What 2,500 Years of Buddhist Psychology Can Teach Us About Anxiety Treatment

Timeless teachings from Buddhist psychology can help calm modern anxieties.

If you've ever sat in a therapist's office -- or, let's be honest, in your car before going into a therapist's office -- you might have wondered: is there actually something deeper going on with my anxiety? Not just brain chemistry, not just cognitive distortions, but something more fundamental about being human?

Buddhist psychology has been exploring exactly that question for over two and a half millennia. Long before we had fMRI machines or the DSM, Buddhist teachers were developing sophisticated frameworks for understanding the anxious, suffering mind -- and, crucially, what to do about it. As a Maryland anxiety therapist, I find that my clients often respond deeply to these ideas -- not because they're looking for a religion, but because these concepts name something they already intuitively know about their own experience. So let's take a tour through some of the most useful Buddhist psychological concepts for anxiety, and talk about how they might actually help.

First, A Quick Clarification (Because I know you’re wondering)

Buddhist psychology isn't about converting to Buddhism, meditating on a cushion for hours, or renouncing your worldly possessions (though if that appeals to you, no judgment). It's a rich tradition of observational and contemplative inquiry into how the mind works and why we suffer. A lot of what it discovered maps beautifully onto what modern neuroscience and psychotherapy have found through completely different methods. That overlap? It's worth paying attention to.

You might also recognize some of these ideas from mindfulness-based therapies, things like Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Acceptance and Commitment Therapy (ACT) all draw heavily on Buddhist psychological concepts. So if you've done any of that work, you'll find some familiar friends here, as well as invitation to dive a little deeper if you are bit Bu-Curious.

The first Noble truth: Suffering is not a personal failing

Here's something the Buddha taught that I wish I could embroider on a pillow for every anxious client I've ever worked with:

Life involves dukkha.

Dukkha is often translated as “suffering”, but it's more nuanced than that. It also means unsatisfactoriness, discomfort, the subtle sense that things are not quite right. And the Buddha's point wasn't that life is terrible; it was that this experience of dukkha is universal. It is woven into the fabric of being alive. You’re not special in this way and you aren’t getting out of this.

This matters enormously for anxiety. So much of what makes anxiety worse is the meta-anxiety: the anxiety about having anxiety. The belief that you are broken, uniquely fragile, fundamentally flawed in a way that other people are not. But Buddhist psychology says: nope. Suffering is the shared human condition. You are not doing life wrong. You are doing life.

Now, “suffering is universa”' doesn't mean “suffering is permanent'“or “there's nothing you can do about it”. That's where the other Noble Truths come in. But this starting point, radical acknowledgment rather than judgment, can help us drop the fight against what’s happening and figure out what to do next.

The Second noble Truth: What keeps Anxiety going

The Second Noble Truth points to the cause of suffering: tanha, which is often translated as craving or clinging. In the context of anxiety, this plays out in some very recognizable ways.

Anxiety often involves an intense craving for certainty. We want to know that things will be okay. We want to guarantee that the worst won't happen. We want to feel safe, permanently, completely, without any loopholes. And when life won't cooperate with that agenda (which is, well, always), we suffer.

There's also a version of clinging that shows up as clinging to comfort and avoiding discomfort at all costs. If you've read my post on anxiety and avoidance, you know this dynamic well. Avoidance gives us a hit of short-term relief but feeds anxiety in the long run. Buddhist psychology would call this clinging to a false sense of safety. And it's one of the main engines that keeps anxiety churning.

The opposite of tanha isn't indifference; it's non-attachment, or equanimity. We'll talk more about what that actually looks like in practice later.

Impermanence (anicca): A radical Idea that changes everything

Anxiety loves permanence. Or rather, anxiety loves the illusion of permanence. It wants to convince you that how you feel right now is how you will always feel. That this panic attack will never end. This dread will live in your chest forever. If that scary thing happens, you will definitely not survive it. And if you could just FIX whatever is wrong, things can stay ok.

Change is part of life. Let go or be dragged.

