The Couch and the Cushion

My book, Freud and the Buddha: the Couch and the Cushion, aims to explore what two traditions dedicated to the alleviation of human suffering, psychoanalysis and Buddhism, can learn from each other.

Both traditions are concerned with the secrets of the mind and arise from careful observations by individuals of the inner workings of the mind. For psychoanalysis, the goal is an understanding of the unconscious which runs our lives and of which we are unaware; for Buddhist meditation, the goal is to free ourselves from unwholesome feelings, misperceptions, misunderstandings and even delusions that keep us from seeing reality as it actually is. There is no shortage of books on the general topic of psychotherapy and meditation. However, this book seeks to add a new perspective by examining these traditions through the eyes of a contemporary psychoanalyst trained in the classical Freudian tradition.

The reader will find both scholarly and experiential chapters by meditators and psychoanalysts. Included is a chapter containing a reprint of a classic paper on Buddhism and psychoanalysis by Nina Coltart, ‘The practice of psychoanalysis and Buddhism’ (2000), which served as part of the inspiration of this book. Her premise is: “There has never been, from the earliest days, any sense of conflict about combining the practice of Buddhism with that of full-time psychoanalysis. Of course there are differences … but there are many more extensive and subtle ways in which they flow in and out of each other, and are mutually reinforcing and clarifying.” Her words spoke directly to me as a classically-trained Freudian analyst shortly after I wandered into Buddhism about six years ago.

This happened because of my long-standing interest in psychoanalytic neutrality and in the fundamental psychoanalytic rule of free association (for the patient) and evenly-hovering attention (its counterpart for the analyst). Saying everything that comes to mind without critical judgment is a profound concept, unique in its simplicity; it is a special window into the mind. Freud viewed free association as the “fundamental rule” of psychoanalysis. Then, one morning, it occurred to me to there might be a similarity between what I, a psychoanalyst, do behind the couch as I listen to patients, and what I imagine Buddhist monks do when meditating. I was aware that Buddhist practitioners observe the mind without judgment and notice whatever comes to mind … and then let it go. I grew increasingly interested in the fact that they tend to do something similar to what I do, with the exception that every now and then I hold on to a passing thought and turn it into an articulated observation, a question, a clarification, or an interpretation.

 

The fundamentals of Buddhism and psychoanalysis

Buddhism is a philosophy, containing within it a unique, complex, and ethical psychology, aimed at relieving human suffering. Later divisions within Buddhism have led some schools to be construed as a religion, but it is more accurately a psychology without a creator or consoling deity. Psychoanalysis is a form of therapy that also treats human suffering. The contributors to this book explore the ways in which these two disciplines, each with its own history, share certain commonalities. Each of the authors is expert in Buddhism or psychoanalysis, or both, and describes his or her extensive experience, thinking, and feelings about their respective fields, enabling the reader to compare and contrast the essential features of each discipline. The contributors include a psychiatrist-author (Epstein), six psychoanalysts (Coltart, Fogel, Hoffer, Kostner, Savelle-Rocklin, and Weber), and a Buddhist scholar (Olendzki). They share many areas of agreement and, of course, some striking, fascinating differences. Each in his or her own way describes the problems of truly understanding such Buddhist concepts as clinging (attachment), impermanence, and the especially difficult to grasp Buddhist concept of ‘no-self’, as well as developing an appreciation of the Buddhist concept of suffering.

Of the three controversial areas that have arisen in this book, the first problematic area is free association, which can be seen by Buddhists as creating a distracting narrative. A second issue is the Buddhist view of the inherent limitation imposed by the conscious effort required to produce words. The third is the idea that even the pursuit of understanding can be a problem because it, too, can interfere with the immediate connection to direct experience.

Regarding free association, Olendzki asserts: “Anathema to the traditional psychotherapist, perhaps, Buddhist meditation is leading the mind to a state, not of enhanced free association, but of freedom from the affliction of free association entirely” (my italics). Dr. Olendzki here comes up with a statement sure to startle every analyst who views the psychoanalytic rule of free association as fundamental. But he explains it, stating that the free associations create a narrative, and the narrative itself is the problem. He continues: “The reflexive tendency of the mind to incessantly make a narrative of everything that arises in experience is itself the cause of much of our suffering, and meditation offers a refreshing refuge from mapping every datum of sensory input to the macro-construction of a meaningful self. In the flow of proper mindfulness practice, one is intensely aware of every episode of consciousness, but lets go of it so immediately in order to open to the next moment, that nothing “sticks” and it all ‘passes through’ the mind.”

Herein lies a fundamental difference between the analytic approach to the unconscious mind and the Buddhist approach to the mind as outlined by Olendzki. For the analyst, free association is the fundamental rule, the basis of the method which provides access to the unconscious. If the analyst eschews free association, what are the alternatives? Analysts value and depend on the narrative to deepen the understanding of the unconscious and how the unconscious, unbeknownst to us, affects how we live our lives. How would analysts function without the fundamental rule? Olendski argues that the self, by instantly turning everything into a narrative, obscures and distorts experience. He suggests that Buddhism offers an alternative: one uses mindfulness to explore the deep and systematic exploration of what really is.

