dukkha (suffering)

Meditation or medication?

Cliff Bostock, Creative Loafing Atlanta: In January 1991, I woke up one morning in the blackest depression of my life. There was nothing unusual about the day, although Operation Desert Storm had begun the day before. I remember lying in bed, listening to reporters on CNN describe what sounded like a video game. No death or blood.

For months afterward, I felt as if I awoke every morning covered in black soot. I’d have to spend a few hours sweeping the soot away before I could do anything productive. The psychic pain of depression this deep is difficult to describe. Contrary to what many people think, it can produce a physical sensation, pain that cannot be exactly located. For me, it was this pain that made me contemplate suicide continually. The wish was not so much to die as to end the pain with a violent act.

I made a contract with my therapist that I would not kill myself until I’d given a tricyclic antidepressant time to take effect. As I’ve written before, I recall the exact moment the drug took effect. I’ve heard many people over the years report the same experience. For me it was as if my heart suddenly revved up and I became fully present in my body. The depression vanished.

As is also true of many others, I realized that I’d probably been depressed most of my life. A few months later, my doctor switched me to the relatively new drug called Prozac. This produced a phenomenal change in me, not only treating my depression, but making me far more productive in my work and more extroverted than I’d ever been.

My doctor told me I’d likely need to be on the drug the rest of my life. My depression was not situational. In fact, my bout of suicidal thinking came during a good period of my life. Like many others, I seem to be predisposed to depression.

I certainly didn’t mind the idea of being on an antidepressant the rest of my life, if it continued to work so well. Unfortunately, though, after two years, the drug had little effect and I returned to a state of dysthymia – low-level depression. I tried many other antidepressants but nothing ever returned me to the state I enjoyed as a newcomer to Prozac.

I’ve got plenty of company. Repeated studies of the drugs have also demonstrated another surprise. Although the actual figures are debatable, the placebo effect is remarkably high in the use of antidepressants, particularly in treatment of mild depression. It’s no wonder they seem to lose effectiveness after a period. Considering that antidepressants are among the most prescribed drugs in the country, finding a way that more effectively treats depression is a priority in the mental-health field.

To many Atlantans, it was probably a surprise last week that the Dalai Lama, the exiled leader of Tibet, has become part of the effort to find an effective, long-term treatment. Here to accept a professorship at Emory, the Dalai Lama conducted a daylong conversation with scientists on the subject of “Mindfulness, Compassion and the Treatment of Depression.” Incredibly, 4,000 people showed up to hear the conversation – which ought to be indicative of the topic’s importance, as well as the Dalai Lama’s celebrity.

I did not attend, but like many others who have been engaged in a meditation practice for some time, even if fitfully, it is no surprise that an increasing body of evidence suggests that it not only can reduce the pain of depression but actually help restructure the brain, which the new science of neuroplasticity has observed in studies of Buddhist monks.

The direct benefit of meditation is that it develops awareness – or “mindfulness” – of the way one’s thoughts and feelings arise spontaneously. With practice, it becomes increasingly easier to leave behind the array of symptoms (including physical ones) that add up to the experience of depression – or any other habitual way of thinking, for that matter.

This is especially true in the practice of compassionate mindfulness. Studies have shown that compassion can literally be taught (which is one reason I believe meditation should be taught in public schools). When we approach the world and ourselves with compassion, suffering paradoxically becomes less burdensome.

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Key to family happiness is accepting difficulties

mindfulness unhappy families

Doctors Diane Gehart and Eric McCollum of California State University and Virginia Tech University say that accepting the existence of miserable times in family relationships is better than striving for perfection.

“The myth of problem-free living is easily identifiable in Western culture through its childhood fairy tales and modern love stories,” they say. Gehart and McCollum argue that the very term “mental health” can conjure a false sense of a life without suffering, and that this can lead to unrealistic expectations that can in turn lead to greater dissatisfaction.

Rather than seeking a life free from teenage moodiness and spousal arguments, they suggest that the Buddhist practice of mindfulness can allow family members to “compassionately engage” with suffering.

