4 0 Kumar

Marlatt, G. A. (2002). Buddhist philosophy and the treatment of addic- tive behavior. Cognitive and Behavioral Practice, 9, 44-50.

Mikulas, W. L. (1978). Four noble truths of Buddhism related to behav- ior therapy. Psychological Record, 28, 59-67.

Mikulas, W. L. (1981). Buddhism and behavior modification, l~sycholog- ical Record, 31, 331-342.

Nhat Hanh, T. (1998). The heart of the Buddha's teaching: Transforming suffering into peace, joy, and liberation. Berkeley, CA: Parallax Press.

Ramaswami, S., & Sheikh, A. A. (1989). Buddhist psychology: Implica- tions for healing. In A. A. Sheikh & K. S. Sheikh (Eds.), Healing east and west: Ancient wisdom and modern psychology (pp. 91-123). New York: John Wiley & Sons.

Robins, C.J. (2002). Zen principles and mindfulness practice in dia- lectical behavior therap}: Cognitive and Behavioral Practice, 9, 50- 57.

Ross, N. W. (1980). Buddhism: A way ofli[b and thought. New York: Vin- tage Books.

Shapiro, D. H. (1978). Instructions for a training package combining

formal and informal Zen meditation with behavioral self-control strategies. Psychologia, 21, 70-76.

Shapiro, D. H., & Zifferblatt, S. M. (1976). Zen meditation and behav- ioral self-control: Similarities, differences, and clinical applica- tions. American Ps~ychologist, 31, 519-531.

Trmeatto, T. (2002). A metacognitive therapy for anxiety disorders: Buddhist psychology applied. Cognitive and Behavioral Practice, 9, 72-78.

Watson, G., Batchelor, S., & Claxton, G. (Eds.). (2000). The psychology of awakening: Buddhism, science, and our day-to-day lives. York Beach, ME: Weiser.

Address correspondence to Peter E. Campos, Ph.D., PRN DATA Health Research Services, 3080 Vine Circle, Decatm; GA 30033-5153; e-mail: pcampos@prndata.com.

Received: January 10, 2000 Accepted: February 20, 2001

• • • • • • • • • • • • • • • • • • • • • • • • • • • • •

An Introduction to Buddhism for the Cognitive-Behavioral Therapist

S a m e e t M. K u m a r , University o f M i a m i

Basic concepts in Buddhism are presented for cognitive-behavioral therapists. Buddhist theoretical causes of suffering are presented as extensions of cognitive assumptions of selfhood. The essentialist position is contrasted to the Buddhist perspectives of dialectics and interdependence. The focus on impermanence in Buddhist thought is presented. The synergistic relationship between compassion and mindfulness is examined. Compassion as both behavioral alternative to essentialism as well as precursor to mindfulness is dis- cussed. Additionally, mindfulness meditation from the Buddhist perspective is presented.

OTH B u d d h i s m a n d psychology seek the faci l i tat ion

o f growth, insight , and m e a n i n g f u l c o n n e c t i o n with

o the r s and f r e e d o m f r o m suffer ing. T h e r e c e n t d i a logue

b e t w e e n psychology a n d B u d d h i s m has resu l ted in the ac-

c e p t a n c e o f Buddh i s t med i t a t i ona l t e c h n i q u e s and pr in-

ciples by m a n y cl inic ians and the i r clients. A l t h o u g h

m u c h i n f o r m a t i o n exists on specific t e c h n i q u e s a n d prac-

tices re levan t to cl inical psychology, the or ig ina l c o n t e x t

and ra t iona le o f these pract ices r emains a mystery to

many psychologists , as well as clients. T h e pu rpose o f this

ar t icle will be to p r e sen t concise ly the basic p remises o f

B u d d h i s m for the cogni t ive-behaviora l therapis t .

Given the i n h e r e n t complex i ty in s u m m a r i z i n g a

2,500-year-old system, this p r e sen t a t i on has no p recon-

cep t ions o f b e i n g c o m p r e h e n s i v e , a n d will u n d o u b t e d l y

be insuff ic ient to those a l ready famil iar with the basic te-

nets o f Buddh i sm. It shou ld also be p o i n t e d o u t that the

topics that a re p r e s e n t e d h e r e do n o t e n c o m p a s s the to-

tality o f Buddh i sm, o r o f all "Buddhisms ."

