Prescribing the Dharma: Psychotherapists, Buddhist Traditions, and Defining Religion by Ira Helderman (review)

While sometimes viewed as a contemporary popular and easily understood trend, the psychotherapeutic use of Buddhist ideas and traditions has a history of more than a century, resulting in a great diversity of significant therapeutic approaches. Books, conferences, organizations, and at least one graduate program provide structure and impetus to "prescribing the dharma."

Ira Helderman's intention, which he accomplishes well, is to examine this assortment of psychotherapeutic approaches to Buddhism in America. We find here his analyses of familiar landmark theorists, such as Carl Jung, William James, and Erich Fromm, along with a host of more recent influential names, like Steven C. Hayes, Karen Kissel Wegela, and Ken Wilber.

Although he maintains a full-time psychotherapy practice and teaches in the Department of Human Development Counseling at Vanderbilt University, Helderman also holds a Ph.D. in "Religion, Psychology, and Culture." That religious studies background is evident throughout the book, with excellent discussions on how to define religion and Buddhism—all against the backdrop of prior literature that exhibits uncritical, even careless, use of terms and categories. Trained both in religious studies and clinical psychology myself, I appreciate Helderman's background and its importance in addressing the overlap in the two fields of Buddhism and psychotherapy.

The structure of the book consists of chapters devoted to delineating and discussing six ways psychotherapists have related to Buddhist teachings and practices. Therapists have taken the following approaches: 1) therapized—integrated certain Buddhist practices into psychotherapy, e.g., Carl Jung, Franz Alexander; 2) filtered—used Buddhist practices that have been research-tested, e.g., Daniel J. Siegel; 3) translated—reconstructed Buddhist practices into secular biomedical terms, e.g., Jon Kabat-Zinn; 4) personalized—used Buddhism in their personal lives, e.g., Erich Fromm; 5) adopted—openly and actively utilized Buddhism, e.g., Paul Cooper; and 6) integrated—incorporated in a thoroughgoing fashion, e.g., Ken Wilber. All of the approaches can be described as combining, in some way, psychotherapy and Buddhism. The last approach, however, is "thoroughgoing" in that it moves beyond the therapy room and utilizes Buddhism to produce an understanding of human beings and, indeed, of all reality.

I do not find fault with this work, but I will make three observations about its limits. First, Helderman does confine his ethnographic research for the most part to non-Asian "convert Buddhist" therapists and organizations. Second, he does not evaluate the clinical value of the various approaches examined; admitting this, he indicates that he may provide a clinical assessment in a future work. It would be a valuable contribution. Finally, his categorization into six therapeutic approaches is sometimes a bit forced, yielding categories that are blurred and overlap. In fairness to Helderman, he states up front and in italics that "my schema should not be mistaken for a series of absolute, hermetically sealed containers into which particular activities can be placed" (17).

A fascinating aspect of this book that the author understands and explains to the reader is the impact that legal and employment contexts—such as publicly funded settings or scientific affiliations—can have on a clinician's use of Buddhist traditions in the therapy room. For example, a therapist may utilize some Buddhist insight or technique, but because the therapist works in a secular context, they strip the technique of religious terminology.

Helderman is comprehensive and insightful in his study of Buddhism and psychotherapy, and this book, likely to be viewed as authoritative for years, is a must-read for anyone with interest in the interdisciplinary topic. Religion scholars, therapists, and Buddhists, even if they do not have a particular interest in the intersection of Buddhism and psychotherapy, will value this book. While informed lay readers and students can certainly benefit as well, Helderman's work is scholarly throughout, and not designed for a lazy reading.