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Chinese Buddhism: Implications for Counseling

The following chapter appeared in Evelyn Lee's book Working with Asian Americans: A Guide for Clinicians (1997). Reprinted with the permission of Guilford Press.

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Chinese Buddhism:

Its Implications for Counseling



The Buddha once said: "There are two kinds of illnesses. What are those two? Physical illness and mental illness. There seem to be people who enjoy freedom from physical illness even for a year or two.... But, rare in this world are those who enjoy freedom from mental illness even for one moment" (Rahula, 1978). When one's mind is healthy, physical illness will diminish. If all the illnesses of one's mind are cured, one is "liberated."

Curing the human mind and producing a state of perfect mental health, equilibrium, and tranquillity are major aims in Buddhism. The extensive scriptures containing Buddha's teachings outline the methods and means to eliminate sufferings and bring happiness to all beings. The aim of this chapter is to summarize several important principles of Buddhism and discuss how these can be applied in therapy.


The founder of Buddhism was Sakyamuni, who lived in Northern India in the sixth century B.C. Though a crown prince in the Kingdom of the Sakayas (in modern Nepal), he felt unfulfilled, even though he seemed to have everything–lots of riches, a wife, and a son (Dhammananda, 1982). One day, while visiting the city, he saw the "Four Passing Sights," namely, an old man, a sick man, a dead man, and a holy recluse (Smith, 1986). These sights, which he had never seen inside the palace before, made a dramatic impact on him. He then realized that life is susceptible to age, death, and suffering.

Sakyamuni wanted to find a "cure," not only for himself, but for all mankind. So he left the palace as a monk, to search for enlightenment. With 6 years of ascetic practices under different religious teachers, he realized that would not lead him to liberation. Thus, he went on his own way. One night, seated under a tree, he attained enlightenment at the age of 35. He then became known as the Buddha, meaning "The Awakened" or "The Enlightened One." The teachings of the Buddha are known as dharma. This word literally means "law," meaning the universal laws that represent things as they really are. The Buddha went on to teach all men and women, without distinction regarding their social class, occupation, or ethnic origin. At the age of 80, the Buddha passed away at Kusinara (Rahula, 1978; Narada, 1982).

Among the founders of the major religions on earth, Buddha was the only teacher who did not claim to be other than a human being. He attributed all his realization, attainments, and achievements to human endeavor and human intelligence. Every person has within himself or herself the potential of becoming a Buddha. The Buddha taught and encouraged each person to develop him- or herself and to work out his or her emancipation, for each human has the power to escape all bondage through his or her own personal efforts and intelligence.


The doctrines of Buddha's teachings (Dhammananda, 1982; Narada, 1982; Niwano, 1990; Rahula, 1978) explain very clearly the causes of human suffering, how we can fundamentally solve the problem of the suffering and distress that we face with in our daily lives, and how we can achieve a mental state of peace and quietude. The following is a brief summary of the basic principles in Buddhism.

Four Noble Truths

According to Buddha's teachings, the problem of existence and its solution are precisely expressed in the Four Noble Truths. The First Truth diagnoses the symptom of an illness and the Second determines its cause. The Third Truth describes the final cure of the disease once the cause has been eliminated, and the Fourth prescribes the medicine or treatment that will bring about the cure. Following are the chief characteristics of the Four Noble Truths:

  • All existence entails suffering.
  • Suffering is caused by ignorance, which leads to craving and illusion.
  • There is an end to suffering, and this state of nonsuffering is nirvana.
  • Nirvana is attained through the practice of the bodhisattva way.

The first of the Four Noble Truths is the Truth of Suffering. Buddha explained the eight causes of suffering. The human condition has always entailed countless sufferings, as exemplified by the eight types enumerated by the Buddha. The first four sufferings are birth, old age, sickness, and death. The second four sufferings are separation from loved ones, association with unpleasant persons and conditions, not getting what one desires or due to unfulfilled wishes, and finally, suffering due to the raging skandas. The five skandas are form, feeling, perception, volition, and consciousness. This is the suffering of the body and the mind. Our physical bodies are subject to birth, old age, disease, death, hunger, thirst, heat, cold, and weariness. Our minds, on the other hand, are afflicted by anger, worry, love, hate, and other emotions. The word "suffering" here does not represent a pessimistic view of life but rather presents a realistic view of life and the world.

The Truth of Cause means that we must reflect on what causes have produced these sufferings, and we must investigate them and understand them clearly. The Buddha found that the fundamental cause of suffering is ignorance. Ignorance, in turn, leads to the rise of self-centered desire. Ignorance and desire combine to blind us and preclude any possibility of realizing our inherent spiritual nature. Because of ignorance, living beings create karma.

