In the introduction to his book, psychiatrist Mark Epstein recounts the story of a smart and eager professor who sought wisdom from an old Zen master. The master offered him tea and, on the professor's acceptance, poured the tea into a cup. To the professor's dismay, however, the master kept pouring the tea into an overflowing cup, even as the tea spread across the floor.
"A mind that is full cannot take in anything new," the master explained. "Like this cup, you are full of opinions and preconceptions." Wisdom and happiness are to be found only by emptying one's cup.
With this story, Epstein illustrates what he believes is an important problem for modern Western culture. Trained to approach life in the same way as the professor in the parable, Westerners tend to fill their lives with things and knowledge the way the master filled the cup with tea. In the psychological arena, this gives rise to a sort of psychological acquisitiveness, whereby we attempt to beef ourselves up with self-esteem, self-confidence, self-expression, or self-control. The message of Buddhism, Epstein argues, is that this Western tendency to build and strengthen the ego toward the ideal of a strong, individuated self will not work. We come to wisdom and peace of mind only by acknowledging the difficulties that are created by the ego's blind need to control and by allowing emptiness to be present as an inevitable and often valuable state.
Beginning with his own sense of emptiness as a boy in high school and then presenting a variety of Buddhist parables, clinical anecdotes, and personal examples, Epstein recounts what he has learned so far in his lifelong journey to understand the mind. Observations of his undergraduate classmates at Harvard, his contacts with the Dalai Lama, his deepening ability to understand and live in both Eastern and Western worlds during medical school and residency, and his subsequent contact with several schools of psychoanalysis, Gestalt therapy, and especially the writings of Winnicott -- this very personal journey reflects Epstein's growing conviction that the Western psychological notion of what it means to have a self is flawed.
Western thought tends to pathologize what is understood in Buddhism as a universally human starting point for wisdom and self-understanding. The "deficiencies" of childhood and the "errors" of adult life often do not represent darkness or void, as they initially seem to, but rather, are occasions that create the possibility of life and freedom. Human urges and conflicts are not necessarily pathologic; instead, they reflect the movement of life as it attempts to become manifest within us. The point is to allow the conflicts to surface and become visible.
In response to the Western proclivity for knowledge, Epstein offers wisdom from the ancient texts of Buddhism; in response to the Western bias toward individuation, he offers connection; in response to the emphasis on rational mind, he offers mind-in-the-heart. In response to the warring of our cultural dualisms, whether between mind and body, individual and community, or men and women, he offers unity and reciprocity. All of this becomes possible through a "middle way" of nonjudgmental awareness that avoids either "attachment" or "aversion" to any of these polarities and, in so doing, transforms experience. Then, says Epstein, one can live in the lion's den of life with honesty and authenticity.
In sizing up the possible relevance of Eastern mysticism to Western postindustrial cultures, it is important to understand that both Western science and Christianity were born in what we now call the East and that many modern problems revolve around ways in which intellectual categories have been reshaped since then. In the emergence of the intellectual basis of Western culture, science and values developed in reaction to each other and, in so doing, became somewhat falsified and alienated from the way in which people actually lived their lives. The most extreme separation occurred in Descartes's sharp isolation of the worlds of mind and matter. Since then, medicine has come to view the body as a machine with parts that could be manipulated. Personhood came to be understood as an increasingly large and fragmented number of components and functions, and academic inquiry was cordoned off into disciplinary ghettos. It is only with growing recognition of the limits of the Cartesian-Newtonian framework for solving human problems, the development of quantum mechanics, general-systems theory, and brain science, and the increasing contact between the West and the East that these old separations are breaking down.
In general, Epstein's discussion is balanced, and he is aware of the paradoxical nature of his topic. In his efforts to explicate the Buddhist worldview, however, he occasionally parodies Western psychology and its notion of the self. Self-esteem, self-confidence, the building of a strong self -- these are not the problem, although some of his statements could lead readers to believe otherwise. Instead, the problem arises when selfhood becomes the only goal. To become oneself, one must also lose oneself. In the expression of an idea so dialectical, one statement immediately implies its opposite. The sweetness of the "middle way" is not learned easily or quickly, and fictions abound on both sides of the discussion.
Plato's Socrates once wondered whether he should be a politician or a physician -- that is, whether he should try to serve the existing tastes and interests of his fellow citizens or continually work to improve their minds and souls. Going to Pieces without Falling Apart will appeal to physicians, therapists, and patients who, like Socrates, opt for the latter.
Reviewed by Jeffrey Rediger, M.D., M.Div.
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