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.



“Writing with an inviting ease and considerable clarity, Epstein first establishes Buddhist fundamentals . . . then goes on to demonstrate interconnections between these spiritual precepts and pertinent psychological concepts.”


“Epstein tries bravely and earnestly to make such matters of the mind and heart as clear as possible. . . . Particularly instructive and impressive is Dr. Epstein’s clinical interest in harnessing a meditative spirituality to the task of achieving a psychologically interpretive awareness. . . . It is no small feat for Dr. Epstein to have labored so long in a vineyard at such a metaphysical remove from that inhabited by most of us doctors, and to have returned not as a polemicist, a propagandist, or even an apologist, but rather as a healer determined to call upon all possible sources of understanding, not to mention inspiration.”

—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-Western 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

Also by Mark Epstein, M.D.

Going to Pieces Without Falling Apart

Going on Being

Open to Desire

            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


Visiting an artist friend recently, I spied a drawing in her dining room that immediately caught my eye. It was done in a child’s hand and was of a guard, standing tall, with, atop his head, a cylinder-shaped hat that had three vertical buttons down its front. Inspired by pictures of sentries at Buckingham Palace, my friend drew it when she was just five or six years old.

“That’s God,” she told me. “When I was little, I heard the word ‘God,’ and I thought people were saying ‘Guard.’ I wanted to know what God looked like.”

I loved the confluence of the words god and guard. When I exclaimed about it, she told me her mother had never asked her about the portrait. “That was my mother,” she laughed. “It would have never occurred to her to talk to me about my drawings—or anything else I was thinking about, for that matter.”

I was struck by her off-handed tone. To me, her mother’s lack of engagement sounded hurtful: an example of the lack of mirroring or attunement that many people spend their lives struggling with. But my friend did not seem bitter; she appeared to have genuine affection for her mother and to have forgiven her shortcomings. I looked more closely at the picture, hoping to find a clue to her emotional health.

To my surprise, there was a clue. Surrounding the guard, there were not one but three telephones. There was a large one on the wall just behind him—the kind that watchmen have in their booths—an old-fashioned one in front on a stool to his left, and a third hovering in the far distance. God was a guard surrounded by telephones. Perhaps my friend was drawing a picture of the barriers she had to erect in the face of her mother’s mal-attunement, I thought—of her own guardedness. The telephones around the periphery were symbols of the communication and understanding she was missing.

But there was another possibility too, one that dawned on me as I gazed at the picture. Maybe my friend’s drawing was a depiction, not only of the problem but also of the solution. If her mother did not have the capacity for the attunement and responsiveness she needed, then perhaps God did. God was guarding her, and the telephones were signs of his availability. My friend’s power to conjure him up, to draw him, was a mark of her nascent ability to reach through her childhood trauma and a sign of her future as an artist. In imagining a God who could take her calls, she was keeping open an alternate channel of communication that would guard her all her life.

My friend’s drawing made me think of the British pediatrician and child analyst D. W. Winnicott (1896–1971), and of the enormous, if often overlooked, understanding he came to after years of clinical work. Although Winnicott showed no interest in or knowledge of Buddhism, his work has been a huge influence on my thinking. In his descriptions of the challenges facing children and their parents as they negotiate the developmental process, he expressed many of the Buddha’s major insights. His work has helped me translate the Buddha’s thinking into the psychological language of our time.

Although Winnicott wrote extensively about the importance of mother-child attunement, he also came to a profound appreciation of how vital it is for a mother to be able to let her child down. A parent has to be willing to disappoint, he found, because disappointment, as the Buddha also said, is inevitable. In so doing, in letting a child down, in being truthful about one’s inability to meet all of one’s child’s needs, a disappointing parent moves a child toward a capacity to cope with everyday life. In one of his final papers, Winnicott wrote movingly of how a child’s primitive anger at his parent’s imperfections can turn into empathy. The critical ingredient for this transformation is the parent’s ability not to take the child’s anger personally, a Buddhist idea if there ever was one.