The Truth of Extinction is the state of absolute quietude wherein all the sufferings in human life are extinguished. This is a state attained only by awakening to the three great truths that Buddha has taught us: "All things are impermanent," "Nothing has an ego," and "Nirvana is quiescence."

Ordinary people cannot easily realize these three great truths. However, the Truth of the Path shows the way how people can practice the bodhisattva way with their mind, body, and actions. This means that they must devote themselves to the practice of the doctrines of the Eightfold Path and the Six Perfections (Tables 30.1 and 30.2). The Eightfold Path consists of right view, right thinking, right speech, right action, right living, right endeavor, right memory, and right meditation. The Six Perfections teaches us the six kinds of practice: donation, keeping the precepts, perseverance, assiduity, meditation, and wisdom.

TABLE 30.1. The Eightfold Path (Niwano, 1976)

Right viewTo see all things rightly, based on the Buddha's wisdom, which discerns and understands the principle of the Reality of All Existence.
Right thinkingTo think rightly, avoiding the three evils of the mind
Right speechTo speak right words, avoiding the four evils of the mouth
Right actionTo act rightly, avoiding the three evils of the body
Right livingTo gain food, clothing, shelter, and other daily necessities in a right way
Right endeavorNever to do evil and always to do good
Right memoryTo have a continuous right mind toward both oneself and others
Right meditationTo strive constantly for the true Law and to be fixed and settled in it

In summary, the Four Noble Truths teach us to face the reality of human suffering, to grasp its real cause, to practice daily the bodhisattva way to help ourselves and others and thereby to extinguish various sufferings.

TABLE 30.2. The Six Perfections (Niwano, 1976)

DonationMakes a miserly one raise the mind of donation: to serve sincerely the community and other people
Keeping the preceptsMakes an arrogant one raise the mind of keeping the commandments: to remove the mind of arrogance and to admonish and discipline oneself
PerseveranceMakes an irascible one raise the mind of perseverance: to remove anger and to endure
AssiduityMakes an indolent one raise the mind of assiduity: to endeavor constantly
MeditationMakes a distracted one raise the mind of meditation: to calm one's mind and not be agitated
WisdomMakes an ignorant one raise the mind of wisdom: to remove prejudice and evil thinking through correct judgment


Karma means "deed" or "action." Whenever there is action, there will be consequences. This is the concept of cause and effect. All the things we do in body, speech, and thought are causes. And all the things that happen to us are results. All that we are at the present moment is the result of the karma that we have produced in the past. Karma is complex and serious. Our deeds, however trivial, leave traces-physically, mentally, and environmentally. The traces left in our minds include memory, knowledge, habit, intelligence, and character. They are produced by the accumulation of our experiences and deeds over a long period of time (Niwano, 1976).

The "karma of a previous existence" that Buddhism teaches is more profound, as it include the karma that our own life has produced through the repetition of birth and death from the infinite past to the present (Niwano, 1976). However, this is not a fatalistic view that everything is predestined, because in between the cause (seed) and effect (fruit), there are many variable conditions (new sets of karma) which can be changed. Thus they can affect the outcome. The idea of karma teaches us clearly that we will reap the fruits of what we have sown. People should take total individual responsibility of their own actions.


According to Buddhist teaching, reincarnation is part of life. Buddhists believe there are at least five planes of life: the Heavenly Beings, Human, Ghosts, Animals, and Hells. All beings in these classes continue in the cycle of rebirth and death until they can be liberated. They also can "transmigrate" from one class to another, from one life to another. Death is part of the endless life cycle.

Four Virtues

  • One should have faith and confidence in moral, spiritual, and intellectual values.
  • One should abstain from destroying and harming life, stealing and cheating, adultery, falsehood, and intoxicating drinks.
  • One should practice charity and generosity, without attachment and craving for one's wealth.
  • One should develop wisdom which leads to the complete destruction of suffering, to the realization of nirvana.

In addition to the four virtues, Buddha also teaches "noble discipline." Six family and social groups should be treated as sacred and worthy of respect and worship. They are parents; teachers; spouse and children; friends, relatives and neighbors; servants, workers, and employees; and religious men. Budda provides a practical guide in how to deal with these family and social relationships in our daily lives.

