My doctor has a book

November 8, 2012 • 11:14 am

My physician, Alex Lickerman, is a terrific doctor, one who spends a lot of time with his patients and treats the whole person rather than the disease. I’ve been enormously impressed with him. He also has a website, “Happiness in this world,” where he posts once a week, covering medical topics with psychological implications (click the first page to see the variety of subjects). He also writes about his own life and how he’s dealt with various obstacles.

Alex is an atheistic Buddhist (we call such culturally Jewish Buddhists “Bu-Jews”) who, though not accepting the supernatural or things like reincarnation, feels that Nichiren Buddhism (his species of the philosophy) has a lot to teach people about how to deal with adversity.  Based on his personal example, I’d have to say his views have merit. I’ve flirted with secular Buddhism from time to time—not as seriously as has, say, Sam Harris, but I do think there’s a core of wisdom in some Buddhist tenets.

That core, as Alex sees it, is presented in a very nice new book that I’d like to plug here: The Undefeated Mind: On the Science of Constructing an Indestructible Self.  It not only explains how Buddhist precepts helped him become a more resilient person, but also shows how he’s applied those lessons to his patients, some of them in very serious medical situations.  There’s simply no doubt that his immersion in Buddhism has made him a better and more caring doctor.

I suppose I’d put this in the category of “self-help” books, but to call it that denigrates what I think can be a very useful guide for some folks.

Here’s the blurb I wrote for the book:

“Buddhism and Western medicine would seem an incongruous mixture, but in the hands of Alex Lickerman they meld seamlessly into a recipe for overcoming life’s hardships—indeed, for turning them into advantages.  An accomplished physician, Lickerman has no truck for the supernatural, but recognizes that the tenets of Nichiren Buddhism have been honed over centuries to help alleviate life’s inevitable sufferings. The Undefeated Mind is a deeply engaging story of how Lickerman has fused modern medicine with ancient wisdom to heal his patients both physically and psychologically—lessons that apply to all of us.”

68 thoughts on “My doctor has a book

              1. (I can’t thread this any deeper)
                One of Heinlein’s less formulaic books – I forget which one – has an AI which responds to proposed changes of programming or data by requiring to be “told three times”. The explicitness of this varies through the story, but it’s essentially a protection against fouling things up.

  1. I bookmarked his blog a few weeks ago after he left an interesting comment here.

    The critics of new atheism like to harp on our lack of “spirituality” — and then they play with deepities where they equate meditation with woo. This gentleman appears to understand the distinction.

    1. What’s “odious” about it? For that matter, what is inherently incorrect about the idea that humans are imperfect?

      1. In a deterministic, causally closed universe, there is no distinction in quality between a human being and anything else in nature. It makes no more sense to say of a person that he is broken or imperfect than it does to say of nature itself that it’s broken or imperfect. That’s what makes it incorrect.

        What makes it noxious is that it needlessly sets humans at war with themselves.

        1. Correct. Imperfection requires some standard against which the shortcomings of humanity can be measured. What is that? God?

          It is different, and perfectly true, to say that humans are fallible.

        2. It also implies that something is available to “fix” a person’s inherent brokenness: a religion, a product, a way of life, or just a charismatic human. This viewpoint robs a person of self-respect, self-reliance, autonomy, responsibility…in other words, qualities usually associated with adulthood and independence.

      2. Because the inverse is ludicrous: there can be no ideal and perfect state of humanness.

        It should be obvious that indoctrinating people with the idea that from birth we are weak, sick, incorrect, misshapen, flawed, broken, bad and in need of correction or enlightenment is psychologically damaging. Additionally regardless whether it’s original sin or our innate egos that are the problem, the concept is dishonest, an unsupported generalization on the human condition that is evidence free.

        If I’ve mischaracterized Nichiren Buddhist teachings, please correct me.

        1. I don’t think it’s necessarily a dishonest concept, but I can’t disagree with anything else you said. I’ve lost already, and the questioning only went one round 🙂

          Still reading Lickerman’s book, though.

    2. With some ‘systems’, even secular ones, I find it hard to distinguish metaphor from literalism sometimes. I suppose an individual adherent can take it either way – much as some ‘atheist’ Christians take all the woo in Christianity as metaphorical symbolism expressing something about human nature. I wonder then, why not stick to plain speaking and avoid being misunderstood as a woomeister. Even if an experienced adherent gets the metaphor it’s possible that novices take it all too literally.

      This might be a book worth reading to see if the distinction is clear.

