Classic and Contemporary Buddhist Works

Buddhism and Psychotherapy Across Cultures - Introduction

Essays on Theories and Practices

by Mark Unno

The chapters in this volume have been collected from “Between Cultures: Buddhism and Psychotherapy in the Twenty-First Century,” a conference held at Boston University, September 10–11, 2004. The conference, which brought together a score of scholars and specialists from Japan and North America, had two parts. First, we met in a seminar format, the participants having submitted their papers beforehand. With the opportunity to read one another’s work ahead of time, we were able to devote the majority of the proceedings to discussion and conversation. Although this meant extra work on the part of the presenters, the effort was rewarded with rich, intimate dialogue. Second, we held a public plenary session featuring five keynote speakers that included stimulating exchanges with the audience.

The title of the conference signifies first of all the cross-cultural interaction between Buddhism and psychotherapy. As Jeremy Safran states, “Both Buddhism and psychotherapy are cultural institutions that originally developed as expressions of the values and the complex tensions and contradictions within their cultures of origins. Both are systems of healing that have evolved over time as culture has evolved, as the configurations of the self have evolved, and as new cultures have assimilated them. And both have transformed the cultures in which they have evolved” (italics added). As this statement implies, cross-cultural interaction occurs not only between the two disciplines of Buddhist and psychotherapeutic practice (involving various schools and approaches within each) but also across geographical and ethnic boundaries. Thus, participating in the conference were clinicians, Buddhists, and scholars of Buddhism and psychotherapy from both Japan and North America, often with two or more specializations represented in a single participant. For example, Jeremy Safran is on the Graduate Faculty of the New School University, a clinical psychotherapist, and a Buddhist practitioner in multiple lineages. Richard Payne is dean of the Institute of Buddhist Studies, a consortium member of the Graduate Theological Union, and also a practicing Shingon Buddhist. Nabeshima Naoki is a scholar of Buddhism from Ryūkoku University but also an ordained priest and an end-of-life counselor. Okada Yasunobu is dean of the Counseling and Psychotherapy Program at Kyoto University and also a clinical Sandplay therapist. And Seigen Yamaoka, former bishop of the Buddhist Churches of America, is currently the resident minister of the Oakland Buddhist Church involved in counseling terminally ill patients. The existence of multiple disciplines within individual participants means that cross-cultural dialogue occurs not only between individuals but even within each person. This interaction of multiple cultural factors between and within individuals is both historic and timely. Never before have so many different sects and schools of Buddhism and psychotherapy come together in so many ways.

In the early history of the interaction between Buddhism and psychotherapy that began over a half-century ago, Buddhist teachers tended to be Asian and the psychotherapists European or North American. As both Buddhism and psychotherapy have grown and diversified in Asia as well as in the West, so too has the literature dealing with their interaction. Today, Japan and the United States are the two largest psychotherapeutic cultures in the world. The Association for Japanese Clinical Psychology, with over fifteen thousand members including psychotherapists, psychiatrists, counselors, and other clinicians, is one of the largest bodies of its kind in the world. The United States has by far the largest number of certified specialists in various clinical fields. Japan and the United States have, within their respective geographical regions, the largest numbers of ordained Buddhist priests, monks, and nuns, as well as academic researchers of Buddhism.

Sheer numbers by themselves mean little. Beyond the numbers, there is the tremendous influence exerted in other cultures and regions. Just as Japan has served as a bridge to Western culture for other Asian cultures in such fields as business, technology, and pop culture, the Association for Japanese Clinical Psychology is becoming a significant resource for the development of clinical practice in other Asian cultures such as China and Korea. While Europe is the birthplace of psychoanalysis, psychotherapy in the United States exerts considerable influence in other Western cultures as well. Interestingly, Buddhists from many Asian cultures have begun to interact on North American soil in ways that they historically had not in Asia. Japan is also now becoming a significant locus of interaction for Buddhists from various parts of Asia.