Compassion and Wisdom

According to Buddhism, for a man to be perfect, he should develop two qualities equally: compassion on one side and wisdom on the other. Here, compassion represents love, charity, kindness, tolerance, and such noble qualities on the emotional side, or qualities of the heart. Wisdom would stand for the intellectual side, or qualities of the mind. If one develops only the emotional, neglecting the intellectual, one may become a good-hearted fool. To develop only the intellectual side and neglect the emotional may turn one into a hardhearted intellect without feelings for others. Therefore, to be perfect, one has to develop both compassion and wisdom equally (Rahula, 1978).


Recently, an increasing number of clinicians have begun to explore the possibilities of employing Buddhist principles and techniques in therapeutics contexts. This trend is important, in view of the increasing number of Asian clients who are Buddhists and non-Asian clients who are interested in alternative healing methods. This respect for clients' religious and spiritual backgrounds is vital, in view of the fact that religious and spiritual beliefs affect how these clients identify and present their problems, explain the causes of the problems, and seek health care.

Many possible approaches to counseling exist that use Buddhist teachings. Here, we discuss only three such approaches.

Conceptual Therapy

This is a cognitive approach of therapy based on the Buddhist concepts that "all of existence is a creation of the mind." People can gradually learn and understand these Buddhist concepts and change their way of thinking, feeling, and acting. Thus, they can change their "negative" behavior to "positive" behavior and attain the therapeutic goal of mental harmony. Following are some case examples of applying Buddhism principles in counseling.

The Concepts of Eight Sufferings and Impermanence

A 50-year-old Chinese woman came for counseling because of depression. Mrs. L took a disability leave from her job as a computer programmer. The bank where she worked was recently "taken over" by other institutions. Consequently, Mrs. L was reassigned to a different department and was under the supervision of a much younger boss who was very demanding and showed no respect for her contribution to the company over the past 20 years. In addition, her mother had passed away recently after suffering from cancer for 3 years. Mrs. L's husband, who used to be quite supportive of his wife, appeared to be less caring because he was preoccupied with his own job security, as his company was planning on "downsizing." Mrs. L's only daughter had just finished graduate school and moved far away to take a new job.

In the beginning phase of counseling, Mrs. L spent most of her time complaining of her "misfortune" and "bad luck." She felt life was unfair to her after years of hard work at business and at home. She asked "why" about her suffering. As a Buddhist, she was encouraged to examine her misfortunes from the Buddhist teachings of eight sufferings, impermanence, and the concept of karma. She realized that the sufferings in her life, such as disease, death, old age, separation from loved ones, unfulfilled wishes, and work with someone whom she hated, were part of human condition. Company mergers or downsizing was part of change and impermanence. This understanding helped her to let go of her grief and anger. She gradually accepted responsibility for taking care of herself. She accepted the situations she was not able to change and focused her energy on those areas in which she was able to make positive changes.

The Concept of Reincarnation

A 48-year-old woman became angry and depressed after she was told by her husband that he had been seeing another woman for the past 4 years. She had thought that she was happy and lucky to have a wonderful marriage and three nice children. Now, all seemed to be an illusion. With therapy, she was able to understand that in her past lives, she also had different people as spouses, and so did her present husband. In their future lives, they are likely to have different people as spouses too. The only change that led to her present misery was her finding out what her husband had done in the past 4 years. Realizing that we are like travelers meeting and separating in time and space, she was determined not to be bothered by the entanglements from past lives and the uncertainties about future lives. She took responsibility for turning her anger into caring so she would not continue her entanglements with her husband. She learned new communication skills to improve the marital relationship and be a better mother. She was able to regain her confidence and happiness. Her husband was so impressed by her positive changes that he decided to end his extramarital affair.

Treatment providers should note that belief in reincarnation is one of the biggest cultural differences between Western and Eastern thought. However, the concept of reincarnation is being explored in mass media today because more and more people are receptive to this idea (Yeung, 1995). There are also many case studies and reports on reincarnation by mental health professionals. Studies on reincarnation vary from reports on individual clinical treatment under hypnosis (Weiss, 1988, 1992), long-term case studies of people who could remember their past-life events (Stevenson, 1977; Story, 1975), and life-before-birth experiences revealed under hypnosis (Wambach, 1979). Books on past-life therapy break through the barriers of conventional psychotherapy to present an innovative and effective treatment approach (Weiss, 1988, 1992).

The Concept of Birth and Death

A 68-year-old woman who used to enjoy life with enthusiasm became despondent and worrisome after a fortune teller told her that she would die at age 70. She became preoccupied with the fear of dying and was frightened about the uncertainties before and after death. She started to worry about missing her four children and grandchildren. As a Chinese Buddhist in beginning practice, she was encouraged to explore the Buddhist concepts of death, cause and effect, and reincarnation. She also studied the Heart Sutra to understand the concept of "no self' and illusion. Gradually, she overcame her fear of dying and death by believing that death is not an end but the beginning of life. Knowing that she has done a lot of good in this life, she felt confident that she would come back as a human being and may meet with her loved ones again. She suffered a major heart attack at the age of 72 and has made a remarkable recovery. She is still alive at age 77.