Mindfulness is the Buddhist practice of nonjudgmentally observing thoughts and feelings in the present moment, and has been used successfully in a variety of therapies to treat depression, anxiety, chronic pain, stress, and eating disorders.

The authors of the paper, “Engaging Suffering: Towards A Mindful Re-Visioning of Family Therapy Practice,” published in the Journal of Marital and Family Therapy, say that although Buddhism is generally considered to be a religion, the technique of mindfulness can be useful even separated from Buddhism’s spiritual beliefs and practices.

The practice of Mindfulness includes the notion of developing equanimity, which means that we accept painful and pleasant experiences when they arise, without judging them as good or bad. The approach of mindfulness helps practitioners to accept the presence of difficult situations without feeling that they have failed or that there is something wrong with them or their relationships.

The authors argue that “family therapists can integrate mindfulness principles into their work to help clients shift how they relate to the unique forms of suffering that one encounters in intimate relationships, such as abuse, divorce, rejection, and loss.”

Has the practice of mindfulness helped your family relationships? Have you found meditation helps you deal with problems more gracefully? Why not drop us a line using the comment box below?

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Robert Collier: “Any thought that is passed on to the subconscious often enough and convincingly enough is finally accepted”

Robert Collier

All too often thoughts set thoughts in motion with little or no conscious intervention on our part, creating an inner avalanche of ideation. Helplessly caught up in this endless cascade, we are swept away by the stories generated by our hopes and fears.

To change the metaphor, each thought sends forth an echoing cry, like an animal calling for its mate, and this cry penetrates the heart, evoking an emotional response. The end result is suffering, stress, depression, anxiety.

Our thoughts form consistent story lines:

  • “Nobody likes me.”
  • “If only such-and-such a thing would happen, then I’d be happy.”
  • “I just know this is going to go wrong.”
  • “I bet he did that deliberately.”

As we listen, without mindfulness, to these story lines, day in and day out (and at night too, for our inner dramatic arc does not cease with conscious thought) we remain utterly convinced that these stories are truth, not imaginings.

And yet thoughts are not facts, but merely the projections of our hopes and fears. As we develop greater mindfulness we begin to recognize this, to catch ourselves in the act of indulging in a story line whose punch line is an ache in the heart. And we start to be able to let go of these story-lines, realizing that they will bring us nothing good.

A further step in some meditation traditions is to cultivate thoughts that will enhance well-being rather than diminish it. And so, in the development of lovingkindness practice we repeat phrases such as “May I be well, may I be happy,” and in mantra practice we repeat phrases that evoke enlightened qualities of insight, compassion, and energy. Even the traditional recitation of the refuges and precepts can be seen as a way of convincing the mind of the value of committing oneself wholeheartedly to the path of awareness and compassion.

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Opening Up to Happiness (Psychology Today Magazine)

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Mark Epstein, Psychology Today: Why happiness is unattainable for some people and why it’s a mistake to wipe out sources of displeasure.

“I’m sick of this,” a patient of mine remarked the other morning. “I can’t stand myself anymore. When am I going to be happy?” It’s not an uncommon question in therapy, yet aspirations for happiness can sound naive or even trivial. “How could she be asking for happiness?” I thought to myself. “Didn’t Freud say that the best that one could expect of therapy was a return to ‘common unhappiness?'” Yet, my patient’s yearning was heartfelt. How could I possibly address it without being misleading?

I approached her dilemma not just as a psychotherapist, but as a longtime Buddhist. Buddhism holds the promise of more than just common unhappiness in life; it sees the pursuit of happiness as our life goal and teaches techniques of mental development to achieve it. To the Dalai Lama, “the purpose of life is to be happy.” He wrote those very words in the foreword to my new book, Thoughts Without a Thinker: Psychotherapy From a Buddhist Perspective (Basic Books, 1995).

“On its own,” he goes on to say, “no amount of technological development can lead to lasting happiness. What is almost always missing is a corresponding inner development.” By inner development, the Dalai Lama means something other than mastering the latest version of Microsoft Word. He is talking about cleaning up our mental environment so that real happiness can be both uncovered and sustained…

Americans have a peculiar relationship to happiness. On the one hand, we consider happiness a right, and we are eager for it—as the advertising world knows. We do everything in our power to try to possess it, most particularly in materialistic form.