Until recently, however, the interaction between Buddhism, psychology, and psychotherapy has been developing largely in parallel in Japan and the United States, in the East and West, with relatively little interaction. We are finally reaching a stage of critical mass in the historical interaction between specialists in these two areas in Asia and the West, and in Japan and the United States in particular. This volume, and the conference from which it derives, represent a timely beginning that should stimulate further work and reflection. The papers range from complex theoretical analyses to historical reflections and discussions of practical problems of clinical and religious practice. Regardless of genre, however, almost all of the papers contain concrete case studies or illustrations. This volume makes several particular contributions. First, it brings together specialists from diverse disciplines from both Japan and North America and provides a forum for their interaction. Many of the following chapters have been revised to include references to the proceedings of the conference and to the participants’ insights or disagreements. Second, this volume includes substantial discussion of the problems that both Buddhists and psychotherapists have encountered in each other’s language and practice. Third, several contributors explore the creative possibilities emerging from the synergy of Buddhism and psychotherapy.

Many conference participants came from a Pure Land Buddhist background, specifically that of Jōdo-shin (commonly known as Shin Buddhism), although Buddhist teachers and scholars of the Zen, Tibetan, and Vipassana traditions were also well represented. Less well known in the American mainstream than the Zen, Tibetan, and Vipassana forms, Pure Land Buddhism is based on entrusting to and ultimately identifying with the liberating power of Amida Buddha. It is the largest stream of Buddhism in East Asia, and Shin Buddhism is the largest sect of Japanese Buddhism and one of the largest followings of any form of Buddhism outside of Asia as well. Additionally, several chapters are devoted to the topic of death and dying in Pure Land Buddhism, although they are broadly framed in terms applicable beyond the specific context of Pure Land or of Shin.

The chapters in Part I address the problems and pitfalls that psychotherapists and Buddhists encounter when they exchange ideas. “Being somebody and being nobody,” the now-famous phrase coined by Jack Engler, has become emblematic of the diverse tendencies and aims of psychotherapy and Buddhist practice: to establish a healthy self, and to realize no-self, respectively. We decided to take Engler’s excellent discussion of the issue, presented in his essay (in Jeremy Safran’s watershed anthology) “Being Somebody and Being Nobody: A Reexamination of the Understanding of Self in Psychoanalysis and Buddhism,” as a starting point for our discussions by having everyone read the piece in preparation for the conference. We were delighted that Engler accepted our invitation to be a keynote speaker. His chapter, “Promises and Perils of the Spiritual Path,” is a refinement of that speech. Although he covers considerable ground already addressed in the prior piece, he shifts his focus to examine the ways that Western practitioners of Buddhism tend to subvert Buddhist practice by using it to avoid facing issues that are often also the subject of psychotherapy—employing, for example, “practices like meditation in the service of defense, rather than selfawareness.” He shows just how deeply embedded issues such as avoidance of responsibility and fear of intimacy can be, and how easy it is to escape into new and exotic religious practices. Concrete and incisive, Engler’s analysis may be likened to MañjuŸrī’s sword that cuts in order to heal.

Richard Payne’s “Individuation and Awakening: Romantic Narrative and the Psychological Interpretation of Buddhism” provides a historical framework for understanding the problems of the Western self in engaging Buddhism. Drawing on the work of Suzanne R. Kirschner, he suggests that Western Buddhists’ narcissistic self-avoidance as described by Engler is due at least in part to the psychologization of Buddhism in a “romantic atonement narrative.” Taking Jung’s model of individuation as emblematic, he describes what he sees as the reduction of Buddhism to a humanized version of the Western religious narrative, in particular that of Christianity. He suggests that Western students of Buddhism too often reduce Buddhism to a narrative of self-alienation (previously Christian sin), atonement (repentance), and self-redemption (divine redemption).

As an alternative, he presents the bodhisattva path described by the Indian master Śāntideva in his Bodhicaryāvatāra as a typical Buddhist narrative. In contrast to the humanistic, individualistic atonement narrative of the psychologized self, he describes the bodhisattva path as a structured, progressive ritual practice culminating in awakening and the directing of bodhisattva virtues in the service of liberating all sentient beings. There is no fall or alienation, no repentance or atonement as the decisive turning point, and thus no redemption, divine or human. Rather, it is a gradual progression that is ritually/liturgically rigorous and is designed to take practitioners beyond themselves in the service of all beings.