Buddhist psychology offers anicca (impermanence) as a corrective. Everything is in constant flux. Experiences arise and pass. Or, as an old supervisor of mine used to tell me, “Constant change is here to stay”. Emotions, including the most intense ones, are not permanent states; they are weather systems that move through. When you're in the grip of a panic attack, this probably sounds deeply unhelpful. But when you've practiced observing impermanence (in meditation, in therapy, in daily life) it becomes a genuine anchor:

'This too shall pass' is not a platitude. It is an observable fact.

One of the most powerful things I work on with clients in anxiety treatment is developing a felt sense of impermanence. Not just knowing it intellectually, but actually beginning to experience anxiety as a wave that crests and recedes rather than a permanent flood. And that this is a GOOD thing, not something that we have to try to prevent with doubling down on demands for certainty and needing everything to become (and stay) just so. This shift can change everything.

Non-Self (anatta) : You are not your anxious thoughts

This one tends to either resonate immediately or sound a little alarming at first. Hear me out.

The concept of anatta, or non-self, points to the observation that what we call 'the self' is not a fixed, solid, permanent thing. It's more like a river . It’s continuous in some sense, but made up of constantly moving water. The thoughts and sensations we experience are not identical to 'us'; they arise and pass within awareness.

For anxiety, this is quietly revolutionary. Anxious thoughts like 'I am a fundamentally anxious person,' 'I will always be like this,' or 'this is just who I am' tend to be taken as solid facts. But Buddhist psychology, and the mindfulness practices that grow from it, invites us to observe: these are thoughts arising in awareness. They are not the whole of you. You are the awareness that notices them, not the content of every worried thought.

This doesn't mean your anxiety isn't real or doesn't hurt. It means you can have a different relationship to it, one in which you are not completely identified with it. There's a little breathing room between you and the thought. And that breathing room? That's where choice lives.

Modern mindfulness-based therapies call this 'defusion' or 'decentering.' Buddhist psychology has been pointing at it for a very long time. Anatta can be a wild concept to try and grasp when we start really getting into the weeds about what it might mean if we don’t believe in a “self”. This lovely, little article brings it down to earth for those of us figuring out how to grab hold of a slippery concept and make it applicable here and now.

Wake up the present with kind, non-judgmental awareness. No meditation cushion needed.

Mindfulness (sati): Paying attention without being mean about it

Mindfulness has become something of a watered down buzzword, which is a shame, because it's genuinely one of the most useful tools I know of for anxiety. In Buddhist psychology, sati, mindfulness or clear awareness, is the practice of bringing kind, non-judgmental attention to present-moment experience.

Once more, for those skimming for the really important bits: kind and non-judgmental attention.

A lot of anxious folks have tried versions of mindfulness and concluded it doesn't work for them, often because they turned it into another thing to do wrong. “I can't stop my thoughts.” “I'm not doing it right.” “Other people can sit still; I clearly can't.” This is mindfulness attempted without the non-judgmental piece, and it tends to create more anxiety, not less.

True mindfulness is not about achieving a blank mind. It's about observing what's actually happening, including the anxious thoughts, the restless body, the wandering attention, with a quality of gentleness. It's noticing “there's that worried thought again” rather than “I'm failing at meditation because I'm having that worried thought again.”

As a Maryland anxiety counselor who specializes in mindfulness-based therapy, I work with clients to build mindfulness skills gradually and practically. It doesn't require sitting on a cushion. It can happen in the shower, on a walk, while doing dishes. It is just bringing that quality of curious, non-judgmental attention to your experience, wherever you are.

Lovingkindness (metta): What if you treated yourself like someone you actually liked?

Anxiety and self-criticism tend to run together. Anxious minds are often incredibly harsh, cataloguing every flaw, replaying every mistake, delivering a running commentary about all the ways you are not enough. It's exhausting, and it makes anxiety worse.

Metta, or lovingkindness, is a practice of deliberately cultivating warmth and goodwill toward others, and toward yourself. This isn't toxic positivity or forced cheerfulness. It's more like the feeling you might have toward a good friend who is struggling: compassion, warmth, the genuine wish that they not suffer.

