Gautama Buddha the Unique Psychotherapist

Dr. Ruwan M Jayatunge M.D. 

Many people interpret Buddhism as a religion and a philosophy (or a practical philosophy) known from antiquity. The Buddhism has a vast system of psychotherapy. The Buddhism offers mental healing allowing growth promotion. Buddhism is a method of mind training. Understanding of the function of mind has been recognized as the basis of Buddhist philosophy. In this context the Lord Buddha can be identified as a unique psychotherapist of all time. 

Psychotherapy is a wide ranging subject. In general Psychotherapy means a treatment of emotional, behavioural, personality disorders based primarily upon verbal or nonverbal communication. The Buddha who was an inimitable mental healer helped a large number of people to overcome stress, emotional problems, and relationship problems etc through gracious and spiritual mediation. 

Modern Psychotherapy started with Dr Sigmund Freud. Freud introduced Psychoanalytic therapy. Psychoanalysis investigates the unconscious mental processes. Psychoanalytic therapy scrutinizes how the unconscious mind influences thoughts and behaviours. Freud used free association, dream interpretation, and analysis of resistance and transference to explore repressed or unconscious impulses, anxieties, and internal conflicts of his clients. The goals of psychodynamic therapy are a client’s self-awareness and understanding of the influence of the past on present behaviour (Haggerty 2006).

Psychoanalytic therapy has been identified as an insight-oriented therapy. Freud was interested in the past (especially the childhood experiences) of his clients. However the Buddhist psychotherapy pays its attention to the past, present and future. The Buddhism has an exclusive psychoanalytic component. The Psychoanalysts such as Erich Fromm and Karen Horney studied the Psychoanalytic component in the Buddhist philosophy. According to Erich Fromm psychoanalysis is not a therapy of commitment but rather an approach that liberates people from the type of commitment required by traditional religion and other social institutions. The Buddha helped to liberate people from emotional bondages and oppressed social conditions two millennia ago. 

Unlike the Freudian psychoanalysis the Buddhist psychoanalysis has a profound spiritual dimension and it extensively focuses on the deeper existential questions. Freud believed that the inner layers of the human personality consist of irrational and savagery wishes. In contrast the Buddha believed in the positive aspects of the human personality and its capabilities. The Buddha preached that the human have the capacity for self growth and achieve higher spiritual level. 

The Buddha did a complete form of analysis and found the root cause of affliction, then successfully treated the particular psychological ailment and brought complete mental release to the person. He made the person to aware of his illogical thought patterns and actions hence giving a profound insight 

In this analysis sometimes the Buddha went up to past lives. Past life therapy also known as regression or resolution therapy allows individuals to complete traumatic and emotionally stimulated past experiences which on an unconscious level are unresolved.

Today PLT or Past Life Therapy or Past life regression is popular in the Western world and it allows the client to resolve past issues in a therapeutic setting using clinical methods. The most famous Western past life therapist was Edgar Cayce who gave over 14,000 "readings" during a period of 43 years. Edgar Cayce demonstrated the uncanny ability to put himself into some kind of self-induced sleep and he could respond to questions asked by his patients about their illnesses. In addition the Psychiatrist Dr. Brian Weiss who was the author of the bestselling book “ Many Lives, Many Masters “ has extensively written about past life therapy. Past life therapy helps the clients to find a meaning in their present suffering. 

Dr. Ian Stevenson who was a Canadian-born  US Psychiatrist and the Chairman of the Department of Psychiatry and Neurology at the University of Virginia in 1957 had spent a large part of his professional life traveling the world, verifying, and documenting thousands of past life memory cases. He began his reincarnation research in 1960. Dr. Ian Stevenson once stated: “Reincarnation, at least as I conceive it, does not nullify what we know about evolution and genetics. It suggests, however, that there may be two streams of evolution -- the biological one and a personal one -- and that during terrestrial lives these streams may interact”

The personality types are important in psychotherapy. Different personality types were discussed by Galen (120 AD) Carl Jung (1875 – 1961) and Professor Hans Eysenck (1916 - 1997). Galen proposed four fundamental personality types such as sanguine (pleasure-seeking and sociable), choleric (ambitious and leader-like), melancholic (analytical and quiet), and phlegmatic (relaxed and peaceful).  According to Carl Jung there are two major types of personalities: Extraversion and Introversion. Professor Hans Eysenck proposed two personality dimensions: extraversion and neuroticism.  

