental reaction to, or representation of, them. This is one of the things Right View is meant to illuminate. In our day-to-day lives, this shortcut is a big help. If someone honks his horn at us, we don’t listen to its sound waves rise and fall; we react and look to see what the problem is. As helpful as this involuntary reaction can be, we use it more than is necessary. It is as if we are constantly on guard. Right View asks us to explore this in the relative calm of meditation. When we see how much it drives us in the micro universe, we get some sense of how it might be conditioning us in the macro one.

  Each new loss, each disappointment, each unanticipated difficulty presents a new challenge. The Buddha made Right View the first branch of the Eightfold Path in order to remind us that a willingness to engage with such challenges is the most important thing of all. The aging of our parents, the deaths of our pets, and the travails of our children or other loved ones often feel like more than we can bear. These days, even getting from one place to another can seem overwhelming. The line through airport security takes forever; the plane sits on the runway while the cabin temperature rises or the
flight is inexplicably canceled. And when you finally do arrive at your destination, someone’s luggage is lost. Daily life is filled with such obstructions. Things break. People hurt our feelings. Ticks carry Lyme disease. Friends get sick and even die.

  “They’re shooting at our regiment now,” a sixty-year-old friend of mine said the other day as he recounted the various illnesses of his closest acquaintances. “We’re the ones coming over the next hill.”

  He was right, but the uncertain underpinnings of life are not specific to any single generation. The first day of school and the first day in an assisted living facility are remarkably similar. Separation and loss touch everyone.

  The Eightfold Path begins with Right View in order to address this at the outset. There is a famous saying in Tibetan Buddhism that a person who tries to meditate without a clear idea of its purpose is like a blind man wandering about in open country with no idea of which direction to go. Right View states that the fundamental purpose of Buddhist meditation is not to create a comfortable hiding place for oneself; it is to acquaint the mind, on a moment-to-moment basis, with impermanence. When the Dalai Lama told the Nepalese hermit to get a life after his years of solitary contemplation, he was invoking this very principle. Enter the flow, he was saying; don’t pretend you are above it all. While meditation can be used to temporarily quiet the mind, from the perspective of the Eightfold Path this is done in the service of a keener and more pronounced observation, not as an end in itself. Just as it is hard to watch a movie in a noisy room where people are talking all of the time, it is difficult to pay attention to the shifting flux of experience when we are distracted by thought. Concentration meditations, in centering the attention on a single object like the breath, still the mind. But mindfulness emphasizes impermanence. When the mind is settled, the underlying ephemeral nature of things can be more clearly perceived. Resistance diminishes, the flight to past and future recedes, and the sense that it might be possible to respond consciously rather than react blindly to events begins to emerge.

  My patients’ attraction to meditation and their subsequent difficulties with it have something to do with the way it has been marketed in our culture and something to do with human psychology. Promoted as a method of stress reduction, as a means of evoking the relaxation response, lowering blood pressure, countering the fight-or-flight response, and increasing cognitive efficiency, meditation has entered Western culture as a practical tool to help people cope. Increasingly, it is being offered not only as an adjunct to psychotherapy, but as a replacement for it. In my view, this is unfortunate. Unfortunate in the same way an overenthusiasm for Prozac was unfortunate. People want there to be a magic bullet. They want something quick and easy that will work. When Prozac first became available, a lot of people who did not need it took it, hoping that it would change them. It helped some people enormously and an enormous number of people not at all. But the placebo effect is very powerful. When people are invested in the possibility of a cure, they will convince themselves, at least for a while, that things are better.

  From a public relations point of view, meditation has benefited from this tendency, but I am suspicious of this. As I have experienced on many retreats, nice things can happen when you meditate. Peaceful feelings can emerge. They do emerge. A concentrated mind is a quiet mind in which the pressures of having to be somebody recede. Artists, writers, mathematicians, chess players, actors, musicians, and athletes, to name a few, know this very well. The self disappears when the mind is concentrated, and there is genuine, if temporary, relief when this happens. In meditation, the feelings of flow that are common in creative pursuits can be accessed, harnessed, and stabilized, sometimes for extended periods of time. But most artists, writers, mathematicians, chess players, actors, musicians, and athletes are no happier, and no more together, than the rest of humanity. If the temporary dissolution of self were all that was needed, problems would not be so tenacious. Even watching television would be therapeutic.