The radical part is turning that toward yourself. For many anxious clients, the idea of treating themselves with the same kindness they'd offer a friend is almost incomprehensible at first. But it's also, often, one of the most transformative shifts they make. Research on self-compassion, much of it building on Buddhist concepts, consistently shows that self-compassion reduces anxiety and improves emotional resilience. Not by letting yourself off the hook, but by creating a safer internal environment where you can actually look clearly at what's going on.

Small story time/personal note: I have a soft spot for the concept of metta because it was the first thing that really drew me into Buddhism. I got a real sense of hope that there was a set of teachings that made sense to me and could provide a viable path for learning and growth. During my senior year of college, I got involved with yoga as a way to manage all the stress and worry about finishing school and having no idea of what in the world was coming next. Doing yoga postures led me to yogic philosophy, which led me to a lovely, funky bookstore (which, sadly, no longer exists). I sat myself on the floor next to the Eastern religion/philosophy section and started making my way through the choices. Yogic philosophy, Taoism, Zen, and on down the shelf. Jack Kornfield’s book, A Path With Heart, opens with the teachings of lovingkindness. There was something about this that was exactly what I needed to hear in that moment. I left with that book and a whole new path in front of me.

the middle way: neither white-knuckling nor giving up

One of the Buddha's early insights was the value of the Middle Way, the path between extreme restriction/self-disclipline and extreme indulgence. In psychological terms, this maps onto something very relevant to anxiety treatment: the balance between avoidance on one end and flooding yourself with anxiety on the other.

Effective anxiety treatment is not about forcing yourself to face your worst fears head-on while you white-knuckle through the panic. It's also not about indefinitely avoiding everything uncomfortable until you feel 'ready' (spoiler: you don't get ready by avoiding). It's about finding a sustainable middle path; moving toward difficult things in manageable steps, with support, while also developing the internal tools to work with discomfort.

This is essentially what good anxiety therapy looks like, whether or not it's framed in Buddhist terms. Gradual exposure and working at your edge. Skill-building. Self-compassion along the way. Not sink-or-swim, not avoidance-forever, but something livable in between. You deserve kindness and care, as well as encouragement and skills to help you grow.

bringing it all together

Buddhist psychology doesn't offer a quick fix for anxiety. Neither, for that matter, does therapy. What both offer is a set of tools, a framework for understanding your experience, and, maybe most importantly, the message that your suffering makes sense, is workable, and does not define you.

The concepts we've explored here, impermanence, non-self, mindfulness, lovingkindness, and the Middle Way, aren't abstract philosophy. They're practical orientations that can genuinely change how you relate to anxiety. Not by eliminating it (anxiety is part of the human package), but by shifting your relationship to it so it no longer runs your life.

If this resonates with you, keep an eye out for future posts on how Buddhist psychology can help with our modern stresses and worries. In the meantime, you can also check out some previous posts related to mindfulness topics such as skills for body awareness, and mindfulness and Cognitive Behavioral Therapy (CBT).

ready to work with a maryland anxiety therapist?

I offer specialized anxiety therapy in College Park, MD, and online throughout Maryland. My approach is warm but direct, practical, and integrates both evidence-based Western therapies and mindfulness-based approaches (including, yes, some of the Buddhist psychological concepts we've talked about here, if you’re down for that). If you're curious about whether therapy might help you find your own middle path with anxiety, I'd love to connect. You can contact me to set up a free 15-minute consultation call to see if we’d be a good fit to work together.

Other services I offer include hypnotherapy, mindfulness-based therapy, life coaching, and support for LGBTQIA+ clients. Additional information is available on my home page.

About the author:

Beth Charbonneau, LCSW-C, is a Maryland therapist, specializing in anxiety therapy and treatment. With over 20 years of experience, she brings a holistic approach to calming the mind and body, and encourages her clients to feel empowered to find more joy in life. More information about her practice can be found on her website.