The Couch and the Cushion: Why Mindfulness Is No Substitute for Therapy

Meditation may promote well-being and insight, but it isn’t a cure for psychological problems.

In her 2010 book Mixing Minds: The Power of Relationship in Psychoanalysis and Buddhism, psychotherapist Pilar Jennings notes, “It is very possible to have a deep and rich spiritual life that reaps all manner of spiritual rewards while core psychological patterns and struggles remain untouched.” Without a doubt, mindfulness is a helpful tool, but nothing can replace the healing power of a relationship with a well-trained and dedicated listener.

In recent years there has been an explosion of interest in spiritually based mindfulness meditation practices, and Jennings succinctly describes a phenomenon, generally known as spiritual bypass, that can happen when we try to use these techniques to solve psychological problems and end up avoiding them instead. Mindfulness meditation increases the ability to live in the present moment and may produce profound insights into the nature of reality, both invaluable tools for crafting a conscious, well-lived life. But these practices were not designed to heal an injured heart.

An American Zen teacher I know recently told me that when people come to talk to her about their anxiety or depression, she frequently suggests that that they should really be seeing a psychotherapist. Like me, she has come to believe that talk therapy, specifically psychodynamic psychotherapy, is more effective than meditation for dealing with emotional problems because it is able to undo psychological patterns and resolve the symptoms that they create.

THE DANGER OF SPIRITUAL BYPASS

I fell in love with Buddhist philosophy as a teenager and believed that Buddhist meditation held the key to magically dissolve the anxiety that had plagued me since childhood. Since I privileged Buddhism over Western science, it never occurred to me to turn to the field of psychology for help.

As soon as I graduated from college, I moved to Japan to study with an esteemed Zen master. The discipline was strict, the floor of the meditation hall was cold, and the teacher was deeply intimidating, but I felt like I had finally arrived and was solidly on my way to transcending the vicissitudes of the mundane world. It soon became apparent, however, that I was also becoming increasingly anxious and depressed, and I started to have frightening visions during meditation that left me feeling physically shaky and disconnected from my body.

I made an appointment to see the teacher and tried to tell him about what was going on. He cut me off mid-sentence and yelled at me. “Illusions!” he shouted. “Your feelings and visions are nothing more than illusions. Forget about them, go back to your cushion, and concentrate on your meditation. Just sit!”

In other words, “Suck it up and get over it.”

And I did. I went back to my cushion and steeled myself against the feelings of the little girl inside me who was terrified and felt completely alone, the one he had just annihilated.

I continued to meditate for years under the guidance of a series of Japanese and Tibetan Buddhist teachers and became skilled at one-pointed concentration and mindfulness. And I just kept stuffing down those “illusory” feelings—until one day in my fifties when I was walking down a street in Greenwich Village and had a full-blown panic attack. I was terrified and called a Buddhist friend of mine, who happens to be a psychoanalyst, to ask her what she thought I should do.

“You need to talk to somebody,” she said.

And that’s how I ended up on the couch of an interpersonal psychoanalyst.

THE VALUE OF TALK THERAPY

All my analyst required me to do was to show up and to talk. And as I began to speak, my emotional body seemed to wake up and find its voice. And, lo and behold, it had a lot to say. I kept talking and my analyst kept listening.

One day, as I was nattering on about something that happened when I was a child, my analyst observed, quietly, “You seem sad.” I started to protest, but then stopped. He had heard it. The sadness underlying my brittle cheerfulness. And then, maybe for the first time, I heard it too. And I started to cry.

This crack in my veneer led me to uncover the deep-seated emotional conflicts that had been festering in my unconscious for years. As we began to explore them, I gradually started to feel better and my life-long anxiety symptoms, such as an exaggerated startle response and chronic nausea, disappeared completely.

Therapy was able to resolve issues that meditation never had.

Over time, I realized that none of my Buddhist teachers had ever really listened to what I had to say. Even with the appearance of a relationship between a meditator and a teacher, when I was performing mindfulness meditation practices, I was basically alone. With my analyst, I was not. And that seems to have made all the difference.