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  • Written by  Miles Neale
  • // Saturday, 11 February 2012 21:21
Miles Neale

What Buddhist Psychotherapy Really Is: Part 2 Treatment

Treatment Methods in Buddhist Psychotherapy

It is clear that all psychotherapies emphasize introspection aimed at self-understanding and rely on the healing relationship. The Buddhist method in particular, incorporates an insight-oriented dialog and interpersonal role-modeling during the session with a contemplative educational triad of meditation, study, and lifestyle between sessions.


Insight-oriented Dialog

Similar to the methodology of cognitive therapies, in the Buddhist approach therapist and patient work together to identify dysfunctional mental patterns of thinking, feeling, and behaving that stem from a patient’s identification with their traumatic narrative. Once these specific issues are recognized, patients are prepared to use the healing relationship as an emotional corrective and employ meditation techniques to counter their particular cognitive-affective-behavioral habits.  A vital nexus exists between the interpersonal process of therapy and the individual process of meditation that enhances the work of both.  While the therapeutic dialog helps to uncover specific aspects of consciousness that need working through, meditation provides access to consciousness itself for the purposes of self-correction and intentional redirection.  The integration of therapy and meditation helps fill the gap that either method alone might neglect.

For example, I have observed how some meditators who have not undergone therapy possess blind spots in their personality issues and defenses, and therefore bypass their core conflicted tendencies resulting from past traumas. Conversely, I have observed some overly therapized patients without a meditation practice struggle to leverage their personal insights into a sustainable action plan towards transformation. But when a patient possesses specific insight into his or her personal issues, has a consistently available emotional guide in the therapist or meditation teacher, and engages in a customized meditative program to meet their target goals, then the process of healing is enhanced and expedited.


Again, similar to that of psychoanalytic therapies, the Buddhist method harnesses the dynamics of human interaction within the context of the therapeutic relationship.  Particularly relevant is the process of mentor-bonding in which the therapist symbolically represents a healthier parental figure that deeply understands and accepts the patient, thus allowing them to internalize validation, self-acceptance, and security.  Essentially, the therapist becomes a positive role-model and supplants the patient’s ridged identification with dysfunctional self-images and beliefs reinforced by limited caregivers, themselves traumatized during childhood.  I have discussed elsewhere how long-term therapy becomes a process of reparenting a patient within an ethos of wisdom and compassion, so that the patient, in turn, becomes a role model and active agent to others in the restructuring of an enlightened society.

Contemplative Education

Buddhist psychotherapy offers a comprehensive contemplative education that includes a number of meditation techniques designed to enhance introspection, develop awareness, cultivate positive emotions, and evoke insight.  These methods are not faith-based; rather, to be effective they require a person to apply personal effort.  As such, they complement weekly therapy sessions, empowering a patient in an internal process of daily mental training that enhances and augments the therapeutic process between sessions.

Meditation comes from the Sanskrit word bhavana, meaning to familiarize or to cultivate the mind.  Individuals typically cultivate the mind towards obsession, repulsion, and self-preoccupation, resulting in depression, anxiety, and narcissism. Buddhist meditation offers a number of antidotes to counteract such afflictions and redirect the mind towards healthier states.  Concentrative meditations (shamata), such as mindfulness of the breath, help still and clarify the mind on a single object of focus, eliminating its usual mode of dullness and agitation.  Contemplative meditations on the four sublime attitudes (brahma viharas), cultivate loving kindness, compassion, joy, and impartiality towards self and others, thus overriding our tendencies towards, hatred, disinterest, envy, and prejudice.  Analytic meditations (vipassana) use discursive examination to penetrate erroneous and deeply held convictions regarding the ontological status of the self and phenomenon, thereby revealing their transient and relative nature and changing our relationship towards them.  Finally, visualizations and performance scripts (sadhana) of the tantric tradition, help to capitalize on the healing potential of the brain and nervous system, using euphoric openness to expedite a process of creative redesign and internalization of a heroic, rather than traumatic, self-image. 

In the Buddhist contemplative educational method, meditation techniques are not practiced in isolation but are conjoined with contemplative study and lifestyle modification to forge a comprehensive rehabilitation program known as the three trainings (trishiksha), with the depth, power, and sophistication to transform the whole person.  In this three-pronged approach, meditation (samadhi) corrects imbalanced mental attitudes of addictive clinging and defensive hostility, the empirical study of the nature of reality (prajna) corrects unrealistic outlooks that reify and identify a self alienated from the world, and a conscious code of conduct (shila) corrects reckless lifestyles that endangers self and others.  In the approach taken at the Nalanda Institute for Contemplative Science, an educational Four-Year Program covering wisdom and ethics as well as group practice of meditation and yoga supplements individual mentoring and counseling.  Those interested in learning more about the complete three-pronged system of meditation, wisdom, and ethics are referred to my article critiquing the modern, pop-culture, one-pronged approach I call McMindfulness.

In sum, Buddhist psychotherapy combines three major elements into its practice: 1) interpersonal dialog aimed at recognizing core issues and blind spots specific to a patient's identification with their traumatic narrative; 2) role-modeling aimed at providing a corrective emotional experience within the long-term process of reparenting; and, 3) individual meditation training yoked with wisdom and ethics, which empowers a patient in their own process of conscious self-correction.

This brief review was intended to introduce some of the key elements that distinguish the Nalanda approach to Buddhist psychotherapy from conventional therapies.  Less than three decades old, Buddhist psychotherapy in general has a growing presence in both mainstream culture and professional circles. It is deeply penetrative in its recognition of the human condition of suffering, tracing it to a root cause of self-reification and identification with a traumatic narrative.  It is extremely generous in its therapeutic goal, honoring man’s innate potential to achieve complete freedom and sustainable happiness.  It is uniquely far-reaching in its view of evolutionary development, proposing an infinite life paradigm aligned closely with our own scientific theories on biological evolution and the conservation of energy.  Finally, Buddhist psychotherapy is comprehensive and multi-modal in its praxis, combining individual with interpersonal correctives, leveraging insight and positive affect with behavioral change, empowering a patient to intervene in their own conscious development with training periods between sessions, and using a holistic three-pronged approach to address outlook, attitude and lifestyle.  While Buddhist psychotherapy still requires theoretical coalescing and standardization, and certainly may not appeal to the sensibilities of all individuals, it does address gaps left by contemporary psychotherapies and has much to offer those embarking on a spiritual path towards self-healing.


Loizzo, J. (2012). Sustainable Happiness: The Mind Science of Wellbeing, Altruism and Inspiration.  Routledge.

Loizzo, J.  (2000). Meditation and Psychotherapy. In Complementary and Alternative Medicine and Psychiatry, Phillip Muskin (ed.). American Psychiatric Association.

Rubin, J. (1996). Buddhism and Psychotherapy: Towards an Integration. Springer. 

Walsh, R. (2007). Contemplative Psychotherapies. In Current Psychotherapies, 8th      Edition. Wadsworth.

Wilber, K. (1993). Spectrum of Consciousness. Quest Books.


Click here to read part 1