Thoughts Without A Thinker

Psychotherapy from a Buddhist Perspective


By Mark Epstein

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Blending the lessons of psychotherapy with Buddhist teachings, Mark Epstein offers a revolutionary understanding of what constitutes a healthy emotional life

The line between psychology and spirituality has blurred, as clinicians, their patients, and religious seekers explore new perspectives on the self. A landmark contribution to the field of psychoanalysis, Thoughts Without a Thinker describes the unique psychological contributions offered by the teachings of Buddhism. Drawing upon his own experiences as a psychotherapist and meditator, New York-based psychiatrist Mark Epstein lays out the path to meditation-inspired healing, and offers a revolutionary new understanding of what constitutes a healthy emotional life.



Also by Mark Epstein, M.D.

Going to Pieces Without Falling Apart

Going on Being

Open to Desire



Mark Epstein, M.D.

A Member of the Perseus Books Group

Parts of chapter 5 previously appeared in different form in Tricycle: The Buddhist Review as “Freud and Dr. Buddha: In Search of Selflessness,” Tricycle 1, no. 3 (spring 1992).

Copyright © 1995 by Mark Epstein, M.D.

Published by Basic Books, A Member of the Perseus Books Group

Hardcover edition first published in 1995 by Basic Books
Paperback edition first published in 1996 by Basic Books

All rights reserved. No part of this book may be reproduced in any manner whatsoever without writ-ten permission except in the case of brief quotations embodied in crit-ical articles and reviews. For information, address Basic Books, 387 Park Avenue South, New York, NY 10016-8810.

The Library of Congress has catalogued the previous edition as follows: Epstein, Mark, 1953–

        Thoughts without a thinker: psychotherapy from a Buddhist perspective / Mark Epstein.
                p. cm.

     Includes index.

     ISBN: 978-0-465-00477-5

1. Buddhism—Psychology. 2. Psychotherapy—Religious aspects—Buddhism. 3. Meditation—Buddhism. I. Title.

     BQ4570.P76E67 1995

     616.89'14' 0882943—dc20


For Arlene

It has been put rather differently by Pirandello as the title of a play—Six Characters in Search of an Author. But why stop at that? Why should it not be something which is even smaller; more fragmentary than that? It is a thought wandering around for some thinker to lodge itself in.

—W. R. Bion


Foreword by the Dalai Lama



Introduction: Knocking on Buddha's Door


Chapter 1 The Wheel of Life: A Buddhist Model of the Neurotic Mind

Chapter 2 Humiliation: The Buddha's First Truth

Chapter 3 Thirst: The Buddha's Second Truth

Chapter 4 Release: The Buddha's Third Truth

Chapter 5 Nowhere Standing: The Buddha's Fourth Truth


Chapter 6 Bare Attention

Chapter 7 The Psychodynamics of Meditation


Chapter 8 Remembering

Chapter 9 Repeating

Chapter 10 Working Through



Foreword by the Dalai Lama

THE PURPOSE OF LIFE is to be happy. As a Buddhist I have found that one’s own mental attitude is the most influential factor in working toward that goal. In order to change conditions outside ourselves, whether they concern the environment or relations with others, we must first change within ourselves. Inner peace is the key. In that state of mind you can face difficulties with calm and reason, while keeping your inner happiness. The Buddhist teachings of love, kindness, and tolerance, the conduct of nonviolence, and the theory that all things are relative, as well as a variety of techniques for calming the mind, are sources of that inner peace.

Recently, psychotherapists, with their background in science and medicine, have begun to explore the possibilities of employing Buddhist techniques in a therapeutic context. I feel this is entirely consistent with the aim of overcoming suffering and improving the welfare of all sentient beings. Living experience of Buddhist meditation has given practitioners a profound knowledge of the workings and nature of the mind, an inner science to complement our understanding of the physical world. On its own no amount of technological development can lead to lasting happiness. What is almost always missing is a corresponding inner development. This is an area in which there is increasing evidence that Buddhist assertions and modern findings have the potential to be valuable to one another.

I am greatly encouraged to see these approaches develop. I congratulate Mark Epstein on completing this book, the result of twenty years’ experience in both Western psychotherapy and Buddhist meditation. Thoughts without a Thinker will not only offer useful insights to therapists, but also stimulate further study and mutual cooperation between therapists and followers of the meditative path.