C o g n i t i v e a n d B e h a v i o r a l P r a c t i c e 9 , 4 0 - 4 3 , 2 0 0 2

1077-7229/02/40-4351.00/0 Copyright © 2002 by Association for Advancement of Behavior Therapy. All rights of reproduction in any form reserved.

D e f i n i t i o n s o f B u d d h i s m

Buddhism is a very b r o a d g e n e r a l i z a t i o n r a t h e r t h a n a

specif ic t e rm. In t he U n i t e d States, the p o p u l a r i z a t i o n

o f B u d d h i s m has r e su l t ed in an a m a l g a m a t i o n o f di-

verse B u d d h i s t t r ad i t ions f r o m all ove r Asia. A l t h o u g h

all schools o f B u d d h i s m sha re basic tenets , it is impor -

t an t to u n d e r s t a n d tha t on the level o f dai ly p rac t i ce ,

the B u d d h i s m p r a c t i c e d in Sri L a n k a di f fers signifi-

cant ly f r o m tha t p r a c t i c e d in M o n g o l i a . T h e i n f o r m a -

t ion p r e s e n t e d in this p a p e r can t h e r e f o r e n o t be ex-

haus t ive to all de f in i t i ons o f B u d d h i s m , b u t is basic to

m o s t o f t h e m .

In add i t ion , A m e r i c a n B u d d h i s m is still in its infancy,

a n d can in i tself be seen as a syncre t i sm o f d i f f e r e n t

s t reams o f p rac t ice . To be fair to the reader , it s h o u l d be

n o t e d tha t the a u t h o r is m o r e fami l i a r wi th T i b e t a n

B u d d h i s m t h a n o t h e r B u d d h i s t t radi t ions . This e m p h a -

sis on T i b e t a n sources is n o t m e a n t to m i n i m i z e the

va lue o r c o n t r i b u t i o n s o f o t h e r schools such as Zen, bu t

is r a t h e r a r e f l ec t i on o f the a u t h o r ' s own e n c o u n t e r wi th

B u d d h i s m .

It is i m p o r t a n t to n o t e that the classification o f Bud-

dh i sm remains controvers ia l . As a body o f bel iefs con-

t a ined in temples , rituals, doc t r ine , and a large body of

An Introduction to Buddhism 41

monks, it certainly bears an outward resemblance to an organized religious system. However, Buddhism does not postulate the existence of a creator being, deity, or h igher power. The deif ied beings por t rayed in Chinese and Ti- be tan iconography can be unde r s tood to be personifica- tions of medi ta t ional practice, or even of certain texts. Therefore , for some scholars, Buddhism appears to be more of a ph i losophy than a religion.

I n d e p e n d e n t of its academic classification, Buddhism shares with clinical psychology the motivation to facilitate beneficial growth and change on individual and societal levels. One of the fundamenta l assumptions of Buddhism is the inheren t evolut ionary potent ia l within each indi- vidual toward con t inued growth.

Because of its emphasis on growth and evolution, Bud- dhism was embraced by many existentialists and human- ists as it ga ined popular i ty in the sixties. The assumption of evolut ionary potent ia l is clearly relevant for cognitive- behavioral therapists as well. In Buddhism, spiri tual evo- lut ion occurs mainly as a result of investigating underly- ing cognitive assumptions about our percep t ion of self and other. In o rde r to unde r s t and what these cognitive processes are, it is impor t an t to under s t and the basic as- sumptions of Buddhism.

Historical Origin

Buddhism was founded in the sixth century B.C.E. in nor th India by a man named Siddhar ta Gautama. As the heir of a local pr incely state, he was born and raised in a she l te red life of luxury and ease beh ind the walls of a pal- ace. However, d isgrunt led at his lack of knowledge about his subjects, he ven tured outside the palace walls in a se- ries of covert tours. On these tours, he was conf ron ted by the ubiquity of suffering evident in the forms of poor, sick, aged, and dying people . Thrown into an existential crisis as a consequence of these encounte rs with suffer- ing, he vowed to r enounce his worldly life in o rde r to bet- ter under s t and the h u m a n condi t ion. After several years of pe r fo rming various austerities in the company of wan- der ing ascetics, he became convinced that the ext remes of hedonis t ic glut tony and ascetic self-mortification d id no t ho ld the answers he was seeking. Siddhar ta that day resolved to medi ta te unti l he had e i ther d ied or ga ined full en l igh tenment .