Many years before these scholars the Buddha realised that different personality types exist and he identified three major types of personalities. The first type is Raga (predominantly sensual pleasure seeking) personalities. Their thoughts and actions are pre occupied with seeking bodily pleasure. The second type Dvesha (anger based) personalities and they are largely impacted by self loathing, resentment and frustration. The third type Moha (irrational) personalities and they are unable to come to a rational conclusion and lack wisdom. Based on personality types the Buddha provided appropriate mental and emotional healing. 

Cognitive Therapy is one of the major components in today’s psychotherapy.  Cognitive Therapy based on gaining insight into unconscious emotions and drives mainly focusing on thoughts, assumptions and beliefs. Albert Ellis's Rational Emotive Therapy is an example of Cognitive therapy. Ellis considers strong emotions to result from an interaction between events in the environment and beliefs and expectations.

In Buddhist point of view suffering is not caused by external traumatic events, but by qualities of mind which shape our perceptions and responses to events. These same words were repeated by the Psychologist Albert Ellis in 1953 when he introduced his action oriented therapeutic approach – Rational Emotive Therapy. According to Ellis not the event that causes psychological distress but the belief held by the client. He further argues that one's emotional distress is actually caused by one's catastrophic thinking in appraising stressful events. Ellis theories that unrealistic appraisals of stress are derived from irrational assumptions.

The Psychiatrist Aaron T Beck - the developer of CBT or Cognitive Behaviour Therapy emphasized the role of cognitive distortions in Depression and anxiety. Cognitive Behaviour Therapy (CBT) is one of the major orientations of psychotherapy and represents a unique category of psychological intervention because it derives from cognitive and behavioural psychological models of human behaviour.

The Lord Buddha used numerous kinds of cognitive therapies. In the story of Kisa-Gotami Buddha used a cognitive mode of action to give insight to a young mother who lost her infant son. She was devastated with grief. She went to the Buddha Carrying the dead body of her son and asked for medicine that would restore her dead son to life. The Buddha told her to get some mustard seeds from a house where there had been no death. Emotionally overwhelmed Kisa -Gotami went from house to house but she could not find a single house where death had not occurred. She gradually got the insight and the meaning of death. She realized that the death is a universal phenomenon. By the end of the day Kisa -Gotami buried her dead son. Although she felt the loss she was able to move away from the pathological grief reaction that impacted her immensely. 

Buddha often used Socratic Method to teach his doctrine. Socrates (470 -399 BC) was a Greek philosopher who engaged in questioning of his students in an unending search for truth. He sought to get to the foundations of his students' and colleagues' views by asking continual questions until a contradiction was exposed, thus proving the fallacy of the initial assumption. This became known as the Socratic Method.

The Buddha had exceptional communication skills. He was able to positively connect with people from all walks of life and people from different social layers with different education levels. He used vivid and colourful examples to give insight to his followers. 

The story of Angulimala narrates how the Buddha used to give insight and mental awakening in extreme situations. Angulimala –an innocent bright student who turned in to a vicious murderer was determined to kill the Buddha. When he saw the Buddha Angulimala started chasing the Buddha and screamed at the Buddha to stop.   The Buddha turned and told Angulimala that he, the Buddha, had already stopped and Angulimala, to do likewise. 

These few words made a cognitive revolution inside Angulimala's head. He realized that the Buddha has already stopped -means he does not commit any violence and does not accumulate any karmic energy that fuel the Sanasara Chakra. But Angulimala he himself is mounting up karmic force that keeps him moving in the Sanasara Chakra. In this analogy the Buddha has stopped but Angulimala is still moving. Angulimala had an aha moment and he was able to realise the gravity of his evil actions. He threw the sward and renounced violence. 

The story Patachara is a dazzling example how the Buddha restored an acute stress reaction. Patachara a young woman went in to an acute stress reaction when she witnessed the death of her husband, two children and the parents. She lost her faculties and became overwhelmed. She came to Buddha weeping and with utter confusion. The Buddha gave her psychological first aid and brought her to proper sensors. 