Payne is careful to distinguish Jung himself from “Jungians” whom he takes to particular task for their simplistic reduction of Buddhism to an instance of Jungian individuation. Jung himself, in fact, seemed to anticipate some of Payne’s criticisms. Of Zen Buddhism he wrote: “Great as is the value of Zen Buddhism for understanding the religious transformational process, its use among Western people is very problematical. The mental education necessary for Zen is lacking in the West. Who among us would place such implicit trust in a superior Master and his incomprehensible ways?” Yet, Payne does not let Jung off the hook entirely, for he sees Jung as implicated in the problematic appropriation of Eastern, and specifically Buddhist, thought into the framework of his psychological theories. Rather than trying to decide whether Payne is praising or blaming Jung, we might take his ambivalence as indicative of something deeper, and that is the difficulty of coming to terms with the “other.” Textually and historically, one might be able to isolate Buddhism in its “pure state,” untainted by westernizing projections, but as a human being, one unavoidably brings with one the tools and baggage of a particular cultural perspective. In seeking to integrate the understanding of the other into one’s worldview, one draws on one’s best tools to craft a bridge, but that bridge is necessarily distorted by those very same tools. One way to view this challenge is: Can one craft a bridge that is strong and serviceable enough to convey what is most important about the other?

Jeremy Safran, largely responding to Payne, seeks to point the way to such bridges in his essay “Cross-Cultural Dialogue and the Resonance of Narrative Strands.” He makes two major points, illustrating them with concrete instances. First, religious traditions and practices, including those of Buddhism and psychotherapy, are never static or fixed. Second, there are many versions or “narratives” of the Buddhist path as well as courses of psychotherapy. Combining these two points, he suggests that (a) neither Buddhism nor psychotherapy can be reduced to an essential narrative, and (b) points of resonance, or bridges to understanding, between various schools of Buddhism and of psychotherapy can be found if one is only open to them. He suggests, for example, pointing to the work of Franz Metcalf, a conference participant, that Zen and object-relations psychotherapy share similar views of the realization of the naturally or inherently awakened self-in-relational-process (rather than a fixed or essential self). Neither of these, he argues, fits either the liturgical self of the bodhisattva path or the atonement self of individuation.

Safran does not argue against the idea that one must become aware of cultural presuppositions or that one must avoid inappropriate projections and appropriations. Rather, by remaining open and flexible one can better see both one’s own assumptions and creative possibilities for building bridges and synthesizing. Echoing some of the themes enunciated in his introduction to Buddhism and Psychoanalysis, his is a forward-looking essay that endeavors to see how Buddhism and psychotherapy might be brought together rather than whether they might be.

Harvey Aronson, in “Buddhist Practice in Relation to Self-Representation: A Cross-Cultural Dialogue,” argues both how difficult and how fruitful it is to bring psychotherapy and Buddhism together. Like Payne, he describes the two fields in terms of narratives, in his case as karmic versus psychological. Drawing on the work of the anthropologist Richard Schweder, he outlines four ways of relating to and integrating the other, the most appropriate and effective being a self-reflexive engagement that leads to a new synthesis. Properly pursued, this leads to self-critical awareness of both the possibilities and limits of integration and synthesis. In addition to the issues discussed by other authors, he examines the diverse sociological contexts of traditionally communal Asian Buddhist cultures and of the individualistic modern West. Showing that “self ” concepts or “self-representations” are inseparable from the world in which one is socialized, Aronson describes several instances of cognitive dissonance and misor noncommunication between Asian Buddhist teachers and Western students embedded in a psychological narrative. Citing the work of the spiritual teacher A. H. Almaas, Aronson also describes how moments of release from obsession with self-image in psychotherapy can be akin to and open windows into the type of samādhi or meditative release realized in Buddhist practice. Among other things, he suggests that psychotherapy independent of any Buddhist practice may be necessary for students who are interested in Buddhism; psychotherapy undergone together with Buddhist practice can be beneficial for progress in both; there are points of resonance between Buddhism and psychotherapy that can enhance the understanding and practice of both in a Western context; and understanding underlying karmic and psychological narratives may be essential for effective engagement of Buddhist practice in the West.