After sitting u n d e r a banyan tree for many nights, and after mindful ly endur ing temptat ions such as hunger, thirst, and lust, he expe r i enced total clarity and insight. After spend ing nearly 7 weeks digest ing this moment , and deba t ing his ability to t ransmit his realization to others, he taught the first of several se rmons in which he e x p o u n d e d the Four Noble Truths. F rom this mo- m e n t after, he became known as the Buddha , o r Awak- ened One.

The Buddhist Path

The Four Noble Truths simply state that (a) suffering is ubiquitous; (b) suffering is a consequence of the auto- matic tendency to cling to phenomena ; (c) the cessation of suffering is possible; and (d) this cessation can be achieved by pract ic ing the Eightfold Noble Path. This path consists of f ight vision, concept ion, speech, con- duct, l ivelihood, effort, mindfulness, and concent ra t ion (Thrangu, 1993). Taken together, the Eightfold Path di- minishes the tendency to cling to p h e n o m e n a while en- r iching the full exper ience of life.

In the Buddhis t context , suffering is an inal ienable par t o f existence inf lamed by any a t t empt to conta in it. Suffering is genera ted by the menta l t endency toward es- sentialism, whose repercussions are of pr imary impor- tance in Buddhism. Essentialism refers to the assumption of a discrete, f ixed self and identity, i n d e p e n d e n t of ex- ternal envi ronmenta l influences or in ternal physical pro- cesses. This no t ion results from the menta l t endency to perceive continui ty while exper ienc ing the passage of time. Al though simple and efficient, essentialism is viewed as an e r roneous templa te because in pos tu la t ing a fixed self, it s imultaneously assumes a fixed other, result- ing in a d ichotomy of self versus other. This dual ism also results in the polar izat ion of thoughts, emotions, and ex- per iences as attractive or aversive in o r d e r to mainta in a p leasant sense of well-being to the assumed, discrete self (Gyatso, 1997). The result is re fer red to as self-cherish- ing. Ultimately, it is f rom self-cherishing as a conse- quence of essentialism that we re inforce a tendency to cling to phenomena . This is in contras t to the Buddhis t concept of selflessness, or emptiness.

F rom the po in t of view of emptiness, p h e n o m e n a arise from a dialectical conf luence of their components . Dia- lectical emergence , unl ike essentialism, does not rely on a concep t of discrete, i n d e p e n d e n t self. Instead, the dia- lectical perspective postulates an infinitely complex and in te rconnec ted web of causes and effects s imultaneously shaping each o ther across mul t ip le levels of analyses. F rom the perspective o f Buddhis t dialectics, all phenom- ena, ranging from feelings to physical structures, are t emporary confluences of mul t ip le influences. If the sim- pler essentialist perspective can be visualized as a tennis match between the two players of self and other, complex dialectical emergence can be visualized as a gradual ly un- folding, f luid latticework.

Self-cherishing should no t be confused with m o d e r n psychological constructs such as self-esteem. It refers in- s tead to the cognitive assumption that identi ty is a stable and i n d e p e n d e n t entity. Because of the automat ic ten- dency toward self-cherishing, we exper ience the inevita- ble changes to ourselves, and others, as suffering. In try- ing to ho ld on to the stability of a passing moment ,

4Z Kumar

feeling, or relat ionship, we struggle against the natural i m p e r m a n e n c e of all phenomena . Al though self-cherish- ing can be beneficial to a l imited extent, it ahnost always, in this context , leads to the exper ience of suffering; we exper ience suffering as the natural o rde r of in te rdepen- dence and i m p e r m a n e n c e constantly manifests itself. In seeking con t en tmen t within the confines of a fixed self, we sow the seeds of our suffering as identi ty is constantly chal lenged, changed, and m o l d e d by the very factors in- volved in its construct ion. For this reason, the Four Noble Truths address the origins and causes of suffering, as well as its antidotes.