December 1994

Preface to the Tenth Anniversary Edition

I have been searching for a way to describe the evolving relationship between Buddhism and psychotherapy, which has continued, in an accelerating fashion over the past decade, to influence the development of each. A recent talk by my friend Stephen Batchelor gave me a new way of understanding this relationship. Stephen is a British author and former Zen and Tibetan Buddhist monk whose many books about Buddhism and Western culture have been a huge inspiration to me. He was talking about the Buddha’s enlightenment, about the Three Messengers that roused the Buddha-to-be from his complacency and started him on his quest for awakening. The Three Messengers were an old person, a sick person, and a corpse, all of whom the Buddha happened upon while riding outside his palace walls, and they provoked in him an awareness of old age, sickness, and death that he had been shielded from by his overprotective father. I had always assumed that the message of the Three Messengers was about the Buddha’s mortality: that it was the sudden vision of his own vulnerability that began him on his journey. I thought, in this context, of a famous talk the Buddha gave many years after his enlightenment that referenced these Three Messengers as the catalyst for the spiritual life:

Did you ever see in the world a man, or a woman, eighty, ninety, or a hundred years old, frail, crooked as a gable-roof, bent down, resting on crutches, with tottering steps, infirm, youth long since fled, with broken teeth, gray or scanty hair or none, wrinkled, with blotched limbs? And did the thought never come to you that you are also subject to decay, that you also cannot escape it?1

Yet Stephen talked about the impact of this sudden awareness of vulnerability in a different way altogether, not as a selfish response on the part of the Buddha, but as a compassionate one. The Buddha’s vision of old age, sickness, and death unleashed an empathic response in which he felt the anguish of those unfortunate beings and realized the extent of such suffering in the world. His quest for enlightenment was thus a quest to eradicate their suffering, not just to secure an escape for himself.

In Stephen’s talk (and in a body of work that he has developed over the past decade), he expanded the field in which we imagine meditation to be practiced. He moved it from an intrapsychic process, in which a solitary meditator struggles on his or her cushion with thoughts, feelings, and emotions that obscure enlightenment, to an interpersonal process, in which the core Buddhist attentional strategy of mindfulness is applied to the feelings of another. Rather than using the visual metaphor of “watching” as a depiction of meditative awareness, Stephen suggested “listening” as a more accurate, and related, description of what meditation encourages. He pointed out that the name of the Chinese representation of compassion, the Buddhist “goddess” Kuan Yin, literally means “observer” (kuan) of “sounds” (yin).2 We practice meditation when we listen to the feelings of another: to their pain, their distress, and their suffering. In this sense, psychotherapy and meditation are one.

In the decade since Thoughts Without a Thinker was first published, the model of psychotherapy has changed in an analogous way. Visionary contributions by analysts such as W.R. Bion and D.W. Winnicott have been gradually assimilated, changing the focus of therapy from an intrapsychic exploration to an interpersonal, or intersubjective, one. In the older view, the function of therapy was to put people in touch with aspects of themselves that they were uncomfortable with, to acquaint them with their unacceptable wishes and desires in an effort to make them more whole. Using the model of the Buddhist Wheel of Life, this meant opening people to their animal natures or bringing awareness to areas of conflict between selfish, sexual or aggressive urges and ethical or moral constraints. Because the roots of these conflicts were often buried in childhood, the focus of therapy was on resurrecting the memories and events that gave form to the current predicament.

Although this approach is still relevant in many individual cases, it is no longer the dominant model for therapy. The focus today is much more on creating an interpersonal environment in which a person can break free of patterns of relationship in which he or she remains stuck not so much by confronting unacceptable wishes but by venturing, as the British child analyst Adam Phillips has put it, into unintelligible aspects of emotional experience.3 Therapy has become a place where an experience of surrender, but not submission, is facilitated: a place where, in Winnicott’s words, a patient can move “from a state of not being able to play into a state of being able to play.”4 In this way, therapy has become much more intimate. The very name that has become attached to the approach, “relational psychotherapy,” speaks of this intimacy. There is an implicit faith that a deeply personal sense of authenticity can emerge from this process, one that is not necessarily dependent on strengthening the so-called “self.”

It is impossible to know if the growing interest in Buddhism in the therapeutic community has been a cause or a result of this shift from the intrapsychic to the interpersonal, from the unacceptable to the unintelligible, or if the two worlds of therapy and Buddhism, increasingly part of one culture, are each responding to the same philosophical currents and individual needs. But the parallels are striking. Both Buddhism and psychotherapy, in a mutually reinforcing relationship with each other, are evolving out of a focus on the solitary aspirations of the individual self into a relational model in which, in Stephen Batchelor’s words, attributes of “elusiveness, ambiguity, unpredictability and utter disregard for the ambitions of ‘selves,’”5 are given room to breathe.

I had a public discussion not long ago with one of my Buddhist teachers about the similarities between this vision of therapy and the Buddhist view. My talk was with Joseph Goldstein, who has passed the better part of the past thirty years teaching meditation at the Insight Meditation Society in Massachusetts and who spent the previous seven years in Bodh Goya, the village where the historical Buddha was enlightened, studying with the late Anagarika Munindra, a Bengali teacher. While Joseph is renowned for his dedication to long retreats of intensive, silent meditation in the style perfected in Asian monasteries, his relationship with Munindra in India was pivotal for his growth. I was interested in having Joseph speak about how Buddhist teachings might relate to issues of personal intimacy.