William Waldron’s “On Selves and Selfless Discourse” offers philosophical, textual, and linguistic analyses of what is meant by “self ” and “no-self ” (atman and anatman), Engler’s “somebody” and “nobody.” Waldron’s essay is among the most theoretically involved in this collection, and it provides a framework for examining the logical and cultural assumptions behind much Buddhist and psychotherapeutic thought.

He begins by examining this analysis as a problem of consciousness. In Buddhism, Abhidharma, and especially Yogācāra, also known as the MindOnly School (Cittamatra), provide models of Buddhist practice based on cognition and consciousness. Specifically, Waldron compares and contrasts the Yogācāra notion of the storehouse consciousness, the ālaya-vijñāna, to models of consciousness offered by depth psychology (Freud, Jung) and cognitive science. The ālaya-vijñāna is a subjectless flow of mutually conditioning events that momentarily constitute at the surface level of consciousness something akin to an ego that experiences and reflects. On the one hand, compared to the ālaya-vijñāna, depth psychology, Waldron finds, is too personalistic and subjectivistic to be a good bridge for understanding; depth psychology seems always to assume personality to be at work, even at the deepest levels of the psyche, such that there seems to be a kind of “ghost in the machine” of consciousness, a person hidden down there somewhere. On the other hand, cognitive science seems to be too impersonal and objectivistic to account for the human suffering and spiritual liberation that form the basis of virtually all of Buddhism including the Yogācāra theory of the ālaya-vijñāna: “Thus, like depth psychology, cognitive science also seems inadequate for conveying both the impersonality of Buddhist discourse and its essential ameliorative aim: that one seeks to understand how the mind works in order to alleviate human ignorance and suffering.” He goes on to describe how the theory of consciousness found in Yogācāra makes possible addressing both the impersonal process of consciousness unfolding and the subjective experience of personal suffering and release. At the heart of his analysis is his presentation of the classical Buddhist notion of dependent co-origination (pratītya-samudpada) through which impersonal causes and conditions give rise to the temporary experience of personal suffering and through which the same suffering can be dissolved into the awareness of the impersonal or nonpersonal.

The second part of Waldron’s essay is devoted to a textual and linguistic examination of the evolution of this kind of personal/impersonal discourse and syntax in Indian Sanskrit literature. This discussion, like the essay as a whole, is quite erudite; it explains compellingly how religious culture helps to create language including syntax as well as how language and syntax help to create religious and philosophical thought and culture. There is nothing essential about language, whether Sanskrit or English, that would go against the very notion of dependent co-origination. Nevertheless, Waldron’s chapter leads one to seriously consider the profound conditioning effect that cultural discourse has upon the habits of consciousness, and how consciousness helps to shape discourse and language, including that of the Buddhist religion as it is assimilated into Western culture.

Tarutani Shigehiro, in “Transcendence and Immanence: Buddhism and Psychotherapy in Japan,” provides a view from the other side of the Pacific Ocean. Reading the preceding chapters, one is apt to assume that Buddhism in Asia continues in its traditional forms uninterrupted. Tarutani describes in vivid terms how this is not the case. Through his analysis of Asahara Shßkß, the leader of the Aum Shinrikyß cult that was responsible for the sarin gas attacks in the Tokyo subway in 1995, he shows how the particular Japanese appropriation of Western individualism and secularism has led to the creation of a distinct set of problems socially, psychologically, and spiritually. Japan as well as other Asian cultures cannot (and probably would not wish to) return to the close-knit agrarian societies of the past any more than Western cultures can revert to their agrarian pasts. The question, then, becomes one of how to move forward in today’s global society.

Tracing the history of the emergence of Japan’s version of the modern self, Tarutani argues that today even the mother-child bond, which traditionally served as the secure ground of connection to both the human and religious realms, has been broken. In order to overturn the current perversion of consciousness and spiritual life, he advocates the cultivation of a nondiscursive awareness akin to Freud’s “evenly suspended attention” and the activation of the trickster figure such as found in Jungian psychology. According to him, a nondiscursive awareness is needed to gain a foothold against the rising tide of a fragmenting society, and a trickster consciousness is necessary to unmask and overturn false consciousness. Overall, the essay presents a tantalizing look into the “other” that shows just how different and how similar are the situations in Japan and North America.

