Book review first published in British Journal of Psychotherapy, 2014, 30: 3

The Trauma of Everyday Life, by Mark Epstein. Published by Penguin Press, New
York, 2013; 225 pp, hardback.

When in 2003 Jeremy Safran published a collection of papers on Buddhism by

psychoanalysts and Buddhist meditators, he subtitled it: an unfolding dialogue. That
was clearly a correct description. The psychoanalysts involved included such well-
known figures as Stephen Mitchell, Stuart Pizer, James Grotstein and Owen Renik.
But every one of them, on both sides of the ‘dialogue’, with the single exception of
Neville Symington in Australia, was American. For UK analytic thinkers, it was as if
we were overhearing an interesting conversation taking place in another room.

This dialogue had its roots in the 1950s, when D.T. Suzuki in particular brought Zen
Buddhism to the United States, and independent psychoanalysts such as Erich Fromm
and Karen Horney recognized something of the richness and psychological profundity
of Buddhist thought. Since then, there has been a big influx of Tibetans and teachers
from other schools, and Buddhism has quietly established itself in religious America
at a more deeply integrated level of seriousness than has yet been possible (though
there are many growing-points) in relatively irreligious Britain. And of course I’m
begging a question in putting it like that. Is Buddhism a religion?

The return of Buddhism onto the American psychoanalytic scene, in the past twenty-
five years or so, links with the rise of ‘relational’ psychoanalysis, which finds a
principal ancestor in Winnicott (so the British don’t need to feel left out entirely).
Winnicott’s ‘no such thing as a baby’ might be the motto above the gates of relational
psychoanalysis, and the no-self doctrine of Buddhism (we never are, we only ‘inter-
are’, as Thich Nhat Hanh put it) fits neatly into place with such thinking. The
relationalist’s emphasis, that psychoanalysis is the co-creation of two subjectivities,
can find support and inspiration in both sources.

1
Mark Epstein has been a major contributor to this development, and he acknowledges
Winnicott, along with relationalists such as Robert Stolorow, as a key thinker in his
psychoanalytic approach. An earlier book, Thoughts Without a Thinker, made a
considerable impact when it appeared in 1996, and in it Epstein looked at
psychoanalytic therapy through the lens of the Buddha’s foundational teaching of the
Four Noble Truths. In the present book, he takes his understanding further,
structuring much of what he says as a psychoanalytic commentary on the legend of
the Buddha’s life. On the one occasion when I’ve met Epstein, he told me he was
trying to get away from the academic style of much analytic writing, and he has
succeeded triumphantly: his book is written in a very accessible style, with many
examples from clinical practice, and several stories from his own life, and there is a
refreshing refusal to take shelter behind the authorities or technical language of either
of his two traditions.

His central point, implied in his title, is the First Noble Truth that ‘all is suffering’.
Some will question Epstein’s use of the word trauma; ‘suffering’ in the Buddha’s
usage is the ‘coefficient of adversity’ in every situation, the sense (in the original
Sanskrit metaphor) in which the wheel never fits perfectly onto the axle. Without
disputing that truth, one might want to reserve the term trauma for the huger, un-
processable events that overwhelm the ego. Epstein, I think, would reply that we
have all suffered such un-processable traumas in babyhood, so there is a base of
traumatic experience in all of us; and I think too, though he doesn’t quote Masud
Khan, he is also thinking of what Khan called ‘cumulative trauma’, the impact upon
us of the smaller but recurrent failures of our environment – the repeated failures of a
kindly parent, for example, to understand the extent of a child’s anger or distress.
Epstein is wanting with his title to contradict the pervasive assumption in our culture
that we should always be ‘feeling great’.

In the Buddha’s case, he certainly suffered a huge early trauma: the death of his
mother when he was seven days old (she died, says the sutra, because she was unable
to endure the joy of having given birth to her son). All the luxury of the Buddha’s
upbringing could not make up for this loss, and when his own son was born life
became intolerable to him: he quit his family and his home and went in search of what
would make life bearable. Epstein discusses this psychological picture with great

2
sensitivity. (He may overstate the extent to which previous Buddhist commentators
have ignored the Buddha’s early loss; very often it goes unmentioned, but I have
heard a Vietnamese monk expound the same story with extraordinary insight, derived
not at all, as far as I could tell, from psychoanalysis, but from reflecting on his own
trauma as a child in the horrors of the Vietnam war.)

