Reframing Mental and Emotional Pain from a Buddhist Psychology Perspective


Consider this scenario: You’re sipping a cup of tea on a cold morning, enjoying the warmth and flavor, and then the tea is gone. You experience a slight annoyance because the pleasant experience has ended. Or perhaps your beloved pet has become ill, and you experience overwhelming grief as you observe her health deteriorating. From the minor annoyance of finishing a delicious meal to the excruciating pain of losing something dear, we experience pleasant or unpleasant conditions incessantly, in every moment.

This continual cycle results in a vast spectrum of mental and emotional reactions ranging from ecstasy to unbearable pain, with varying levels of intensity and duration. Our understanding of, and response to, the continual contact with pleasant and unpleasant experiences either promotes emotional and mental wellness or intensifies mental and emotional suffering.

Illustration of a plant growing through a maze of darkness to emerge into sunlight

Buddhist Psychology offers an alternative lens that examines and seeks to gain insights about this human experience. The Five Hindrances framework explores understanding and recovering from mental and emotional pain by delving into the intricate interplay between mental processes, emotions, and external conditions. It empowers those suffering from mental and emotional pain by normalizing their experiences. By emphasizing the dynamic nature of mental and emotional states, Buddhist Psychology encourages individuals to explore the underlying causes of their suffering and develop strategies for coping and resilience.

Contemplative practices in Buddhist Psychology encourage observing mental and emotional processes to gain insights about them. This involves recognizing patterns that foster mental and emotional well-being while compassionately addressing those that do not. For instance, the mental process of analyzing can be beneficial when solving an algebra problem, but it may not be helpful in coping with emotional pain following the death of a loved one. Acceptance of the loss, as difficult as that might be, is a more adaptive response. Similarly, the mental process of planning helps up to set goals and prioritize. However persistent worry about future events can lead to anxiety and stress. A contemplative approach refrains from pathologizing and instead focuses on understanding and cultivating conditions that promote emotional and mental well-being. As contemplation deepens, a type of “treatment plan” often begins to emerge as we learn to distinguish between non-beneficial and beneficial mental processes, their causes, and conditions, and how to cultivate positive mental and emotional patterns and responses.

The Five Hindrances contain alternative concepts for understanding mental health and well-being as well the causes and conditions which create mental and emotional distress. The Five Hindrances include:

Sensual Desire. This hindrance refers to the almost constant drive to seek pleasure and comfort while avoiding pain and discomfort. Pleasure-seeking varies in intensity, from slight cravings to irrational obsessions and compulsions. We often believe that obtaining a particular object (girlfriend, new car, new figure, recognition, fame, etc.) will bring contentment. However, once we obtain the object, contentment is fleeting, and dissatisfaction soon returns. Hyper-consumerism, coupled with hyper-competitiveness, clouds our ability to see what truly brings us peace, joy, and contentment. It is easy to lose sight of what brings stillness and joy when we are bombarded by enticing advertisements defining that for us. This constant cycle of craving and dissatisfaction can lead to significant emotional and mental distress.

A basic mindfulness strategy is to recognize the hindrance as it arises. Sometimes desires are apparent, such as intense cravings for a particular food; others are subtle and experienced as a slight irritation. The constant cycle of wanting and dissatisfaction can undermine our mental and emotional well-being. If you look at this hindrance carefully, you might find that in every moment, there is a desire arising. The present moment contains X, but you don’t want X; you want Y. We are either grasping for a completely different condition other than the one that ‘IS,’ or the present moment might be generally pleasant, but we can think of one or two things we might like to change.

Mindfulness of desire may also reveal cravings that are healthy, such as for nutritious food or exercise. However, even healthy cravings may disrupt our focus on the present moment, causing frustration if unfulfilled.

Ill Will and Aversion. This hindrance encompasses a vast array of experiences that range from finding something slightly distasteful, or off-putting, to intense hatred. Ill will and aversion can be seen as the opposite of sensual desire. While sensual desire pursues, ill will and aversion pushes away. Ill will and aversion can be directed internally (negative self-talk, self-harm) or externally (hurtful words, violence). During high intensity levels of ill will and aversion, the potential for impulsive, irrational, or illogical thought and emotional patterns emerge. Like the previous hindrance, ill will and aversion are pervasive experiences of the human condition. Therefore, mindful awareness when faced with challenging conditions—those we dislike or even hate—is a powerful coping skill to regulate and cope with distressing thoughts and emotions.