After she became rational Buddha explained her the true meaning of suffering and the nature of impermanence giving numerous examples. Patachara realised that the death and suffering are innate parts of the human existence. Therefore her husband, two children and the parents could not evade these universal maladies. 

The story of Patachara reveals an excellent case study of trauma counselling. As indicated by psychologists trauma counselling should offer practical help that works and should teach skills to manage flashbacks, painful memories and anxiety. Buddha used practically most of the above mentioned avenues to resolve the grief reaction of Patachara.

The Psychiatrist Dr. Elisabeth Kübler-Ross provided emotional comfort to the terminally ill patients and provided comfortable non agonizing final moments for them. She was one of the pioneers in Hospice care. Hospice care is a type of care and philosophy of care that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient's pain and symptoms, and attending to their emotional and spiritual needs. The Buddha provided such care to a terminally ill monk named Puthigattha Thissa. Also the Buddha provided hospice care to his own father – the King Suddhodana. 

There are obvious similarities between the empathy offered by the Buddha and the empathy that had been described by Carl Rogers who played an important historical role in the development of Client Centered Therapy. Empathy is a fundamental ability for being able to develop relationships with other people, and thus develop one's personality. The Buddha offered empathy without any pre conditions and   accepted people with unconditional positive regard. The Buddha offered empathy and accepted people such as Angulimala (a killer), Ammbapali (a prostitute), Sunitha (an untouchable), Soopaka (a victim of child abuse), Ajasathha (a King who committed patricide), Sachhaka (a pompous academic with extreme arrogance), Upali (a poor barber), Aalavaka (a callous cannibal) without any pre judgements. 

The Buddha believed in human freedom. Carl Rogers felt that it was irrelevant whether or not people really had free will. He further says we feel free when choices are available to us. Rogers pointed out that the fully-functioning person acknowledges that feeling of freedom, and takes responsibility for his choices. The Buddha doesn't reject the human freedom with complete responsibility for one's action.

Robert Carkhuff -one of the pioneers in Client Centered Therapy studied and worked with Carl Rogers. He published his outstanding book Towards Effective Counseling and Psychotherapy in 1967. Robert Carkhuff introduced seven co conditions such as empathy, respect, concreteness, genuineness, self disclosure, confrontation and immediacy. 

In psychotherapy immediacy is a vital module. The story of Rajjumala reveals the immediacy put into practice by the Buddha. Rajjumala was a domestic servant who became distressed by the ill treatments of her mistress. She decided to commit suicide and end her suffering. The Buddha intervened and saves her life. Then she was offered an alternative solution to be free from her slavery. Rajjumala accepts the spiritual path and becomes a free human being. She finds her liberation. This is a fabulous example of suicide prevention counselling and Robert Carkhuff's seventh co condition "immediacy" put in to action.  

The Existential Psychotherapy is a form of psychotherapy which aims at enhancing self knowledge. In Buddha's teaching existentialism is widely described. Buddhism brings up questions about ethics and the nature of our existence. The goals of existential therapy are to enable people to become more truthful with them, to widen their perspective on themselves and the world around them, to find clarity on how to proceed in the future while taking lessons from the past and creating something valuable to live for in the present. Also it helps to explore the client's physical, social, psychological and spiritual dimensions.

The Buddha used numerous existential approaches to provide insight and self growth. The story of Mattakundali illustrates such approach. Mattakundali was a young boy - a son of a greedy miser. Although his father was rich he did not like to spend on Mattakundali‘s illness and neglected his health needs. Mattakundali’s illness aggravated and he passed away without receiving appropriate medical attention. Upon his death the father became devastated and filled with grief and self guilt. He blamed himself for the death of Mattakundali. Practically every day he went to the cemetery and mourned for his dead son. 

The Buddha helped Mattakundali‘s father to resolve his unceasing grief using an existential approach. Hence Mattakundali‘s father realised the meaning of death and his grief reaction was resolved. 

The Viennese Psychiatrist and the NAZI Holocaust survivor Dr Victor Frankel introduced logo therapy. According to Logo Therapy the search for a meaning in life is identified as the primary motivational force in human beings. Frankel believed that humans are not fully subject to conditions but are basically free to decide and capable of taking their stance towards internal (psychological) and external (biological and social) conditions. Frankel encouraged his patents to find a meaning in their suffering.