The Concept of Compassion

A 60-year-old depressed man had lost his business and become utterly bitter and isolated after he was humiliated by a young man whom he had helped to build a successful business enterprise. The young man refused to reciprocate. Prior to this loss, he had been sympathetic and helpful to others and was now quite disappointed that his friends did not offer help when he was in need of assistance. In the beginning of therapy, he was resistant to any help and spent most of the counseling sessions expressing his anger toward his ungrateful friends. One day, he picked up a booklet in temple about the concept of compassion in Buddhism. He tried to apply it to deal with his personal crisis. One day, he said, "I was compassionate before and I was very happy. I should not assume the role of a victim after I had setbacks. There is not much time to waste in life. Unable to forgive, I was full of grudges which actually hurt myself. I am going to resume being compassionate and forgiving again." He gradually regained his physical and mental health and eventually his business.

The Concept of Interdependence

A 16-year-old boy was very arrogant and selfish. Even though he was the best student in class, he had no friends and was isolated. At home, he bullied his younger sisters, and because he was the only son, he was favored by his grandparents. He became depressed after he lost the number-one position in class after being hospitalized for a few weeks because of a viral infection. In therapy, the boy and the counselor discussed the concept of interdependence. The counselor used various analogies. For example, to highlight the concept the counselor used the analogy of a car needing the proper combination of the engine, the tires, and even a small screw to run smoothly. The boy started to realize that many family members, teachers, and friends had contributed to his academic success in the past and he should not be so arrogant. Gradually, he was able to appreciate the importance of mutual respect and the equal contributions of other people in life. He eventually regained his number-one position in class but shed his arrogance and selfishness. He became a happier person and made many friends.

Practical Therapy

This is a behavioral approach of therapy that teaches people to do something to achieve mental harmony and stability. It emphasizes the need to persevere and practice every day.


Meditation is the principal practice used to develop one's mind along the path to the end of suffering. The goal is to calm the scattered and unbalanced mind. In Buddhism, meditation does not mean "hard thinking." It means calming the body and thought processes and then observing all that goes on inside oneself. The most general and widely practiced meditative technique is breathing meditation, which consists of focusing one's attention on the breath and then observing the consequent bodily and mental processes. Counting numbers and walking can also be used as preliminary meditation techniques. Its primary contribution to mental development is in the establishment of the calm that arises when one banishes all enmity and ill will from one's mind. While we practice conscious breathing, our thinking slows down and we can give ourselves a real rest. Most of the time, we think too much, and mindful breathing helps us to be calm, relaxed, and peaceful. It helps us stop thinking so much and stop being possessed by sorrows of the past and worries about the future. It enables us to be in touch with life, which is wonderful in the present moment (Hanh, 1992). Meditation is generally helpful for most people with or without emotional stress. However, people who have such psychotic symptoms as hallucinations should not meditate without close supervision (some people may experience hallucination during meditation).

Buddhist masters developed many different meditation techniques. For example, mindfulness and walking meditation are very useful in dealing with negative emotions (Hanh, 1992). Many mental health professionals also apply meditation in conjunction with psychotherapy. For example, Epstein (1995) explains the unique psychological contributions of the teaching of Buddhism, and also describes the path of meditation in contemporary psychological language and lays groundwork for a meditation-inspired psychotherapy.


When we are worried or emotionally disturbed, we can concentrate on chanting the Buddha's name to feel connected to and protected by the Buddha. This also helps to remind us about the Buddha's virtues of perfect compassion and wisdom. Chanting is also used in certain life conditions. For example, for the Mahayana Pure Land Sect, when a person is dying, family members and friends gather around and chant the name of the Amitabha Buddha. This is to stabilize the mind of the dying person and to help him or her chant. Members of this sect believe that if the dying person chants the name of the Amitabha Buddha with absolute sincerity, it is enough to bring him or her into the most connection with the Buddha (Yeung, 1995)

Practicing the Buddha's Teachings

As mentioned in the previous section, Buddha's teachings offer a profound analysis of the problem of suffering while providing both an alternate vision free of suffering and the actual methods we need to realize that awakening. The Buddha established the Five Moral Precepts as basic Virtues for human life and the very essence of spiritual cultivation. They are as follows: Do not kill, do not steal, do not engage in sexual misconduct, do not speak falsely, and do not take intoxicants. The moral precepts are rooted in self-respect and respect for others. The path that leads to the cessation of suffering is to practice the bodhisattva way. This means that an individual should devote him- or herself to the practice of the doctrines of The Eightfold Path (Table 30.1) and The Six Perfections (Table 30.2).