The practice of mindfulness, particularly attention regulation, helps us recognize when ill will and aversion arise. Understanding that the aversive mind is not the rational mind allows us to detach from these thoughts. This recognition supports the ‘mindfulness pause,’ which encourages postponing impulsive actions driven by ill will and aversion. For example, if someone feels intense anger towards a colleague, mindfulness can help them acknowledge this anger without immediately reacting. This pause allows for a more measured and rational response, reducing the potential for conflict.

While ill will and aversion can be seen as the opposite of sensual desire, they share a significant similarity: both are persistent and experienced almost constantly. In varying levels of intensity, the present moment is either lacking something we crave, or contains something we don’t like. The lens of Buddhist Psychology offers invaluable insights into recognizing and understanding conditions, objects, or phenomena that we find disagreeable. However, through contemplative practices like mindfulness and meditation, we can illuminate our awareness. By doing so, we gain a deeper understanding of when ill will and aversion arise, allowing us to restore equanimity in both body and mind.

Sloth and Torpor. Sloth and torpor refer to the hindrance of physical laziness and mental laziness respectively. Like all the hindrances, sloth and torpor manifest in various levels of intensity. When sloth arises, contemplative practices encourage recognizing the conditions that give rise to it, as well as noticing its qualities such as duration and triggers. For instance, when feel lazy and don’t want to exercise, I’ve noticed making a small effort, like putting on my tennis shoes often dissipates the feeling of sloth. Torpor, or mental laziness, manifests as an aversion to mental activities perceived as challenging or uninteresting. While lack of interest can reach pathological levels, it’s not always harmful.  Buddhist Psychology urges us to turn our awareness to the conditions giving rise to these hindrances and to cultivate healthy responses. Sloth might dissipate with proper nutrition, rest, or exercise, while torpor may fade by engaging in novel experiences, finding purpose, or enhancing concentration. Overcoming sloth and torpor requires the right effort and pushing through discomfort, forming a foundation for overcoming all hindrances.

Restlessness and Worry. This hindrance consists of both physical and mental aspects. The physical aspect of restlessness presents on a spectrum ranging from slight unease or fidgeting to hyperactivity, tenseness, and nervousness. The mental aspect is worry, which results in mental processes such as rumination and negative thinking. Both restlessness and worry can vary in intensity, from mild unease to overwhelming distress.

Buddhist Psychology recognizes restlessness and worry as normal biological responses to danger or uncertainty. When restlessness or worry arise, examining the previous hindrances can be helpful. The present moment, as we currently perceive it, contains conditions we don’t want (aversion), is lacking something we want (desire), or is without passion or purpose (sloth and torpor). Awareness of this and all hindrances also reveals their transitional nature. Hindrances appear, gain intensity, peak, and then gradually fade away. They are not gone permanently, as they can arise again when the conditions are right.

Awareness and contemplation of this hindrance reveal how it can precede positive mental states, such as when mild worry results in problem-solving. However, it is generally necessary to recognize the hindrance at low intensity levels to take advantage of the beneficial motivation and redirection it may provide.

Doubt. This hindrance reflects not knowing or knowing wrongly. Not recognizing the full scope, characteristics, causes, and conditions of reality results in doubt or knowing wrongly. For example, while my senses tell me I am sitting in a chair, this perception does not recognize the full scope of reality, which includes the fact that I am moving around the sun at 67,000 MPH. Most of what we “know” comes from input derived from our sense organs. The reality derived from our limited sense perception is vastly incomplete.

In Buddhist Psychology, the brain is considered a sense organ. If the eye provides sensory information about color and form, the sensory input derived from the brain includes thoughts, memories, perceptions, predictions, and more. If our eyes, nose, mouth, ears, and skin provide limited data about reality, the sensory input of the mind is similarly limited. Of the approximate 60,000 thoughts I have every day, I wonder if any of them are completely accurate.

Examination of doubt in psychotherapy presents notions of sensory input of the brain—thoughts, perceptions, memories—and casts suspicion on their validity. It then becomes much easier to challenge firmly held beliefs. This dialogue can proceed to include discussions of a new reality, hopes, and possibilities.