  —

  My wife is a sculptor who understands the joy that immersion in creative process can bring. She spends long and laborious hours in her studio but generally emerges enlivened and clear. Through her, I have met and worked with numerous artists whose experiences in their studios, where the sense of self is temporarily suspended under the spell of one’s creative pursuits, parallel what can happen in meditation. But working with these artists has reinforced my sense that familiarity with flow, by itself, is not ordinarily enough to help with the deepest challenges life throws at us. Something akin to the Buddha’s Right View is also needed.

  Arlene and I had a very meaningful demonstration of this a couple of years after we were married. We were visiting with Joseph Goldstein, one of my earliest Buddhist teachers, whom she did not yet know very well. Arlene received a piece of advice from Joseph that day that had a huge impact on her. It was not meditation advice per se, but it did seem to contain the essence of Right View. We both remember the interaction vividly, although when we saw Joseph recently and reminded him of it he seemed to have no recollection of it at all. In fact, he seemed slightly surprised, even sheepish, to hear what he had told her.

  “That was very bold of me,” he said with some embarrassment, after she recounted the story to him.

  —

  Shortly after our first child was born, in the mid-1980s, Arlene’s best friend from art school was diagnosed with cancer. Her friend was an amazing person: brilliant, energetic, ambitious, and full of life. She and my wife shared a spacious loft in downtown Boston for several years after graduating from the Rhode Island School of Design and she was the maid of honor at our wedding. When we moved to New York, she remained in Boston, and when she got sick my wife traveled back and forth to see her as much as she possibly could. Her physicians at first thought she had ovarian cancer, but when the tumors failed to respond to any of the standard treatments, they investigated further and changed their diagnosis to a cancer of the connective tissue called a leiomyosarcoma, a rare, mysterious, aggressive, and, in this case, fatal disease.

  Arlene was terribly upset when she spoke with Joseph. The news had gone from bad to worse, to worse than she could possibly imagine, and it was hard for her to hold the twin realities of our infant daughter’s aliveness and her friend’s illness. We did not see Joseph often, but she had gotten to know him a little and she knew how much I trusted him. Joseph and I had already been friends for twelve years. I had met him while I was still in college and first interested in Buddhism. He had just returned from seven years in India and I was one of his first students in the West. I had traveled with him in Asia to meet his Buddhist teachers there and had done a number of silent retreats under his auspices. I am sure this bond made the subsequent conversation possible. Joseph was like family to me and this must have put both of them at ease with each other. Arlene tearfully explained the situation to him.

  “Stop making such a big deal out of it,” he replied upon hearing her sorrowful account. “Life is like this. Like fireworks.” He gestured with one hand as if to mimic the fleeting nature of things. “Vibrant and alive,” he continued, “and then gone.”

  Arlene felt what Joseph was saying very deeply. There was warmth to his words that may not come through on the page. He was being realistic; he wasn’t being unkind, nor was he coddling her; and she appreciated it. But he was also giving her very specific advice.

  “Don’t make such a big deal out of it.”

  I am not sure she had ever considered that as a possibility.

  I can see why Joseph seemed taken aback when reminded of this. Were I not to know the circumstances of the conversation so intimately, and the parties involved so well, I might think that Joseph sounded callous or my wife naive. But I can attest to the impact his advice had on her, as well as to her lack of naiveté. The conversation came at just the right moment and was given with all the care, confrontation, and clarification that the best psychotherapists se
ek to cultivate when offering counsel to their patients. Joseph helped Arlene at a very difficult moment in a way that has had a lasting effect on both her life and her work. But his words were nothing I could ever imagine saying to a patient or a friend. Talk about advice not given! Yet, somehow, Joseph must have felt that Arlene could handle it. She remains grateful to him to this day.

  There are various ways to understand what Joseph was trying to communicate and why it was so helpful. From one perspective, he was simply being a Buddhist teacher and pointing out the inevitability of change. One of the most fundamental principles of Buddhism, after all, is that impermanence is the inescapable flavor of worldly life. In using the metaphor of the fireworks, Joseph was undoubtedly evoking the Buddha’s fire sermon, one of the first that he gave after his enlightenment, in which he famously declared, “Everything is burning,” capturing the reality of transience in one devastating image. My wife understood the Buddhist reference, but she was touched on more than a conceptual level. Her mind was engaged by Joseph’s admonition and she took the ball and ran with it.