For numerous decades, Western spiritual culture has been significantly influenced by the rebranding of Buddhist meditative practices (mindfulness, presence, and the glorification of “the now”). As a psychiatrist, I have observed the emergence of this movement within the therapy space. Patients come in referencing teachers, applications, and literature encouraging them to remain present, to observe their breath, to let go of attachment to what lies ahead or what has passed. Many have attempted this, often sincerely and bravely. Yet, a significant number sit before me perplexed and disillusioned: “I stayed in the present, but I’m still lost.”
Their anguish arises not solely from distraction or restlessness; it stems from the framework of their lives, from unresolved conflicts surrounding responsibility, meaning, mortality, and the sheer unpredictability of being human. For these individuals, mindfulness turns into another obligation, another performance metric, another indicator of failure. Remaining still amidst a burning house does not put out the flames. Over time, I have grown increasingly convinced that a singular focus on the present moment (though beneficial for calming the nervous system) does not address the deeper existential anxieties that generate human suffering. Humans are oriented toward the future. We exist not just in the immediacy of breath and sensation, but within a narrative, one that extends forwards and backwards, connecting us to memory, culture, ancestry, fate, and death. When we sever this temporal aspect, we sever a crucial source of meaning.
**The oppression of the present**
It has become nearly blasphemous to challenge the dominance of the now. However, in clinical practice, I have observed the consequences of treating the present moment as the sole moment of importance. Patients facing unemployment, marital breakdown, chronic illness, or existential despair are urged to “just be.” They endeavor, yet they stumble. Each stumble amplifies shame. If a patient is engulfed in deep sorrow (or confronting the disintegration of their life’s support system), “be present” may feel dismissive. It fails to acknowledge the gravity of the crisis. It demands that they emotionally process pain that is not yet digestible. The present can become unbearable when devoid of context. It can even appear as a snare.
**Reclaiming the future as a therapeutic influence**
What I have found to be more lasting (psychologically, spiritually, and existentially) is a transition from mindfulness of the present to the significance of the future. Not fantasy, not escapism. But the intentional, disciplined realization that life is a trajectory, not a snapshot. The human mind requires hope, direction, continuity, and purpose. These are faculties oriented towards the future. Viktor Frankl recognized this in the concentration camps; his survival was linked not to breathing methods but to a vivid mental construction of a future self. Neuroscience now supports what Frankl sensed: future-oriented thinking activates reward circuits, dampens the amygdala, and reinforces the dopaminergic pathways associated with motivation and resilience. To alleviate existential anxiety, we must assist patients in rediscovering that they are not static beings trapped in a moment; they are travelers. They are pilgrims. And pilgrims progress.
**The brevity of life and the clarity it provides**
Ironically, the remedy to the oppression of the present is not denial of death but closeness to it. When we acknowledge that our days are limited, the present ceases to be an oppressive vessel; it transforms into a meaningful segment of a finite narrative. I have found that patients who reflect on life’s brevity often experience liberation rather than oppression. The awareness of mortality diminishes the urgency of the present while broadening perspective. Issues shrink when viewed through the lens of impermanence. The judgments of others become less burdensome. The anxious craving for immediate solutions lessens. Awareness of death repositions suffering within a wider framework.
**A transcendent horizon beyond time and space**
Beyond future ambitions or goals lies another dimension, which might be termed the transcendent future, the horizon of consciousness that transcends linear time. Whether perceived as God, the soul, the collective unconscious, or a spiritual realm, it offers something crucial: the reassurance that existence extends beyond the current challenge. I have witnessed profoundly depressed patients undergo a subtle transformation when they begin to perceive (even slightly) that their lives are part of a more extensive, evolving reality. Suffering becomes less stifling when viewed in a cosmic scope. This is not whimsical thinking; it represents existential expansion.
**A more complete way of existing as a human**
Mindfulness certainly has its rightful role; it stabilizes the mind and grounds the body. However, humans are not intended to exist solely in the present; they are designed to span across time. To recall the past. To envision the future. To engage in the profound spiritual act of hope. A psychology grounded solely in presence is inadequate. A psychology enriched by the past, present, future, and the transcendent is complete. As a physician-psychiatrist