    1. Presumably one is a Buddhist – are their cultural Buddhists? It’s not unimaginable – who has embraced Judaism, and the other a Jew who has embraced Buddhism.

  2. “Western” medicine? Science-based medicine takes ideas from the East and the West, the North and the South, the sea-coast and the mountains. Regionalism does not belong in science-based medicine.

  3. Apart from it’s involvement with the right-wing nationalism of Sōka Gakkai, Nichiren Buddhism has at it’s heart the belief that Buddhahood can be actualised by chanting the Namu Myoho Renge Kyo – this is popularly extended to chanting for anything one desires: wealth, success, sex . . .
    Anyone for the rationality usually in evedence here? It is exactly cognate with Christian prayer, not generally given such an easy ride hereabouts.

    1. Anyone for the rationality usually in evedence here?”

      I would respectfully propose it’s because strict rationality cannot adequately answer the question of why one should continue living on Planet Earth — especially if one is living in continual (and relentless) physical and/or mental pain.

      Richard Dawkins, in Part 3 of Sex, Death, & the Meaning of Life, concluded that the pursuit of scientific understanding of the universe is the reason he “gets out of bed in the morning.”

      Dawkins of course stopped short of asserting that his personal view is a knockdown argument for everyone. I would suggest that this is because he knew that would be fallacious reasoning.

      You gotta admit: “To be or not to be is a pretty tough question for science!

    2. I used to know some Nichiren Shōshū Buddishists, as they called themselves, and not only did they chant Nam Yoho Renge Kyo repeatedly, they particularly did it with great ceremony in front of a cupboard called a Gohonzon containing incense and other artifacts. They also chanted at length from a book in presumbaly Japanese using a phonetic transliteration, with no claim to know what they were chanting about. One said she was greatly attached to her Gohonzon, which seemed a very un-Buddhist thing to be.

      Lovely people otherwise.

      1. From what else I see here, I’m guessing Nichiren Shōshū is only one stream of Nichiren Buddhism, and perhaps not a particularly orthodox one.

    1. I’m always a bit startled when fellow secularists denigrate buddhism. It is not that we who are curious about it equate buddhism with the rigor of science. Of course not. Nor do we glorify Buddha per se. In fact his historicity is even less precise than that of Jesus.
      Actually, it takes an appreciation of how difficult and counter-intuitive empiricism and naturalism have been to humanity to see a redeeming sparkle in philosophical takes of bygone eras. Buddhism and a few other Indian philosophies like Charvaka undoubtedly displayed laudable skepticism. It was not science. And it may very well have been full of holes. But these inchoate Nastik philosophies were impressive for their time. That is the point. They advanced the study of compassion, caring and self-reflection on its own merits, sans the bully sky-daddy. They helped shine a spotlight on oneself, compelling one to feel, to perceive and to cultivate a consciousness that checked our base animal instincts. It was a starting point to view the universe by containing the “privileged perspective.” It would be a great folly to dismiss it as just woo.
      Thankfully many have not. Sam Harris is a great advocate who points out that secular culture need not be cold and uninviting to the teeming masses on the other side. If anything we embrace the most exquisite and uplifting of human experiences. We hone compassion, introspection and self-realization, only to a higher degree. And we have the cojones to tip our hat to ancient and albeit imperfect schools of thought. Those who follow Ginger Campbell MD may well be familiar with the works of Daniel Siegel and Delany Dean. None of these guys are now saying superstition is okay. But they do have the intellectual courage to seek out gold nuggets from a highly superstitious era to move us forward in a scientific era.

      1. You could say exactly the same thing about Christianity and Islam.

        I’m posting from Dubai airport public wifi, so I’d better be careful about what I say.

  4. I thought I might leap in here to make a few points:

    1. Nichiren Buddhism argues that human beings innately possess all the strength and wisdom they need to solve whatever problems might confront them (about as far from suggesting that human beings are “broken” as you could get), and further that by engaging in Buddhist practice one can awaken that wisdom. It also suggests that by chanting Nam-myoho-renge-kyo one can indeed attain enlightenment.

    2. Though I’ve been practicing Nichiren Buddhism for over two decades, I also agree with the commenter who equated that idea with the Christian concept of prayer–it is indeed woo.

    3. Nevertheless, I’ve received what I consider to be great benefit from the practice. I consider this to have occurred through mechanisms that must be entirely explainable by natural, scientific means (though I currently can’t do so). I suspect–but don’t know–that it has something to do with a meditative effect, which the scientific literature has shown in study after study is quite measurably real.