If all goes well, at the beginning an infant is led to believe that his mother is an extension of himself, magically appearing to assuage every need. Over time this perfection comes under attack. No parent can keep it up forever. There is difficulty inherent to the relationship, and the child gradually comes to realize that the parent is a separate person, with his or her own limitations. When a parent is “good-enough,” in Winnicott’s language, the child’s anger (and/or the parent’s response) does not destabilize the relationship too much. The child comes to see that his parents are not destroyed by his outrage, that his parents survive, and he begins to develop considerate feelings for them as separate—if flawed—individuals. Those considerate feelings do not negate the angry ones, but they do mitigate them. Appreciation and frustration come to coexist.

My friend’s drawing of the god/guard seemed to encompass Winnicott’s point. She was able to do something creative with her mother’s lack of attunement rather than be only disturbed by it. It had not become a sticking point, the last word in a fraught relationship, but instead had launched her as an artist. She had taken her frustration and done something with it. Even at an early age, she was already moving past an insistence on perfection, on what Winnicott’s biographer Adam Phillips has called a never-ending “need for understanding and being understood.”1 As Phillips makes clear, the relentless demand to make relationships flawless squeezes the life out of them. With this insight, psychoanalysis and Buddhism are of a piece. As the Buddha articulated in the first of his Four Noble Truths, there is trauma at the heart of existence. Trying to remedy it through understanding one’s childhood, as if by understanding it we could make it disappear, is not what Freud or the Buddha recommended. Psychoanalysis, Phillips writes, helps one to make sense of one’s history, but at the same time it “is best read as a long elegy for the intelligibility of our lives.”2

Looking at my friend’s drawing put me in mind of another one I had recently seen. I was at the Japan Society at an exhibit of the calligraphies of a famous eighteenth-century Zen master named Hakuin. He was an old man when he made his drawing, but it bore more than a passing resemblance to my friend’s childhood artwork. Hakuin, who lived from 1686 to 1768, did not start making art until after his enlightenment at the age of sixty. He was a major figure in the history of Zen Buddhism, credited with reviving the Rinzai school of Zen and known for the way he was able to use koans, riddles that could not be solved by logical thought, to open people’s minds. Between the ages of sixty and eighty, after more than forty years of Zen practice, he began to paint, creating playful and poetic calligraphies that telegraphed the essence of Zen thought. He is now recognized as one of Japan’s greatest artists as well as one of her most accomplished Buddhist teachers.

The picture I was remembering was of a monkey and a cuckoo. The monkey was in the foreground, like the guard in my friend’s drawing, but instead of standing erect, he was crouching with his hands over his ears. The cuckoo was in the background, like the telephones in the drawing of the guard, flying across the visual field with its beak open in song. The crouching monkey, long a symbol in the Buddhist world of the untrained thinking mind, was clearly stressed out. A pained expression was on his face; he was concentrating on something or trying very hard to keep something in or get something out of his mind. If the phone was ringing, he would not be able to hear it. Like the undeveloped mind, the metaphorical monkey is always in motion, jumping from one attempt at self-satisfaction to another, from one thought to another. “Monkey mind” is something that people who begin to meditate have an immediate understanding of as they begin to tune into the restless nature of their own psyches, to the incessant and mostly unproductive chatter of their thoughts.

The cuckoo, symbolic in Japanese culture of the coming of summer, is representative of all of the ease, relaxation, warmth, and light associated with the pleasures of that season. There is a tradition in Japan of young couples staying up late at night in the countryside to try to catch the first call of the cuckoo in the warming weather. The first sound, like the first bite of a delicious meal or the first sip of a cup of tea, has an essence prized by the Japanese aesthetic, an immediacy untrammeled by ruminating thought. The cuckoo, unlike most other birds, sings when it is in flight, so Hakuin’s painting of the bird flying across the open sky with an open beak has the implicit sound of its song associated with it, a song that the monkey could not easily hear even as the cuckoo flew above him.

Hakuin wrote a calligraphic poem to accompany the picture. In translation, it read,

                                “Even when not listening,

                                Lift up one hand

                                The cuckoo.”