There is also a conflict regarding the use of words between psychoanalysis and Buddhism. Olendzki points out that it takes mental work to put words together and that work distracts us from the immediacy of experience. Olendzki’s line of thinking affirms the Buddhist priority of awareness over insight. Thus, his focus on direct experience of unconscious and conscious communication leads us to question the creation of words, narratives, and even intellectual understanding (insight). Importantly, awareness in meditation gives no priority to words; meditation doesn’t need words.

By contrast, free association, while by no means limited to words, is closely linked to words in practice. Memories are naturally expressed in words. The uncovering of memories, and using words, is a vital aspect of psychoanalysis. The interruption of the patient’s flow of associations, usually in the form of words, is often an important indicator of unconscious intrusion, calling for analytic exploration. Olendzki raises important questions which cannot be ignored: “The knowing of facts, even important facts about one’s own history and inner workings, involves the aggregate of perception more than the aggregate of consciousness, and thus must be mediated through language and conceptual thought. A fatal limitation of all forms of talking therapy, from the Buddhist perspective, is that it must be cast into language in order to be both created and understood, which ensures that it is passing through interpretive filters” (my italics). He continues: “Even if this can be minimized by free association and the bypassing of normal editing processes, it is still a product of perception and thus represents just another chapter in the story.” Here he makes another important point: “We are inevitably distracted from direct experience by the mental effort required to create language. Language cannot help but create a new distance from the immediacy of experience in order to accomplish the cognitive work necessary to form the descriptive words necessary for communication to another. Meditation doesn’t require words.”

If psychoanalysts question the use of words, what are they left with? Nonverbal communication? Silence? Shared silent meditation? Carefully chosen words limited by rationing? In response to this wordless emphasis on direct, unmediated awareness of experience, I can’t help but raise the question of whether intuition is here being excessively glorified and perhaps idealized. My own conclusion is that we have to embrace a new awareness of the impediments and limitations that the creation of words imposes on us. Finally, in her chapter, Dr. Weber raises a third important question that bears on some of the differences we have been following between the Buddhist and psychoanalytic approaches. Does the analytic commitment to pursue understanding interfere with an immediate connection with the patient’s experience? By this question, Dr. Weber challenges another fundamental principle of thought—namely that insight and understanding, including emotional understanding, are important goals of psychoanalysis. Dr. Weber is not only suggesting that the pursuit of understanding interferes with immediate, direct awareness and communication, but, even more, she questions whether we should be pursuing understanding all together. Weber (and also Bion) see “understanding” as a “bug-bear.”

What do they see as the problem with understanding? Just as Dr. Epstein has pointed out Winnicott’s affinity for Buddhism, I have had a long-standing suspicion that Bion’s writing has been strongly influenced by Buddhism. For example, Bion (1967a) stated: “Psychoanalytic observation is concerned neither with what has happened nor with what is going to happen but with what is happening” (italics in the original). Aguayo (2014), describing Bion’s Los Angeles seminars (1967), states that Bion, along with telling analysts that they need to abandon memory and desire, “urged the analyst to abandon the regurgitation of previous formulas, or the recitation of ‘brute facts’ embedded in the ‘desire to understand.’ It was important to forget what one knows in the immediacy of the current session, so that some new (and heretofore unknown) pattern might be allowed to evolve.” To me, that sounds like a Buddhist open mind. Not surprisingly, Pelled (2007) has also compared Bion’s concept of reverie with Buddhist meditation.

Conclusion

In retrospect, and supported by the detailed comparison of Buddhism and psychoanalysis that I explore in this book, there has been a growing awareness that Freud’s legacy, brilliant as it is, has favored thinking and understanding (left brain) over feeling (right brain). This has also led to the minimizing of the importance of the role of the real, actual, relationship between analyst and patient. Therapeutic action, which was originally understood as primarily a result of the unconscious becoming conscious, is now also more clearly seen as a function of the relationship between analyst and patient. Current attention to intersubjectivity and the interpersonal field has served as a welcome corrective and deepened psychoanalytic understanding of transference and countertransference. The age-old debate about the role of thinking and feeling in human experience, while still far from being resolved, is deepening.

The future of psychoanalysis, in my opinion, lies in adding new insights about the central role of the body and its relation to feeling to the valuable corpus of psychoanalytic thought. Both Freud’s original concept of unconscious communication and the Buddhist notion of interbeing (French: interêtre, a word coined by Thich Nhat Hahn, 1988) will be enriched by the meditators and psychoanalysts of the future.

Axel Hoffer, MD, is a Training and Supervising Analyst in Boston and Associate Professor of Psychiatry (part-time) at Harvard Medical School. He won the Journal of the American Psychoanalytic Association prize for his paper ‘Toward a definition of psychoanalytic neutrality.’ He has also written the Foreword to Freud’s monograph ‘A Phylogenetic Fantasy’, and the Introduction to the second volume of the Freud-Ferenczi Correspondence. He has lectured and supervised in the United States, Europe, Eastern Europe, Russia and Israel.  His new book, Freud and the Buddha: the Couch and the Cushion, is published this week by Karnac Books.