    4. I wrote the book not to promulgate the mystic principles that (unfortunately) run through the philosophy of Nichiren Buddhism, but the practical psychological ones. I used these principles primarily as a way to organize the book, focusing more in the main on the science that supports the idea that resilience can be learned. It is, after all, the science that points the way to the practical interventions that people can use to make themselves stronger, whether they have any interest in practicing Buddhism or not.

    5. My deepest gratitude to Jerry for maintaining this website as a forum to promote scientific, evidence-based thinking and for putting up a post about my book!

    1. “the practical psychological ones. I used these principles primarily as a way to organize the book, focusing more in the main on the science that supports the idea that resilience can be learned.”

      As I suspected, and why your book is of interest to me.

    2. Thank-you for being here, Dr. Lickerman!

      Without putting you on the spot, because I’m certain you are enormously busy, may I ask what you would consider to be the proper “forum” for a more extended, personal discussion on these matters?

      Do you have time to exchange a few emails, for instance? A telephone conversation, perhaps? May I contact your office?

      (Maybe I’ve just answered my own question. Sorry again if I’ve put you in an uncomfortable position.)

    3. Hello Alex Lickerman,

      Perhaps I have and will be mischaracterizing Nichiren Buddhism but isn’t what’s taught as the main roadblock to attaining enlightenment our egos? If so, is this not of a kind with original sin–an innate and unavoidably human flaw, and something to overcome and transcend?

        1. But those delusional beliefs about our own nature, aren’t they caused by the distorted perspective that the ego has to bring (otherwise there wouldn’t be an ego, i.e.: a filter)..?

        2. Yes.
          I always say that there are seven billion and one universes. One real one and one created in the imagination of each person.
          So the goal of science is almost the same as Buddhism, to overcome mistakes in our imagination to see reality clearly.

        3. It’s common to refer to delusional beliefs as specific acquired bad information and not a general feature or trait. While our psychology may make use susceptible to certain delusions (e.g., false positive pattern recognition) it doesn’t work to equate delusional beliefs with predispositions. When you say delusional beliefs about our nature it sounds like everyone has the same delusional beliefs about our nature or everyone is equally wrong about our own nature.

    4. I must admit, I’m of rather a mixed mind on all of this.

      I wouldn’t at all dispute the possibility that there is real benefit to be had from some of the rituals of Buddhism. At the same time, I don’t think you’d dispute the fact that it’s very easy for woo to get mixed up with Buddhism, and that said woo can be quite toxic at times — witness all the Buddhist parts of the world with all the same religiously-driven social disfunction we have in the West.

      There must surely be a direct parallel with herbal medicine. Willow bark tea will alleviate your headache as surely as an aspirin…but good luck getting the dosage optimal, and there’s plenty of room for impurities and what-not. Not that the aspirin is perfect, but it’s a decided improvement upon the herbal form. (And, besides, willow bark tea tastes nasty.)

      I would very much be interested in an empirical analysis of Buddhism to determine what parts are effective. Chanting, for example: is it the repetitiveness of the act? If so, might some other repetitititititive act be more effective? Is it the physiology of the acoustic stimulation? If so, might some other vocalization or some other recorded sound do a better job? Is it something of a placebo effect? If so, might it be necessary to tailor the false-but-helpful belief to the individual for maximum benefit? And so on.

      Is there any chance you’re investigating any of these sorts of things, or that you’re aware of somebody who is?



      1. Ben,
        I completely agree that it’s all too easy to lose track of what is genuinely helpful and makes sense in Buddhism and what is woo (my new favorite term). When I first started to practice Buddhism, I was obsessed with the mechanism by which it might work (I define what I mean by “work” in the book). I scoured the scientific literature for studies that looked at the effects of chanting, but found none. I recently did so again and still found little.

        My current guess (based loosely on some recent reading I’ve done on creativity) is that chanting distracts one from the babbling of the conscious mind and allows nuggets of wisdom to bubble up (presumably from the same place all creative ideas come from, wherever that is). But, of course, this is nothing more than a guess.

        I have no idea just why the nuggets that have bubbled up for me have so often represented solutions to many of my life’s problems. It would be fascinating to perform studies to answer the questions you ask. At the very least, it would make it easier to separate out what is truly valuable about Buddhism and what is woo. I’m not equipped to do such studies, unfortunately. Nor do I know of anyone who is looking at this currently.

        1. Thanks for the response, Doc. I think our host might know somebody with the qualifications to perform that research. Jerry, any chance you could point Sam to this discussion?