Hakuin was the originator of the famous Zen koan, “What is the sound of one hand clapping?” or as Hakuin put it, “What is the sound of one hand?” The Zen koan is meant to induce an intuitive understanding of the Buddha’s wisdom. It circumvents the kind of deliberate and obsessive thinking the monkey represents. There is no obvious sound to one hand clapping; the koan conveys a sense of the emptiness infused with compassion—the engaged silence—at the heart of the Buddha’s awakening. The painting makes this explicit. The monkey crouching with his hands over his ears is the perfect image of a thinker paralyzed by his own thoughts, oblivious to the sounds of liberation all around him.

When I first saw the drawing and read Hakuin’s inscription, I thought I understood his intent. “Even when not listening, lift up one hand!” I thought of my own meditations, of how the simple act of attending to the sounds of the natural world all around me countered the oppressiveness of my repetitive thoughts. “Release yourself from the grip of your monkey mind. Open your ears to the sound of the cuckoo. It is there, even when you are not listening,” I imagined Hakuin saying. “Just lift your hand off of your ear for a moment. Then you will understand.” The juxtaposition of the preoccupied monkey with the soaring sweetness of the cuckoo’s cry had a poignancy I associated with the Buddha’s awakening. He too saw past his reactive mind into the underlying fabric of things. He lifted one hand and heard the call of the relational world.

Not long after seeing the show at the Japan Society, I described my interpretation of the koan to another friend, the Buddhist scholar and professor Robert A. F. Thurman of Columbia University. He did not dispute my analysis directly but had one more thought about the drawing: “What do people do when they are drowning?” he asked me. I couldn’t come up with much of an answer, so he filled in the one he was looking for. “They lift one hand,” he said. Professor Thurman was putting another twist on the Buddhist message. In his view, Hakuin was reminding people of the benevolent kindness of the bodhisattvas, those beings who have already awakened to their relational natures and remain in the everyday world. According to some believers, their energy is available even when one is in the midst of one’s own suffering—one has only to ask for it. Like my friend’s childhood god who was standing by his three telephones, the awakened bodhisattvas are afloat in the universe, waiting for our calls. According to Buddhist logic, although they have already freed themselves from the fires of clinging, they keep themselves available to be of service to others. Understanding themselves as purely relational beings and freed from their own subjective cravings, they find meaning in their accessibility to others.

These bodhisattvas can be personified as external beings, or they can represent the Buddha nature already present within us. The most famous bodhisattva of Asia is known variously as Kuan Yin or as Avalokiteshvara. Kuan Yin, popular in China, is a female figure whose name means “knower” or “observer” of sounds. Avalokiteshvara, “the Lord who looks down,” is a male entity who rose in prominence in India and Tibet as a representation of the Buddha’s compassion. Kuan Yin is thought of as “she who hears our cries,” and is one who responds with a mother’s sympathy to our troubles. Avalokiteshvara is shown with a thousand arms to signify his ability to save all beings: he has enough hands for everyone. His arms are like the three telephones in my friend’s childhood drawing: they enable him to take multiple calls, to reach down and grasp more than one drowning person at a time. According to this reading of the imagery, Hakuin is saying something very specific. If we can acknowledge the truth of our suffering, we will spontaneously reach out. We will lift a hand in the manner of a drowning person and create the possibility of receiving help. The bodhisattvas, like the cuckoo, are already there for the asking.

As much as I appreciated this interpretation and as much comfort as I might derive from the idea of enlightened bodhisattvas hearing my cries, the notion of Buddha nature dwelling within offers me the most hope. This is something I have tried to bring into my work as a psychotherapist. The compassionately aware bodhisattvas can then stand in as metaphors for the benevolent stance of the Buddhist perspective, already accessible in each of us. For me, this is the message that Hakuin wants us to hear, the same one my friend was reaching for in her drawing of the guard. By lifting one hand and being truthful with ourselves we can learn to observe with kindness. Psychotherapy is a perfect terrain for this. The wisdom of the Buddha and the insights of psychoanalysis, like the guard in my friend’s drawing, are there to answer our calls.

Notes to Preface

1. Adam Phillips, Missing Out: In Praise of the Unlived Life (London: Hamish Hamilton, 2012), p. 62.

2. Ibid., p. 63.


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.