Buddhist Psychology presents a simple yet profound template for recognizing the biological, emotional, and mental reactions that result in mental and emotional pain. This pain exists on the spectrum, from slightly noticeable to intense and overwhelming. Contemplative and awareness practices encourage a disciplines examination of the hindrances, exploring their presence, absence, the conditions that make them arise and dissipate, and the adaptive levels of their intensity. The Five Hindrances add additional depth to our understanding of experiences that create emotional pain. This approach to recognizing the human experiences that lead to mental and emotional suffering feels kinder and may promote a less stigmatizing identity than one arising from an official diagnosis.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. All the Buddha did was observe and through observing, understand himself, and this is the essence of psychological healing that you speak of. My difficulty is understanding how such a simple process is turned into such an enormous sprawling mass of Buddhist thought which can’t compare to the direct insights gleaned from simply observing and through observing, understanding what is. And the Dalai Lama is a very funny and very nice man, but he’s about as enlightened as my toe nail. That is not an insult! My toe nail is very Zen. But the Buddha would never have been a Buddhist would he. You know he wouldn’t, and these silly traditions about the Dalai Lama being the Buddha make a mockery of his timeless and simple wisdom. You can’t in good conscience argue against that, can you, because you know what the Buddha actually said. He said don’t follow and don’t practice. Don’t listen to authority. See and understand. He may have said this or that number of noble or whatever truths, but utterances contain truths – you don’t have to number them and brainwash yourself by repeating them incessantly. You just have to see and understand the reality they are talking about! Do you see what a mental disease Buddhism, indeed all religion, has turned into?

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    • “…utterances contain truths – you don’t have to number them and brainwash yourself by repeating them incessantly. You just have to see and understand the reality they are talking about!”

      Yes! Tedium defeats many a purpose.

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  2. I stopped reading where it said analysis will not help the emotional pain experienced when you lose a loved one. A Buddhist might consider the intrinsic emptiness of all conditioned phenomena. And in this light, it is hard to feel sad about death. In the Buddhist scriptures, Siddhartha Gotama tells a disciple requesting help for a dying child to find a home where someone hasn’t died. Obviously they are not able to do so. Even Siddhartha Gotama himself died when Ananda did not beg him three times to stay in this world for the remainder of the eon. And then his students who did not heed his teaching clutched their ankles in their hands and cradled themselves back and forth like babies. The students who heeded Buddhism carried themselves onward to the goal in the understanding that all conditioned phenomena are transitory; even the contingent, historical, human body of an enlightened one.

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  3. I disagree with your interpretation. The historical Buddha Siddhartha Gotama instructed The Sangha to refer to the collection of his insights and compare them to what Buddhist teachers might say to see whether they exist in concordance to each other. In that sense, I agree with some aspects of your comment. Religion is the opium of the masses, it relieves suffering for vast multitudes of people; it is the heart of a heartless world. I reject your analysis that religion is a disease. Tenzin Gyatso is recognized as The Bodhisattva Avalokitesvara by many thousands of people. I recommend this article by Michael Parenti to inform the reader about how The People’s Republic of China assisted the Tibetan People in liberating themselves from feudalist autocracy:

    In the final analysis, applied religion is a productive pursuit for millions of people and I consider it an intrinsic aspect of our human process.

    The Narayaneeyam has taught some people that atheism and anti-theism also draw their practitioners closer to what is called God. I also recommend the writings of the Catholic Cardinal Nicholaus Cusanus to the interested Witness.

    By the way, Siddhartha Gotama acknowledged himself to have achieved the deathless. In modern language, I might say that he also considered himself the very archetype of what Buddhists aspire to. Yes, I do think it is accurate to say that Siddhartha Gotama was a Buddhist. His teachings transcended his biographical identity. Therefore because he was ‘The Buddha’ of our era (but not the only ‘Buddha’ — there are infinities of infinities of Buddhas who exist independent of Time or the quality/quantity dualism) he was literally his own follower. Refer to the sutras for more information.

    As for teachers, I agree with you that one must become one’s own teacher. The writings of Sextus Empiricus are also relevant to the aspiring skeptic. However, to associate with good company is an excellent method of self-instruction.

    Also, recitation of sutras is a practice that has been endorsed by Buddhist leaders for a very long time. Chanting a Buddha’s name is also considered beneficial by many highly regarded teachers. Even in the Zen school you reference, repetition of a Koan (sometimes translated as riddle) is one of the methods of initiation teachers use to help students.

    I hope this helps.
    Namo Amitabha

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    • I expect you’re right, but who cares? The Buddha was you minus all the crap in your head including your religion and practices. Why not ditch the junk and become the Buddha? It is a form of insanity that you don’t see this.

