What Makes Buddhist Psychotherapy Buddhist? Part 1 - The "Middle Path"

If you got a group of ten Buddhist psychotherapists together and asked them this question, you would probably hear ten different answers. That's because there is no official definition of Buddhist psychotherapy and no universal set of standards to determine if a therapist is practicing in a Buddhist way.

Basically, psychotherapy is Buddhist if the therapist says it is. Each therapist has the freedom to integrate the wisdom of Buddhism into their therapy work however it makes sense to them. So this series is really a description of how I personally conduct Buddhist psychotherapy in my private practice, and not a global definition of what Buddhist psychotherapy is.

It's important to remember that the goal of Buddhist psychotherapy is never to convert clients. It should never be the therapist's agenda for you to start studying or practicing Buddhism (or any other particular tradition).

In my view, my calling the psychotherapy I practice "Buddhist" is just being transparent about the theoretical lens I use as a therapist, so that you as a client are well-informed about my biases and the kind of treatment you are receiving.

"Middle Path" Approach

Buddhism is known as the "middle path" because it advocates for avoiding philosophical extremes. One example of this is avoiding both extreme asceticism (severe self-discipline and rejection of worldly pleasures) and unbounded hedonism (unconstrained self-indulgence in worldly pleasures).

There is a famous story from the Buddhist sutras where the Buddha nearly starves to death after engaging in a prolonged period of extreme fasting as a spiritual practice. He is saved by a girl named Sujata who brings him rice pudding, which revives him completely. On the basis of this experience, the Buddha realizes that they way to enlightenment is neither in extreme deprivation nor extreme self-indulgence.

Similarly, in Buddhist psychotherapy, there is a sense that answer to our psychological problems often involves finding a "middle way." One example is learning to have a healthy range of emotions where we experience our feelings organically and let them pass naturally. We can learn to move out of patterns of avoidance where we constantly say everything is fine when when it's not, or claim we don't experience anger or jealousy. At the same time, we can learn to transition away from the opposite extreme of engaging in histrionics where we react dramatically to every challenge life throws our way.

Sometimes for our psychological health we need to make more extreme choices, like stopping substance use completely or going to rehab when an addiction has taken hold or leaving a toxic relationship that is harmful. In Buddhist psychotherapy, we avoid even the extreme of saying we'll never take an extreme action, when sometimes extreme action might be needed.