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Whether the reader is looking for an introduction to Buddhist principles or an introduction to psychoanalysis, Mark Epsteins book, Thoughts Without a Thinker: Psychotherapy from a Buddhist Perspective, provides both. The author is a private psychiatrist in New York and practicing Buddhist. He is also consulting editor to Tricycle: The Buddhist Review, a major Buddhist periodical, and therefore has the qualifications to bring these two, traditionally opposing views, together. He does a good job of laying down the two fields side by side and drawing parallels. The result is new insight into psychoanalysis for both patient and therapist.
The book is organized into three easily digestible sections. This prevents the newcomer to one or both fields from being overwhelmed. Epstein outlines Buddhist teachings in psychodynamic terms in Section I, parallels meditation and analytic inquiry in Section II, and finally synthesizes the two by showing how Buddhist principles can be applied to psychodynamic therapy in Section III. Moving first through an introduction of basic Buddhist principles such as Samsara, the Four Noble Truths, and the Eight-Fold Path, the reader has a good sense of basic Buddhist teachings. In moving to meditation, the crux of Buddhist practice, Epstein draws a great analogy calling meditation "analysis turned inward." The last section provides personal cases and examples of how these principles have created new avenues for therapy in the authors practice and how the Buddhist practice of meditation readies the mind for therapy.
Epsteins book is a much better introduction to Buddhist philosophy than psychoanalysis. This is not surprising since dynamic therapy, or what most people would consider "Freudian" therapy is a diverse and evolving field. He introduces the reader to key figures in Dynamic therapy such as Freud, Jung, and Winnicott. As a psychiatry resident, I could not help but notice that the subtitle seemed to imply that psychoanalysis is equivalent to psychotherapy. In reality, it is only one of many psychotherapeutic approaches, such as cognitive behavioral or interpersonal therapy. Dynamic therapy does happen to lend itself to Epsteins approach since it is much more philosophically oriented. I propose several alternate subtitles, which may be more representative of the material covered, such as Buddhism from a Psychoanalysts Perspective or Psychoanalysis from a Buddhist Perspective.
The three major take away points from this work are 1) Buddhism dovetails nicely with dynamic therapy and is not at odds. A quote from Epsteins book puts this into focus. In speaking about the Buddha and his attainment of enlightenment he states, "Nothing was changed but the perspective of the observer. When asked, "What are You?" by an awestruck would be follower, the Buddha only responded, "I am awake."" 2) Meditation prepares the mind for therapy and decreases resistance, and 3) The goal in therapy and Buddhism is "not the absence of illness, but the presence of wellbeing."
Overall, I enjoyed reading this book since I am both a psychiatrist in training and religious studies enthusiast. Religion, since it is such a major part of many peoples lives, should be more easily brought into the therapeutic realm and not avoided, whether Buddhist, Christian, Hindu or Muslim. Mark Epsteins book was informative, stimulating and original with great implications for the future of psychotherapy. Besides, any book on Buddhism with a forward by the Dalai Lama is worth at least a quick peruse.
Thomas Cobb is currently a psychiatry resident at the University of Michigan. His interests include psychiatric resident education, neuropsychiatry, theology and religious history. He has reviewed psychiatric texts for other publishers and hopes to publish in the field soon. Future plans are in academic psychiatry with a focus on integrative approaches to the patient, from neurons to philosophy.
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