          And, back to you, Alex: how do you personally keep the woo from infecting your mind? You are, after all, immersing yourself in it.

          Last, I’ll note that we all tend to have flashes of inspiration when we take a break from whatever we’re working on. Some of my greatest ideas have come to me in the shower, or when I’m out walking the cat. Is what you get from chanting any different?


          1. To keep woo from infecting my mind isn’t all that difficult. I constantly monitor my biases (i.e., attempt to distinguish what I may want to be true vs. what evidence suggests is true). What’s more difficult is deciding when to challenge the distorted beliefs of others. To help others recognize when their beliefs are unjustified requires more than merely pointing out that no evidence exists to support what they believe. It requires inculcating in them an emotional belief in the value of scientific thinking, and I’ve found that’s what’s REALLY hard.

            1. It requires inculcating in them an emotional belief in the value of scientific thinking, and I’ve found that’s what’s REALLY hard.

              You know, I think most all of the ills faced by society could be solved by getting people fully on board with the merits of rational empiricism. It seems like you’ve actually had some (limited) success with that, and that you’ve been at it for a while.

              Care to share any tips?


          2. I would love to see more research into the brain and meditation as it relates to creativity, problem-solving and performance.

            I once went to a therapist who was a cognitive behavioralist and he said that many in his field find that mindfulness is a great tool for people who are grieving, trying to cope with anxiety etc. He said that there is definitely some research being done in Psychology along these avenues, though I can’t cite any. They take a secular view, obviously, and simply see meditation as an excellent exercise for the brain that allows a person to learn to tune out the regular white noise of the brain for various benefits.

            I have always felt that I do some of my best and most creative thinking is done when I’m on long walks and mostly just focussed on my breathing and watching my step. I have had many song ideas when hiking in the mountains.

            And I think it’s pretty well established that performance can also be enhanced by a form of meditation. Most star athletes agree that when they are in “the zone” (playing as if they know the opponent’s every move, performing their physical tasks with heightened precision etc.) that they feel a tremendous feeling of calm. I can’t tell you how many times I’ve heard a great athlete (most often tennis players, as it is my favorite sport) when asked how they just demolished their opponent far easier than anyone expected, or just performed feats that are extremely rare, answer with something along the lines of “You know, I was just SEEING the ball really well today.” I have even experienced it myself on occasion.

            I definitely think that there is something to chanting as a means to help achieve that kind of heightened performance. After all, most coaches say that you should have some simple, repetitive mantra that is on a constant loop in your mind to help keep focus and avoid distractions and keep nerves at bay. I also play the drums and have found recently that when I’m practicing my rudiments and trying to push my playing further into difficult patterns, I always have low-frequency humming that I do. Even if I’m playing a song, I hum a non-descript OM’ish tone that has no relation to what I’m playing. I’ve tried to stop doing it and it’s very difficult. If I stop the OM my playing starts to become unraveled. It’s strange because while I have read a few books on Buddhism and tried meditation here and there, I never expressly tried to add meditation to my drumming. It just sort of happens naturally.

            Anyways, looks like an interesting book. I look forward to checking it out.

        2. Just as a note that may inspire some further thinking, regarding the efficacy of chanting:

          I found myself getting into a sort of “beta trance” while running on a treadmill, years ago when I was a regular at the gym (the gym was 200 yards from my house, so it was easy! Now that gym is defunct). The monotony of running on a treadmill was actually something I enjoyed. It was akin to simply meditating, and blocking out worries and speculations. Eventually, I became highly “awake” yet calm while running on the treadmill. No traffic lights, obstacles, side events, other runners, disturbing my run. Had many problem-solving moments, creative moments, on the treadmill.

          I began to mentally picture myself in a similar, monotonous, longterm run by our ancestors, out on the savannah in Africa, running down game by exhausting the prey (even in modern times, 19th century Apache could run 70 miles in a day). Evolution-wise, those who became most mentally acute while running, who had active, problem-solving minds operating at the most successful level while running, passed those features along to their descendants. One can chant, in a way (breathing rhythms), while running. Perhaps our ancestors chanted, as a way to keep their prey up and running rather than opting for a hiding place in the bush (and, perhaps, alerting big, big felines and other carnivores to our imminent arrival, so as to not surprise them.)

          Repetitively chanting may subconsciously awaken a mental state that was a state of mind that was, over time, associated with successful hunting by hominids.

        3. My current guess (based loosely on some recent reading I’ve done on creativity) is that chanting distracts one from the babbling of the conscious mind and allows nuggets of wisdom to bubble up (presumably from the same place all creative ideas come from, wherever that is).