As our discussion evolved, we tried to clarify for our audience whether, in fact, there were significant differences between the therapeutic approach and the meditative one. One of the participants offered the following comment. “In meditation,” he said, “we try to keep opening to our experience, >not in a detached way, as is sometimes thought, but in a non-attached way. We don’t do the kind of digging that is done in psychotherapy.”

I was unnerved at first by this comment. It came toward the beginning of our discussion, and I had not expected it.

“Digging?” I thought to myself. “Is that what I’m supposed to be doing? Maybe I should be digging more,” I wondered briefly, momentarily worried that my approach to therapy was flawed.

The metaphor was certainly familiar enough, albeit rather old-fashioned. Freud used it frequently in his descriptions of the therapeutic action of psychoanalysis when he compared therapy to the archaeological excavations of ancient Rome. Underneath the bustling, modern metropolis can be found all of the layers of the past, just as underneath our civilized exteriors can be found all of our primitive longings, and unresolved conflicts, that helped to form us.

The idea that therapy involves digging for the roots of our predicament is certainly a natural one. It suggests that if we could only uncover the one core event, or the one core conflict, that made us who we are (or prevents us from being who we could be), we would suddenly feel liberated. But for most people it is never that simple. Even if they unearth the difficulties that prevent them from being who they are, they still have to figure out what to do about those difficulties. As a therapist, I have found that I never need to dig very much. I simply wait, not in a detached sense, but, as I have learned from meditation, in a non-attached way. In fact, it was from Joseph that I learned the most about how to wait and listen. The manner in which he taught me to observe my own mind in meditation is how I have always tried to listen to my patients. This does not mean that I do not respond, that I am not myself when I work, that I do not care, or that I do not sometimes need to probe.

But by not having a personal agenda in my therapeutic interactions, by putting my self on hold, I can make room for whatever appears on its own.

Often what emerges does seem to come from the depths. It may have something to do with a person’s unresolved issues from the past, emotional trauma not fully processed, old hurts still being nursed, or, as Freud suggested, unacceptable erotic or aggressive longings creating internal conflict. And these are important to air. But their retrieval is really only a by-product of a willingness to be present with whatever unfolds in the moment, a willingness that both my patient and I have agreed to try to maintain. This unfolding does not always reveal childhood trauma, but even when it does, the process does not have to stop there. People come to therapy not just to make sense of the past but to shake free of it. The uncovering of the past is really only a prelude to the mystery of the present. This is another area where the spiritual intersects with the psychological. Maintaining openness is a meditative, as well as a psychotherapeutic, process—and it inevitably brings emotional material, not always immediately intelligible emotional material, in its wake.

Therapy makes space interpersonally in the same manner that meditation can. It might be better to think of therapy as surfacing rather than digging. As the hugely influential British psychoanalyst W.R. Bion has described, a therapist’s job is to decipher the emotional experience that arises between therapist and patient:

“The task confronting the analyst is to bring intuition and reason to bear on an emotional experience between two people (of whom he is one) in such a way that not only he but also the analysand gains an understanding of the analysand’s response to that emotional situation.” 6

Understanding an emotional experience in the present is very different from digging into the past. It can sometimes require exploration of memories and associations, as in a classical psychoanalysis, but the therapeutic emphasis is on understanding something that is at once very present and yet also frustratingly elusive. Emotional experiences that reveal themselves in therapy are often remnants, or traces, of the past. They tend to be echoes of whatever was sacrificed as a person stepped forward to cope with a difficult interpersonal environment. Understanding emotional experiences means more than knowing something intellectual about their sources; it means recovering a capacity for feeling, or in Bion’s often cryptic language, dreaming that has been lost. The great gift of this renewed capacity, brought about by the strengthening of what is called mindfulness in Buddhist psychology, is the ability to know one’s feelings without having to act on them, or be acted on by them, in an unconscious way.

I have a little notebook, a very small one, that I always bring with me when I go on a meditation retreat, just in case I have a thought or hear a teaching that I want to try to preserve. Although it goes against the grain of the retreat’s stated purpose of attention to the ephemerality of all experience, it has still been helpful to me on occasion. What I have noticed over time is that I tend to write down the same few things, almost as if I have never heard or thought them before. The most frequent notation in my notebook is one that Joseph Goldstein often repeats when he is giving meditation instruction. I have variations of it dating back thirty years. In its simplest form it goes something like this: “It’s not what we are feeling that’s important but how we relate to it that matters.” Each time I hear Joseph say this, it is as if a bell sounds in my head. All of my self-judgments are immediately called into question, and I find myself able, for a time, to settle more into myself, with less friction, tension, or discontent.