The essays in Part II explore the possible synergy of Buddhism and psychotherapy. In “Psychotherapy and Buddhism: Attending to Sand,” Okada Yasunobu meditates on the religious and psychotherapeutic significance of sand. Beginning with some reflections on the specific qualities of sand, Okada goes on to describe the Shingon Buddhist practice of the Mantra of Light and Sand, one of the most widely disseminated practices of Japanese esoteric Buddhism, in which the practitioners carry, apply, and sprinkle grains of sand to alleviate suffering of all kinds and to purify the karma of the practitioner. Next, Okada gives an overview of Sandplay therapy, one of the fastest-growing forms of psychotherapy in the world, with Japan at the hub of this explosion. He provides case studies with illustrations, and he notes both similarities and differences between the use of sand in the Mantra of Light ritual and in Sandplay. He also discusses the mandalic use of sand in the general training of counselors and psychotherapists at Kyoto University and concludes with reflections on sand as a literary motif in Japanese and Western literature.

Sand is so ordinary and plentiful; yet when one looks closely, it is so extraordinary and precious. Okada’s chapter offers an opportunity to consider this almost eerie juxtaposition of the ordinary and extraordinary, the ubiquitous and precious—juxtapositions that, upon consideration, also seem to be at the heart of other forms of psychotherapy and Buddhist practice.

In “The Borderline between Buddhism and Psychotherapy,” I consider four areas where these two disciplines meet or diverge. First, they both attempt to meet the immediate practical suffering and needs of people while remaining grounded in a larger theoretical framework or worldview. Second, the effectiveness of both requires deep listening and deep hearing. Third, this deep hearing, whether in therapy or in Buddhist practice, often involves unexpected insights and approaches, or “rule-breaking.” And finally, both psychotherapy and Buddhist practice face challenges posed by a global society that exhibits some of the characteristics of the borderline personality. I explore these four areas using examples and illustrations from: Albert Camus’s novel The Plague; the life of Kisa Gotami, a laywoman and eventual nun in the community of the historical Buddha Śākyamuni; case studies by the American psychotherapist Milton Erickson; the life of Shinran, the founding figure of Shin Buddhism; and my own modest experiences.

In “Naikan Therapy and Shin Buddhism,” Taitetsu Unno undertakes a comparative study of Naikan therapy, a distinctly Japanese form of psychotherapy that has begun to take root in North America, and the Shin Buddhist tradition out of which Naikan grew. Placing the development of each in historical context, he describes the practice of mi-shirabe, or self-reflection, that has been characteristic of both. In Naikan, this self-reflection is formalized into intensive guided individual retreats in which the participant is asked to reflect on indebtedness to others, beginning with family members, especially parents. In Shin Buddhism, this occurs more organically in a process of religious awakening that recognizes the unique internal time frame that exists for each religious seeker.

In a number of prominent forms of Western psychotherapy, one often begins by recognizing and describing difficulties suffered at the hands of family members, especially parents. The diametrically opposed emphases of Asian forms of psychotherapy such as Naikan and Western psychoanalysis reflect precisely the kinds of cultural differences and cognitive dissonances examined by Engler, Aronson, and others. These differences between Japanese and Western psychotherapies parallel the differences that Aronson says often exist between the expectations of Asian Buddhist teachers and Western students: “Depending on who the specific traditional teacher is,” Aronson writes, “we may hear traditional moral advice about pride and be less likely to hear psychologically sensitive responses that address the psychological dilemmas of self-assertion and self-abnegation.” It is an interesting twist, then, that a form of psychotherapy that seems so alien to the American mind-set has begun to take root here.

In this chapter, Unno also introduces some of the basic elements of the Shin Buddhist path, such as intoning the Name of Amida Buddha, “Namu Amida Butsu,” based on the hearing of the Name as the embodiment of boundless compassion. To articulate these themes Unno gives an outline of Shin religious thought, offers examples of religious awareness in Shin poetry, and reflects on his experiences with D. T. Suzuki, a devoted student of the Shin tradition as well as a noted scholar of Zen.