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  4. I’m channelling Mother Nature for you: “Hey, I beat the beat, you eat the beat, then beat the beat, I beat the beat right, I beat the beat tight: I beat the beat boss so betray me and die/ I am the bobcat and the elephant: I am the night and her unconscious fist: I have your head locked in between my tighs: I’ll turn you gunners into daffodils.” PS, the only reason we unconsciously created civilization is that we were unconsciously recreating the womb through our actions, which is the nirvana principle of total environmental non-violence or equinimity. But instead we created office furniture and spectacles and need electric shocks like coffee and donald trump to keep us awake. Woops


    Telephone tomato
    Telephone tomato c*nt no
    Telephone tomato
    Jo Biden’s face is on my c*nt yo
    Donald Trump’s dick is in my face yo
    Rishi Sunaks lips are on my dick yo
    My needling dick is up his arse yo
    Telephone tomato
    Telephone tomato c*nt no

    Have a nice day.

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    • Man has the power of creative reason which is the ability to willfully increase his potential relative population-density by bringing his mind into greater cohesion with the negentropic order of the universe. This is what separates us from the animals. In a healthy economy human beings constantly advance technologically which allows our civilization to support more and more members of our species.

      There’s a book you might like called Knowledge of the Womb, written by a Greek psychiatrist who pioneered a science called autopsychognosia. Stanislav Grof’s perinatal matrices also stand relevant. The truth is, the womb can be a very traumatic experience.

      From the perspective of established Buddhist doctrine, nirvana and samsara are essentially one similitude.

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  5. Mommy, I hate my body. OK then, you must be in the wrong one. Why not iron out your pancake breasts! Then you’re a man and everything is fine.

    Or we could try and make our kids feel loved, encourage self-love, which implies self-acceptance, and then if they decide to transition it won’t be a result of our mental pathology. Only the body can be male or female. Thought can think ‘I am male or female’ but this is no-fact. Awareness itself is beyond gender, and masculine, femanine and neutral currents of consciousness pass through us all. Instead we go for the socially conditioned auto-rejection of what is and encourage creatures of nature to become something they can never be, which is what they are not. Thus the world goes mad.

    I’m sorry – this is not strictly relevance because it is the simple fact, and there’s no place for simple facts in a culture dominated by opinions, conclusions, theories, assumptions, social norms and other destructive non-facts issued from a social mind that forgot the clitoris even existed out of fear. We see ladies jump on chairs to escape the mouse or spider. Well you’ll frighten a man even more with a clitoris. Unless they are a gynaecologist, which is of no comfort to women at all.

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  6. Thank you so much, Diane, for this excellent summary of the theory of the five hindrances. I will share your article with a friend who is very identified with “her ADHD” and thus looks at herself as if something was wrong and defective about her.

    I told her that we Buddhists think that restlessness and worry are a very common and normal thing. And that we would describe her personality style simply as one that has a lot of it but that it was not necessary to think it was bad or wrong.

    I explained to her that she was adding another layer of pain by condemning it on top of the unpleasant experience herself and she instantly understood that that was the case. I also told her that she could find out about what her agitation was really about by learning meditation.

    I also told her that agitation was not the only “annoying” thing one can have. When I told her that its opposites were sloth and torpor I think she was already feeling a bit better about herself: At least she didn’t have too much of those!

    If you are interested in my feedback about the overall drive of your article: I think your approach is still pretty clinical. You are still trying too hard to stop the bad things. I would try to even more let go of that approach.

    It is not necessary to adapt the eightfold path to the “special needs” of anyone, not even to folks with mental health issues. The standard teachings work for anyone at every time and in every situation. It is just that you have to be smart to chose what “practice” might be best four you when you have chronic psychic problems or when you find yourself under a lot of pressure.

    Sometimes, for example in a depressive episode, yoga, doing crafts like sewing, cleaning, and going for long walks are preferable to silent retreats. Metta or prayer practices might be more helpful than Zen meditation ect. And I think that if you could support people in chosing the right combination of practices at the right amount (less is more) and at the right time. That would be very helpful for so many people.

    What I think is totally unnecessary is to apply techniques like questioning believes as is suggested in CBT and what you also talk about above. I don’t think that they are in accordance to the Buddhist teachings. It is not an intellectual understanding of they’re “dysfunctionality” that makes us able to let go of them.

    Buddhist psychology claims that it is only an intuitive understanding about something causing us pain, wisdom, that is able to do so. Wisdom arises simply by following the teachings and the practices. We can’t push or pull or squeeze our minds to more inner freedom. When we practice with ease and right effort good results will come naturally.

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  7. I think if more people in the west studied Buddhist psychology 98% of them wouldn’t end up in a therapist’s office or seeking psychiatric drugs as in it there lies a foreseeable end to toxic guilt and the forever search for co-dependent relationships with earthly (or otherworldly) beings.

    “Buddha Philosophy and Western Psychology”,

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