Mindfulness confers upon us the capacity to relate to emotional life in an open, balanced, accepting, and tolerant way, while freeing us to act with compassion, rather than on impulse, in response. How this capacity interacts with methods of psychotherapy will undoubtedly continue to evolve, but, whatever new forms may emerge, the essential contribution of the Buddhist perspective will always remain the same. Emotional experiences are sounds we can learn to observe with kindness. Then our world, like Kuan Yin’s, becomes filled with music.

Salisbury Cove, Maine


AS I PUT THIS BOOK together, I was struck by the number of teachers I have had who had nothing to do with my orthodox schooling or training. This comes from someone who has spent the better part of his life in some kind of educational facility. It is to the credit of those institutions that I still had the time and energy to explore outside the established venues. I thank only a fraction of those who made a difference for me, those who most directly influenced my writing of this book.

For his kindness, generosity, and indefatigable wisdom, I would like to thank the late Isadore From, who patiently guided me through my first years as a psychotherapist. I wish he were still here. For their meditation instruction, guidance, and example, I am fortunate to be able to thank Jack Kornfield and Joseph Goldstein. For teaching, encouragement, and discussion over the past twenty years, all of which have figured into this book, I am indebted to Daniel Goleman. For reaching out to me and revealing the life that yet flourishes in psychoanalysis, I am grateful to Emmanuel Ghent, Michael Eigen, and Gerald Fogel. In addition, Helen Tworkov, Jack Engler, Stuart Margulies, Mark Finn, Karen Hopenwasser, Bob and Nena Thurman, Richard Barsky, Anne Edelstein, Scott Martino, and my editor, Jo Ann Miller, have all contributed to my efforts to bring together the often disparate worlds of Buddhism and psychotherapy. Arlene, Sonia, Will, and the rest of my family gave me the peace of mind that I needed to carry this project to completion, while my patients have inspired me with their openness, honesty, and humor. I would like to thank them each by name, but will refrain.


My patients have generously shared themselves with me and provided material for this book; in all cases cited herein I have changed names, as well as other identifying details, or constructed composites, in order to protect privacy.




THE QUESTION I am most frequently asked has to do with how Buddhism has influenced me as a therapist, how I have integrated it into my work. This is a formidable question, since I did not set out to become a “Buddhist psychotherapist.” I pursued a study of both Eastern and Western systems simultaneously. I met my first meditation teachers at about the same time that I was exposed to Freudian theory, traveled to India and Southeast Asia around the time of my medical studies, and spent weeks in silent retreat before ever sitting with my first therapy patient. I was not schooled in how to integrate the two: I had no real choice in the matter. As befits the intensely personal nature of both meditation and psychotherapy, my own attempts at integration have been, above all, private ones.


  • "One of the most sophisticated integrations of the therapeutic and spiritual disciplines."—Daniel Goleman, New York Times
  • "Eloquent yet down-to-earth, this gem offers an exhilarating and expansive perspective on the therapeutic process."—Booklist
  • "A highly personal, thoughtful, illuminating synthesis.... Patients, psychologists, and mediators...will find much spiritual nourishment."—Publishers Weekly
  • "Mark Epstein's book is inspired by its lucidity.... After Thoughts Without a Thinker, psychotherapy without a Buddhist perspective looks like a diminished thing."—Adam Phillips, author of Missing Out: In Praise of the Unlived Life
  • "A groundbreaking work.... The book will take its place among the classics of the literature of meditation."—Jon Kabat-Zinn, author of Mindfulness for Beginners
  • "Epstein tries bravely and earnestly to make such matters of the mind and heart as clear as possible."—Robert Coles, New England Journal of Medicine
  • "Epstein's solid book offers another example of contemporary efforts to revitalize psychotherapy."—Spirituality and Practice
  • "A marvelous book that is at once scholarly and fresh, informative and personal."—Stephen A. Mitchell, author of Can Love Last?
  • "A most lucid and expert account of the wedding of psychotherapy and meditation. An Eastern-Wester psychology that truly speaks from the inside of both worlds."—Jack Kornfield, author of Meditation for Beginners
  • "I loved Thoughts Without a Thinker. Mark Epstein has given us a brilliant account of how an ancient science of mind, based on a rich meditative tradition, can complement therapy and lead to new dimensions of wisdom and wholeness."—Joan Borysenko, author of Fried: Why You Burn Out and How to Revive

On Sale
Jul 30, 2013
Page Count
272 pages
Basic Books

Mark Epstein

About the Author

Mark Epstein, M.D., is a graduate of Harvard College and Harvard Medical School. He is the author of several books, including Going to Pieces Without Falling Apart, Going on Being, The Trauma of Everyday Life, and Advice Not Given. He practices psychiatry and lives in New York City.

Learn more about this author