The i m p e r m a n e n c e of all p h e n o m e n a can be contex- tualized in the i m p e r m a n e n c e of life itself. In Buddhism, fear of i m p e r m a n e n c e and dea th is seen as a major con- t r ibutory factor to self-cherishing. By embrac ing these fears as well as the pr incip le of impermanence , we also combat self-cherishing. Buddhis t pract ice can involve daily reflections on the certainty and unpredic tabi l i ty of death. Like suffering, existential tensions concern ing mortal i ty also grow when at tempts are made to deny or contain them. By reflect ing on death, the motivat ion of the prac t i t ioner becomes s t ronger to engage in p rope r pract ice and resul tant behaviors lest dea th be close by (Gampopa , 1998). Reflect ing on death, like ref lect ing on the causes of suffering, can weaken the t endency of self-cherishing.

Within the context of i n t e r d e p e n d e n t existence, all actions have resul tant consequences. The law of cause and effect, or karma, plays a central role in the ra t ionale beh ind ethical behavioral pr inciples presented in the Four Noble Truths. Karma literally means "action," or "behavior" (Brazier, 1995). Stated simply, karma theory states that the consequences of our behaviors are evident at mul t ip le levels of analyses, not l imited to our perceived individuality. However, like a boomerang , these conse- quences, wholesome and harmful , tend to be red i rec ted back to the behavioral agents that or iginate their exis- tence. Since Buddhism is conce rned with the alleviation of suffering, becoming aware of harmful consequences is essential for genera t ing positive behaviors that will l imit them.

Compassion and Mindfulness Loving-kindness is a Buddhis t practice of pr imary im-

por tance that integrates the theory of karma with the pr incip le of i n t e rdependence in o rde r to l imit self- cherishing. An acceptance of the ubiquity of suffering is necessary for compassion to arise. Loving-kindness, often t ranslated as compassion, involves cultivating an at t i tude of universal, uncondi t iona l acceptance. With this atti- tude, essentialist boundar ies that define self and o ther tend to dissipate as one develops compass ionate equa- nimity toward all living beings. Compassion is def ined as

active caring, in contrast to the more passive connota- tions of pity or sympathy (Gyatso, 1994).

We become aware of the l imitat ions of our compassion in a t tempt ing to apply it in everyday life. Genera t ing awareness of these l imitat ions is an essential founda t ion for the deve lopmen t of mindfulness. In the cognizance of our l imitations, a compassionate , accept ing at t i tude toward ourselves forms the f o u n d a t i o n for mindfu l - ness while s t rengthening a compass ionate stance toward others. Mindfulness is therefore an extension of a com- passionate att i tude, while at the same t ime compassion is necessary for mindfulness. Indeed , mindfulness and compassion are frequently discussed as two inter twined aspects of practice in Buddhis t l i terature.

Mindfulness is a pr imary pract ice used in Buddhis t medi ta t ion techniques. On a basic level, it involves follow- ing the rhythmic mot ion of the b rea th with an a t t i tude of nonjudgmenta l , present -centered awareness (Kabat- Zinn, 1990). This awareness is directed toward all thoughts, feelings, and sensations that occur dur ing practice. Fre- quently refer red to as distractions, they form the basis for developing equanimity and acceptance. The pract ice of mindfulness does not seek to "empty the mind"; instead, it is a much greater feat to observe, with acceptance, how full the mind actually is. When appl ied sporadically, mindfulness can be extremely relaxing. However, when appl ied regularly, mindfldness can be a revolut ionary and t ransformat ive cognitive, emot iona l , and spir i tual exper ience.

It is paradoxical that in o rde r to facilitate mindfulness of our own thoughts, feelings, and sensations, we must first enable ourselves to be more compass ionate toward others. However, this pa radox lies at the hear t of the Bud- dhist path that seeks f reedom from suffering for all be- ings, and does not dist inguish between self and other. Ad- ditionally, the fact that compassion for others precedes mindfulness of one ' s own behaviors is fur ther verification of the interconnectedness of all beings (Rinpoche, 1991).