          Is this possibly a similar mechanism to “sleeping on a problem”? I believe it is a well-recognised idea (sorry, no citation, but you are welcome to disagree) that complex problems often seem simpler after a good night’s sleep. And I agree with Ben about getting great ideas in the shower. My only problem with that is that I frequently find myself coming out the shower with my head still covered in shampoo.

          1. I think there’s something to this, yes. Answers to problems clearly can arise from many different levels in the brain, the conscious level representing only one of them (and not even necessarily always yielding the wisest).

        4. Alex,
          there are folks trying “to separate out what is truly valuable about Buddhism and what is woo”. I also don´t know someone who´s doing studies on the effectievness of rituals (that´s what Ben asked). But the work of separating the valuable in buddhism from the woo is in full play. There is the Center for Pragmatic Buddhism ( with Owen Flanagan and Tom Clark ( on its advisory board. Stephen Batchelor is another one who has created a completely secular approach to buddhism without any woo-woo. Another good source is www.

  5. I note that the esteemed Dr. V.S. Ramachandran** has also contributed a “blurb” for the book as follows:-

    “Eastern religious practices such as chanting are often brushed aside as ‘mysticism’ by Western science. In this highly original book based on extensive case studies, Lickerman effectively bridges these two great traditions, providing novel insights along the way on how we can all triumph over the psychological impact of adversity and live joyfully, even in this ‘vale of tears'”

    **Director of the Center for Brain and Cognition at University of California San Diego and author of the New York Times bestseller The Tell-Tale Brain]

    A blurb from V.S.R. & J.A.C. both? Gotta be a useful book

    For those in the UK HERE’S the page for the paperback & Kindle versions of The Undefeated Mind

    P.S. Anyone reading this who suffers from chronic pain would do well to Google Ramachandran on “pain is an opinion”. I’ve applied the practical insights of V.S.R. on pain to myself ~ it worked.

  6. Sometimes I miss not being a Jew because I then can’t be a Bu-Jew or sport a Jew-fro. So many fun possibilities and I miss out on them all.

    Being a “none of the above” I guess I can only be a Bu-Who which makes me sad.

  7. This I’ve go to read. I’m intrigued. What Buddhist, Bu-Jew or not, even talks of an “Indestructible Self” let alone encourages constructing one? Thanks to Kindle, I’ll probably soon find out. That title is definitely not kosher.

  8. “If only Buddhism wouldn’t have that rebarbative reincarnation concept, it would be perfect.”

    I used to think that too. Unless I was able to see the uncreated nature of consciousness and how our incapacity to see it condemns us to stick to what our senses are telling us.

  9. A little tidbit — saw an interview with the Dalai Lama wherein he states that you don’t even have to believe in god to be Buddhist or to find happiness. I kinda suspect he’s one of those people who believe in belief, and that he’s more rational that most of us realize. I’ve read that he’s loves science too.

  10. I flirted with Buddhism during my new age phase on my journey to atheism. I liked lots of the ideas and of course meditation (some forms)has been shown to help you physically and mentally, especially in dealing with stress. I do yoga purely as physical exercise, which right now my knee is not allowing. But again, as with other religions or religious philosophical thinking, one can always point to the square pegs that will never fit in the round holes of the ideas.

    Take the very first idea that Dr. Lickman proposes- (1. Nichiren Buddhism argues that human beings innately possess all the strength and wisdom they need to solve whatever problems might confront them…) This flies out the window if one is born mentally retarded. I think making absolute statements about the nature of human beings is always fraught with potholes in the road.

    Plus, Buddhism as a practice and a religion is not very woman friendly, and the idea of taking children out of their homes at very young ages to study the faith is sheer cultism and abuse.

    Using the image of Buddha on the cover of this book tends to give credence/support for the religion itself because that is what will come to the viewer’s mind before reading the content. So I would have walked right past it in the bookstore because of that cover.

    I also have a question. Would Dr. Lickman be as compassionate a doctor as is claimed if Buddhist thought and writings were not in the world?

  11. Presumably, most or all of whatever is supposed to be valuable in Buddhism has not helped the Buddhists from west Myanmar (Burma), who recently managed to murder plenty of Muslims and burn down the houses of many others. I’m sure you can find plenty on this in the BBC website, if the election distracted the US networks from their usual superb coverage of international news.

  12. Superstition is superstition. But I doubt there isn’t a buddhism that isn’t religious supernatural to boot (e.g. “souls” and their “rebirth”).

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