Anne Klein in her essay “Psychology, the Sacred, and Energetic Sensing” proposes that spiritual energy and the faculty of energetic sensing, as found in the prāna, rlung, and qi of Indian, Tibetan, and Chinese Buddhism, respectively, may provide the basis for a psychology of the sacred, a psychology in which the logos emphasis of psychotherapy as the “talking cure” and the body or somatic practices of Buddhism can be bridged. Drawing on the work of A. H. Almaas as well as mystics in wisdom traditions around the world, Klein describes an unbounded wholeness that resonates with the Shin theme of boundless compassion and that expresses the effortless, spontaneous realization of sacred energy permeating body, heart, and mind. Using case studies, poetry, and metaphor as well as psychological and philosophical analyses, Klein seeks to delineate the logic of this psychology of the sacred and evoke its sensibility in the reader.

A key element of this sacred psychology is the realization of the wombmatrix and the maternal as the mature or ultimate stage of awakening. She relates this to, but also contrasts it with, infantile or regressive urges to return to the warm embrace of the biological mother’s womb. There are similarities in the palpable, somatic qualities of awakening and regression, but they are diametrically opposed in the directionality of their development. The realization of the sacred maternal as found in the Buddhist womb-matrix signifies the ability to encompass and nurture all beings in their own mature realization of cosmic responsibility.

The essays collected in Part III explore themes of death and dying. They discuss Buddhist doctrine, history, and current practices in both Japan and North America. The focus is on Pure Land Buddhism, in particular the Shin tradition, but much of the discussion is applicable to broader Buddhist and religious contexts of facing death, care for the dying, and grief following death. Julie Hanada-Lee, an ordained Shin Buddhist minister, is currently a supervisor-in-training with Clinical Pastoral Education, a nondenominational program that is nevertheless taught through Christian-affiliated institutions. In “Shandao’s Verses on Guiding Others and Healing the Heart,” Hanada-Lee gives a personal account of the challenges and rewards of learning how to train others in clinical pastoral care involving loss, grief, and death. Using the Four Noble Truths and Shin Buddhist teachings of compassion as its framework, her essay vividly illustrates several points discussed in earlier chapters. These include the misuse of religious practice as a means of avoiding personal issues, the importance of deep listening and deep hearing, and the unexpected nature of religious insight that unfolds within a structured path but that paradoxically cannot be programmed or intentionally sought. Although she herself is still in training, she conveys naturally and in ordinary language what are often discussed more technically and abstractly as issues of projection, transference, and countertransference.

Seigen Yamaoka, a Shin minister in Oakland, California, presents the Six Aspects, part of a larger program called MAP (Meaning and Process), that he has developed to provide guidance for a distinctly North American Shin Buddhist ministry. Yamaoka, who received his religious training in Japan, initially found himself lost in attempting to minister to North American congregations, precisely because of the kinds of cultural disjunction and cognitive dissonances described in earlier chapters. Drawing on traditional doctrine but reformulating and adjusting for a vastly different culture, Yamaoka presents through theory and case studies how MAP works, especially in relation to the terminally ill and their families. If there is any moment that tests the Western narrative of romantic self-redemption described by Payne, surely death must be it. Although many of the members of Oakland Buddhist Church were raised in ethnic Asian households with strong Buddhist values, as Americans they have been deeply steeped in the romantic narrative of self-redemption. In the face of death, however, this narrative fails for many of them (although it may very well work for others), leaving them with great fear, anxiety, and confusion. Some of the case studies Yamaoka presents illustrate this failure vividly, and they show how MAP serves as a bridge to the core of the Shin path of realizing deep oneness beyond life and death, the boundless compassion of Amida Buddha.

In “A Buddhist Perspective on Death and Compassion: End-of-Life Care in Japanese Pure Land Buddhism,” Nabeshima Naoki describes the development of end-of-life care in Shin Buddhism, the intellectual history of death and dying in Pure Land Buddhism, and contemporary case studies that illustrate current Shin practice, including the program of Vihara Care. One of Nabeshima’s points is applicable to other areas of social engagement: Buddhism is sometimes criticized for the lack of a more proactive, programmatic approach to social issues. Certainly, such criticisms are warranted, and one of the characteristics of Buddhism in the West has been to develop this dimension of its practices, resulting in what has come to be known as “engaged Buddhism,” including Buddhist-oriented hospice programs.