Applying Buddhist Stories in Therapy

Storytelling can be used effectively to enhance the client's understanding of a certain situation. Many Buddhist stories can be used in counseling sessions. Following are three examples:

  • Are you still carrying her? This story can be used to illustrate the concept of "letting go" and not hanging on to the past. A young monk went on a trip with his master. On their way, they met a young woman who was hesitating near a small stream. To cross the stream would mean that she would get her dress wet. The old master offered to carry her across. After some thought and with a certain embarrassment, she agreed. After they had crossed the stream, they parted and went on their separate ways. However, the incident bothered the young monk. That night after they were settled, he said to the old monk that monks were not supposed to be near women, let alone carry them. To which the old monk replied: "I left the woman at the bank of the stream. Are you still carrying her?" (Cheng & Lo, 1991).
  • Can you save my son? This story helps a client accept certain realities in life, such as dying. A woman lost her only infant, and she became extremely distraught. She carried her dead son's body to the Buddha. She wanted him to revive her son. She was beyond reason. Seeing the woman in such overwhelming grief, the Buddha agreed to help if she would bring back some mustard seeds. She was very happy to hear that. However, the Buddha told her that the seeds had to be from a household where no one had died. Without hesitation, she set forth to look for the seeds from village to village. After a long and exhaustive search, she found no such seeds but discovered the nature of life (Narada, 1982). When she went back to see the Buddha, she was calm and peaceful.
  • Can you help me find enlightenment? This story helps a client become less arrogant and become more open to learning new skills. One day, a proud young man went to a Chan (Zen) master for advice on how to become enlightened. The master looked at the young man for a few minutes, not saying anything. He then invited the young man to have tea with him. He poured the hot tea until it overflowed. The young man was stunned; he asked why the master did not stop pouring. The master answered: "If your mind is like this cup–already full–there is no hope you'll ever learn anything new."


Buddhism and psychotherapy share common goals: to alleviate human suffering and achieve inner peace. While Western psychology has contributed much to the understanding of the biological and social aspects of human behavior, Buddhism has also provided a clear understanding of human spirit and the nature of the mind. In a systematic way, it identifies and diagnoses the symptoms of human suffering, determines its cause, describes cures for illnesses, and prescribes treatments that will bring happiness and lasting contentment. The timeless message of Buddhist dharma may have been the best counseling repository in the past 2,500 years. The Buddha, as a healer with compassion and wisdom, can serve as an excellent teacher and role model. The practical Buddhist teachings of love, understanding, tolerance, and impermanence are all applicable to modern life.


Cheng, L. Y., & Lo, H-T. (1991). On the advantages of cross-culture psychotherapy: The minority therapist/mainstream patient dyad. Psychiatry, 54, 386-396.

The Dalai Lama. (1994). The way to freedom. New York: Harper Collins.

Dhammananda, K. K. (1982). What the Buddhists believe. Kuala Lumpur, Malaysia: Buddhist Missionary Society.

Epstein, M. (1995). Thoughts without a thinker: Psychotherapy from a Buddhist perspective. New York: Basic Books.

Hanh, T. N. (1992). Peace is every step. New York: Bantam Books.

Narada, M. T. (1982). The Buddha and his teachings. Singapore: Buddhist Meditation Center.

Niwano, N. (1976). Buddhism for today. Tokyo: Kosei.

Rahula, W. P. (1978). What the Buddha taught. London: Gordon Fraser. Smith, H. (1986). The religions of man. New York: Harper & Row.

Smith, H. (1986). The religions of man. New York: Harper & Row.

Stevenson, I. (1977). The explanatory value of the idea of reincarnation. Journal of Nervous and Mental Disease, 5, 305-326.

Story, F. (1975). Rebirth as doctrine and experience. Sri Lanka: Buddhist Publication Society.

Wambach, H. (1979). Life before life. New York: Bantam Books.

Weiss, B. L. (1988). Many lives, many masters. New York: Simon & Schuster.

Weiss, B. L. (1992). Through time into healing. New York: Simon & Schuster.

Yeung, W. H. (1995). Buddhism, death, and dying. In J. K. Parry- & A. Shen Ryan (Eds.), A cross-cultural look at death, dying and religion. Chicago: Nelson-Hall.

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