Cyclic Existence Greater menta l clarity, achieved by sustained mindful-

ness practice, is a necessary founda t ion for the develop- men t of wisdom and insight. Medi ta t ion is therefore con- s idered to be a pr imary vehicle for facili tating clarity, and is therefore essential for spiri tual development . Accord- ing to Buddhism, the spiri tual progress of one lifetime lays the founda t ion for spiri tual progress in the next life- time. Each lifetime is an effect caused by actions in the previous existence. Beings re incarnate due to karmic res- idue and countless in te rconnec ted links that have accu- mula ted over many lifetimes. This cycle of existence, s a m -

sara, comple te with endless repet i t ions of bir th, o ld age, and death, is wrought with suffering, yet is the only op- por tuni ty for spiritual development . Indeed , it is only

An Introduction to Buddhism 43

th rough spiri tual pract ice that l iberat ion from cyclic ex- istence can occur. Spiri tual growth, occurr ing th rough the practices of medi ta t ion and compassion, gradually re- duces self-cherishing tendencies that result in aggression and greed, c lear ing the way for fur ther progress and growth in subsequent lifetimes (Rinpoche, 1991).

En l igh tenmen t is synonymous with f r eedom from suf- fering, as well as total clarity and insight into the nature of all phenomena . In o r d e r to at tain this goal, the anti- dote to essentialism needs to be appl ied, like medicine, with p r o p e r dosage, adminis t ra t ion, and compliance. Buddhis t pract ice is ul t imately buil t a round f r eedom from suffering, and en l igh t enmen t is the furthest evolu- t ionary extension of this f reedom.

Conclus ions

The informat ion summar ized in this pape r should no t be confused with a comprehens ive presenta t ion of Bud- dhism. Indeed , the Buddhism presen ted here may itself be an empty p h e n o m e n o n const ructed to suit the needs of 21st-century psychotherapy. It should be no ted that this par t icular construct ion has occur red by the author ' s own exper ience with Tibetan Buddhism, and so should not be confused as a universal guide to Buddhis t practice for the clinical psychologist. Instead, only an a t t empt was made at present ing some of the relevant founda t ion stones in the Buddhis t context .

There may be d i sagreement by some readers as to the value of certain terms and the exclusion of others. Addi- tionally, this presenta t ion lacks many of the lengthy lists c o m m o n to presenta t ions of Buddhism. This was a delib- erate choice by the au thor to presen t a focused snapshot of a complex deve lopmenta l j ou rney without excessive j a rgon . This also emphasizes the relative diversity of Bud-

dhist tradit ions, and the construct ion of a newer, emerg- ing Amer ican Buddhism.

There is ne i the r sufficient space for a discussion of dif- fe rent Buddhisms, no r is this the appropr ia t e fo rum for such a discussion. Instead, the concepts p resen ted in this pape r can be used to guide the clinical psychologist in fur ther explorat ions in the subsequent articles. As Bud- dhist concepts and practices gain grea ter acceptance in cur ren t therapy practice, it is impor t an t to gain an under- s tanding of the original context of this knowledge. Such an under s t and ing will undoub ted ly be enr ich ing for both Buddhism and psychology, as bo th strive to improve the h u m a n condi t ion.

References

Brazier, D. (1995). Zen therapy: Transcending the sorrows of the natural mind. New York: John Wiley & Sons.

Gampopa. (1998). The jewel ornament of liberation: The wish-fulfilling gem of the noble teachings. (K. K. Gyaltsen, Trans.). Ithaca, NY: Snow Lion Publications.

Gyatso, T. (1997). Sleeping, dreaming, and dying." An exploration of con- sciousness with the Dalai Lama. Boston, MA: Wisdom Publications.

Gyatso, T. (1994). A flash of lightning in the dark of night: A guide to the Bodhisattva's way of life. (Padmakara Translation Group, Trans.). Boston, MA: Shambhala Publishing.

Kabat-Zinn,J. (1990). Full catastrophe living: Using the wisdom oJ your body and mind to face stress, pain, and illness. New York: Dell.

Rinpoche, E (1991). Liberation in the palm of your hand: A concise discourse on thepath to enlightenment. (M. Richards, Trans.). Boston, MA: Wis- dom Publications.

Thrangu, K. (1993). The practice of tranquility and insight: A guide to Tibetan Buddhist meditation. (R Roberts, Trans.). Boston, MA: Shambhala Publishing.

Address correspondence to Sameet Kumar, Ph.D., Mt. Sinai Compre- hensive Cancer Center, Psychosocial Services, Miami Beach, FL 33140; e-mail: sameetkumar@yahoo.com.

Received: January 10, 2000 Accepted: February 20, 2001