The central question for the psychotherapist about Buddhism is: how does meditation
relate to the analyst’s ‘evenly-hovering attention’, or to the patient’s mind in free
association? Epstein’s account of Buddhist meditation is of a rediscovery of maternal
holding. The Buddha’s first impulse when he left home was to follow the
conventional religious path of his day, namely, to practise austerities. A recent
exhibition of bronze sculptures in London’s Royal Academy included a chillingly-
detailed ‘fasting Buddha’ from the second century. Anyone who has worked with
anorexic patients would recognize its accuracy. In Epstein’s reading, such austerities
represent the attempt to master and control one’s trauma by dissociating from it,
which we are familiar with in our patients. According to legend the Buddha was
superlatively good at them, but the attempt was doomed to failure. It was when the
Buddha finally abandoned his austerities, and accepted some ordinary milk-and-rice
from Sujata, that he became ready for his experience of Enlightenment. In Epstein’s
words: ‘the path out of fear and dissociation depends on the ability to use reflective
awareness to study the nature of everyday experience’ (124) – not on increasing the
dissociation by self-punishment.

This phrase, ‘reflective awareness’, is a key to understanding the nature both of the
psychoanalyst’s reverie and of the meditator’s ‘mindfulness’. ‘We have the ability’,
says Epstein, ‘to be both subject and object to ourselves, and this capacity of
reflective self-awareness has the potential to enlighten us, to ease the burdens we all
carry’ (140). In meditation, ‘the ego surrenders its supremacy to the auxiliary
function of mindfulness’ (156). These sentences give, I think, the clearest picture of
Epstein’s understanding of what happens in meditation.

Although Epstein speaks of the trauma of everyday life, he is especially concerned

with the traumas of infancy which become installed in implicit memory and then
influence us in ways beyond our control, producing distortions in relatedness.

3
‘Unresolved trauma’, he writes, ‘waits at the gate of experience, looking for an
opportunity to express itself’ (147). He illustrates this with a painful story of his own
distress, when he viewed a video from twenty-five years previously of a moment
when he blundered in on the careful, playful relating of his wife and baby daughter.
His shock and shame at his self-recognition are very moving, and so too is his
realisation, later on, that his shame-inducing behaviour had deep roots in his own
early experience. The result was not ‘self-forgiveness’, exactly, but self-acceptance.
With this vulnerable example, oddly like a milder version of the Buddha’s experience
(the encounter with a new mother-and-baby awakening unmanageable echoes from
the past), Epstein shows vividly the mental developments that can take place in a
process of mindful self-awareness.

New to me, and very fascinating, was a series of dreams Epstein discusses, which the
Buddha dreamt after abandoning his austerities and before achieving Enlightenment.
The sutra that is their source supplies them with blandly pious interpretations;
Epstein’s interpretations (let’s be a little triumphalist on behalf of psychoanalysis!)
show us how much more profoundly illuminating they become when viewed in a
psychoanalytic perspective. They make it convincing that what was happening in the
Buddha was the inner discovery of a maternal ‘safe-holding’ capacity, by which
traumatic experience could be rendered endurable, and from which the stillness and
concentration, the fundamental ‘stopping and looking’ of Buddhist meditation, could
be practised.

Well, this is a fascinating book and I warmly commend it to anyone even slightly
intrigued by these issues. Perhaps some readers will be left, as I am, with a question.
Does it mean that Buddhism is, at the end of the day, just another psychotherapy,
much like ‘mindfulness behaviour therapy’, which is derived from Buddhist
meditational practice but makes no claim to be religious? Perhaps Buddhism is just a
profound and thoughtful sort of psychotherapy, and nothing more than that? ‘The
Buddha was figuring out how to relate’, says Epstein (143). Is that all he was doing?

I suppose it depends what it is you think he was figuring out how to relate to.
Epstein’s reading shows persuasively that the Buddha legend certainly from one
aspect can be read as describing a psychotherapy necessitated by early loss. The

4
outcome of the story, however, is not that the Buddha, having worked through the
depressive position, soberly returned to his wife and family, apologizing for inflicting
on them a trauma not unlike the abandonment he himself had experienced. That
would have been a perfectly good outcome of successful psychotherapy. But it is not
what happened.

References

Epstein, M. (1996) Thoughts Without a Thinker: psychotherapy from a Buddhist

perspective. New York: Basic Books; London: Duckworth
Safran, J. (2003) Buddhism and Psychoanalysis: an unfolding dialogue. Boston:
Wisdom Publications