As Nabeshima points out, however, traditionally in Japan (and also in other traditional Buddhist cultures), strong networks of local support in the form of extended families, temples, and villages provided the setting in which individuals were able to meet the end of life in a supportive environment surrounded by human love and Buddhist compassion. This was also the case with other social issues such as care for the mentally ill, the physically disabled, and the poor. When Buddhism first spread to foreign lands, it tended to blend with local beliefs and cultures. To a significant degree, this allowed organic, local networks of social support to continue, and in the best cases Buddhism helped them to flourish. This is in contrast with Christianity, which, seeking to displace local religions, often provided alternative social services and institutions. Both the Buddhist and the Christian models surely have their strengths and weaknesses, and it is therefore important to recognize their differing histories and approaches.

However, as Japanese society has become increasingly compartmentalized, following first the Christian pattern and then the secular West, Japanese Buddhists have increasingly found it necessary to develop institutionally organized programs for addressing social needs including those at the end of life. According to Nabeshima, Buddhists have done so in a distinctly Buddhist manner. “Hospice care or palliative care aims to care for and support patients and their families with compassion until the patient dies. [Buddhist] Vihara Care shares this same goal, but secondly also seeks to care for and support bereaved families during their grief after a loved one’s death. The Vihara movement aims to link grieving people with deceased loved ones through memories even after death, [understanding that all beings are mothers and fathers, brothers and sisters, in the timeless process of rebirth].”

In addition to the essays in the main body of this volume, two articles and a list of key terms are included as special appendices. In “Illusions of the Self in Buddhism and Winnicott” Franz Metcalf considers the possibility of bridging the language of Zen Buddhist practice with that of object-relations psychotherapy. The article is written largely as a response to Jack Engler’s article “Being Somebody and Being Nobody: A Reexamination of the Understanding of Self in Psychoanalysis and Buddhism,” included in Safran’s Buddhism and Psychoanalysis, and secondarily to some of the views articulated by Jeremy Safran’s introduction to the same volume. The Metcalf piece constitutes part of a dialogue that continues through the present volume, and those unfamiliar with Engler and Safran’s work may find it a bit hard to follow in isolation. Its unusual “call-and-response” format makes clear its dialogical character.

Naitō Chikō’s essay “Shinran’s Thought Regarding Birth in the Pure Land” offers an account of such birth according to a traditional Japanese sectarian presentation of Shinran’s thought. Of particular note are Naitō’s treatment of how to understand the moment of death, which is said to be the moment of birth in Amida’s Pure Land; how this moment relates to the working of shinjin, or true entrusting, that occurs as the Shin practicer entrusts heror himself to Amida’s boundless compassion; how this true entrusting ultimately comes from Amida as one’s own deepest and truest reality; and how the best preparation for death is thus not to think of death but to focus on realizing shinjin, true entrusting, in the present moment, here and now. Although this essay does not address the specific topic of Buddhism and psychotherapy, it provides helpful background for those unfamiliar with Shinran’s thought, as noted by some of the authors in this volume.

For those unfamiliar with Pure Land Buddhism generally and Shin Buddhism in particular, an overview of some of the key terms is also provided as an appendix.

As a beginning rather than a culmination, the chapters included in this collection reflect the enthusiasm, collaborative spirit, and meanderings of those moving together into relatively uncharted waters. In that sense, they may raise more questions than they answer, and even raise some eyebrows. But we will have done our job if that is the case, for the issues discussed herein call for attention and some eyebrow-raising. As the old Zen proverb says, we are all the blind leading the blind, and perhaps some good will have been done if we find the contours of our blindness illuminated by the brilliant light of awakening, Buddhist, psychotherapeutic, or otherwise.


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© Mark Unno, Buddhism and Psychotherapy Across Cultures (Wisdom Publications, 2006)

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