According to Dr Victor Frankel people can discover this meaning in life in three different ways: (1) by creating a work or doing a deed; (2) by experiencing something or encountering someone; and (3) by the attitude we take toward unavoidable suffering" and that "everything can be taken from a man but one thing: the last of the human freedoms – to choose one's attitude in any given set of circumstances. 

The Buddha too encouraged his disciples to explore and search for meaning. Buddhist psychotherapy mainly deals with self-knowledge, thoughts, feelings and actions and being mindful of one’s momentary experience without judgment.  

The Acceptance and commitment therapy   is a form of clinical behavior analysis   used in psychotherapy. It is an empirically-based psychological intervention that uses acceptance and mindfulness strategies mixed in different ways (Plumb et al., 2009). Acceptance and Commitment Therapy is focused on six processes (acceptance, defusion, self, now, values, and action) that bear on a single overall target (psychological flexibility). Fung (2014) indicates some of the common tenets in Buddhism such as the Four Noble Truths and No-Self that has been adopted in the Acceptance and commitment therapy.  

The French Philosopher René Descartes argued that the mind a thinking thing can exist apart from its extended body and therefore, the mind is a substance distinct from the body, a substance whose essence is thought. The modern psychology views mind as the totality of conscious and unconscious mental processes and activities  by which one is aware of surroundings, and by which one experiences feelings, emotions, and desires, and is able to attend, remember, learn, reason, and make decisions. The Buddhism defines mind as a non-physical phenomenon which perceives, thinks, recognises, experiences and reacts to the environment.  

In the Buddha's teaching meditation has a special place. Meditation can be used for personal growth. Buddhist meditation practices have become a topic of widespread interest in both science and medicine. (Britton et al., 2014). 

The Buddhist meditation is a process of mental clarification and geared to direct perception. The purpose of Buddhist meditation therefore is to gain intellectual understanding of the universal truth. Buddhist Vipassana meditation gives realization of impermanence, suffering and non-self. The Mettha (loving-kindness) meditation helps to reduce anger and a perfect way to control aggressive feelings. 

Nemours researches concur the therapeutic effect of meditation to reduce stress and anxiety. Traditional Buddhist formulations describe meditation as a state of relaxed alertness that must guard against both excessive hyperarousal –restlessness and excessive hypoarousal -drowsiness, sleep (Britton et al., 2014).Today many psychotherapeutic centers use meditation as a successful therapeutic tool. 

The Buddha was a unique psychotherapist. His therapeutic methods helped millions of people throughout the centuries. Today the Western world has realized the psychological essence of Buddhism. Many Psychotherapeutic systems in the West derived from Buddha's teaching. Buddha showed empathy and non judgmental acceptance to everyone who came to him. He helped people to gain insight and helped in growth promotion while eliminating troubling and painful emotions. His therapeutic methods are exceptional and can be applied for all time.

References 

Britton, W.B. , Lindahl, J.R., Cahn, B.R., Davis, J.H., Goldman, R.E. (2014). Awakening is not a metaphor: the effects of Buddhist meditation practices on basic wakefulness. 

Ann N Y Acad Sci.  1307:64-81.  

Eysenck, H. J. (1947). The structure of human personality. New York: John Wiley and Sons, Inc

Frankl, Viktor. (2006). Man's Search for Meaning. Beacon Press.

Fung K.(2014). Acceptance and Commitment Therapy: Western adoption of Buddhist tenets?Transcult Psychiatry. 1363461514537544.

Haggerty, J. (2006). Psychodynamic Therapy. Psych Central. Retrieved from http://psychcentral.com/lib/psychodynamic-therapy/000119

Jayatunge , R.M. (2008) Buddhism and Psychology. AHAS Publications Sri Lanka 

Neale, M(2012), “What Buddhist Psychotherapy Really Is” Retrieved from  

http://www.milesneale.com/wp- content/uploads/2012/02/WhatBuddhistPsychotherapyReallyIs.pdf

Plumb,J.C.,   Stewart, I.,    Dahl,G.J.,   Lundgren, T (2009).   "In Search of Meaning: Values in Modern Clinical Behavior Analysis". Behav Anal. 32 (1): 85–103.  

Stevenson, I. (1974). Twenty Cases Suggestive of Reincarnation (2nd rev ed.). Charlottesville: University Press of Virginia.