This is a far cry from the way in which the great psychologist William James imagined it would be. James was impressed with the psychological sophistication of Buddhism and predicted that it would be a major influence on Western psychology. A story about him sets the stage for this book. While lecturing at Harvard in the early 1900s, James suddenly stopped when he recognized a visiting Buddhist monk from Sri Lanka in his audience. “Take my chair,” he is reported to have said. “You are better equipped to lecture on psychology than I. This is the psychology everybody will be studying twenty-five years from now.”1 James was one of the first to appreciate the psychological dimension of Buddhist thought, yet he was not as accomplished at prophecy as he was at psychology. Several years earlier, in Vienna, Freud had published The Interpretation of Dreams, and it was Freud’s psychology, not the Buddha’s, that has had a far greater impact in the West over the subsequent decades.

At the time of James’s lecture, the influence of Eastern philosophy was just beginning to be felt among Western psychologists. In psychoanalytic circles, an interest in Oriental thought was common. Many of Freud’s early colleagues and followers (including Ernest Jones, Otto Rank, Sandor Ferenczi, Franz Alexander, Lou Andreas-Salome, and Carl Jung) were conversant with ideas about Eastern mysticism and attempted to address it from a psychoanalytic perspective. Freud’s friend Romain Rolland, the French poet and author, was a devout follower of the Hindu teachers Ramakrishna and Vivekananda, and he engaged Freud in a lively correspondence about his meditative experiences, as described extensively in Freud’s Civilization and Its Discontents. Fascinated by, if somewhat skeptical of, his friend’s reports, Freud struggled to apply his psychoanalytic understanding to Rolland’s experiences. In 1930 Freud wrote:

I shall now try with your guidance to penetrate into the Indian jungle from which until now an uncertain blending of Hellenic love of proportion, Jewish sobriety, and philistine timidity have kept me away. I really ought to have tackled it earlier, for the plants of this soil shouldn’t be alien to me; I have dug to certain depths for their roots. But it isn’t easy to pass beyond the limits of one’s nature.2

As one who shares with Freud all three of these characteristics—the “love of proportion, Jewish sobriety, and philistine timidity”—I can attest that none of them need make the Buddhist approach incomprehensible. Freud himself did his best to penetrate the Indian jungle, despite his misgivings. Under Rolland’s influence, Freud described the “oceanic feeling” as the prototypical mystical experience: a sense of limitless and unbounded oneness with the universe that seeks the “restoration of limitless narcissism” and the “resurrection of infantile helplessness.”3 This equation of the meditative experience with a return to the breast or the womb has gone virtually unchallenged within the psychoanalytic community since Freud’s commentary. While it does capture some truth, it takes no account of the investigative or analytical practices most distinctive of Buddhism and most related to the psychodynamic approach. Whereas James seemed to be opening psychology up to the potential contributions of the Buddhist approach, Freud effectively closed it down. This stemmed not from Freud’s unwillingness to apply psychoanalytic investigation to the range of meditative states but from a basic unfamiliarity with what Buddhist meditation, at least, was actually about.

James understood something that subsequent generations of more psychoanalytically influenced commentators did not: the essential psychological dimension of Buddhist spiritual experience. Far from being a mystical retreat from the complexities of mental and emotional experience, the Buddhist approach requires that all of the psyche be subject to meditative awareness. It is here that the overlap with what has come to be called psychotherapy is most obvious. Meditation is not world denying; the slowing down that it requires is in service of closer examination of the day-to-day mind. This examination is, by definition, psychological. Its object is to question the true nature of the self and to end the production of self-created mental suffering. It is a pursuit that various schools of psychotherapy have been approaching independently, often without benefit of the overarching methodology of the Buddhist psychologists of mind. As long as Buddhism could be seen as a mystical, or otherworldly, pursuit, as an Eastern exoticism incomprehensible to the Western mind, as a spiritual pursuit with little relevance to our complicated neurotic attachments, it could be kept isolated from the psychological mainstream, and its insights could be relegated to the esoteric shelves of “Eastern philosophy.” Yet, Buddhism has something essential to teach contemporary psychotherapists: it long ago perfected a technique of confronting and uprooting human narcissism, a goal that Western psychotherapy has only recently begun even to contemplate.


  • "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