On the other hand, we tend to denigrate the pursuit of happiness as something shallow or superficial, akin to taking up woodcarving or scuba diving. But, as the Dalai Lama always emphasizes, happiness is not a hobby, nor is it a trivial pursuit. It is a fundamental drive as basic as those of sex or aggression, but not often as legitimized in our cynical, postmodern culture. In fact, Americans are waking up to the Dalai Lama’s point: Materialistic comforts by themselves have not led to lasting happiness. Having reached that conclusion, however, we do not often see another way, and retreat into our comforts—barricading ourselves from what appears to be a hostile and threatening world. Acquiring and protecting, we continue to crave a happiness that seems both deserved and out of reach.

My experience as a psychiatrist trained in Western medicine and in the philosophy and practice of Buddhism has given me a unique perspective. I have come to see that our problem is that we don’t know what happiness is. We confuse it with a life uncluttered by feelings of anxiety, rage, doubt, and sadness. But happiness is something entirely different. It’s the ability to receive the pleasant without grasping and the unpleasant without condemning.

All the Wrong Places

Buddhism and psychoanalysis teach us that the very ways we seek happiness actually block us from finding it. Our first mistake is in trying to wipe out all sources of displeasure and search for a perennial state of well-being that, for most of us in our deepest fantasies, resembles nothing so much as a prolonged erotic reverie. One of my patients said it best with his adolescent fantasies of romantic love. He described his perfect woman as someone who would faithfully leave him with an erection every time she exited the house.

This approach to happiness is instinctual, deriving from our earliest experiences, when intense emotional states of pleasure and gratification inevitably are interrupted by absence and frustration, evoking equally intense states of rage or anxiety. Anyone’s first response would be to try to preserve the pleasurable states and eliminate the unpleasurable ones. Even as adults we rarely come to terms with the fact that good and bad are two sides of the same coin, that those who make pleasures possible are also the source of our misery. In Western society, with its extended family structure and rabid pursuit of individualism, people often find themselves with nowhere to turn for support in dealing with these feelings. In more traditional Eastern societies, there is a much greater social and familial support system that helps people contain their anguish.

However much we as adults think we have come to terms with the fact that no one can be all good or all bad, we are still intolerant of frustrations to our own pleasure. We continue to grasp at the very objects that have previously disappointed us. A wealthy patient of mine exemplifies this predicament. After a gourmet meal, he craves a cognac. After the cognac, a cigarette; after the cigarette he will want to make love; after making love, another cigarette. Soon, he begins to crave sleep, preferably without any disturbing dreams. His search for happiness through pleasures of the senses seemed to never have an end, and he was not happy. We think only of manipulating the external world; we never stop to examine ourselves.

Our search for perpetual gratification often plays out in intimate relationships. Take my friend who was very much in love with his new wife, but plagued by rage and bitterness over her sexual unavailability when she became pregnant. He could not help taking it personally. His happiness in her pregnancy was overwhelmed by his inability to tolerate his own sexual frustration, and he could not get past the feeling that if she really loved him she would be as interested in sex with him as he was with her. He was restricted by his tunnel vision; his own pleasure or displeasure was his only reference point.

We identify with the feelings of violation, rejection, or injury and we long for a happiness in which no such feelings could arise. Yet as Freud pointed out, even intense erotic pleasures are tinged with unhappiness since they all must come to an end, in the form of a relaxation of tension. Post-orgasmic depression is a well-known phenomenon. We long for this not to be so, but it is physiologically impossible.
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The Buddha’s point about happiness is very similar. As long as we continue trying to eliminate all displeasure and preserve only pleasure for a prolonged sense of well-being, no lasting happiness is possible. Rage, envy, and the desire for revenge will always interfere. Real life and its complications inevitably trickle in. There is a well-known story in the Buddhist tradition, that of Kisagotami, that illustrates how important it is to give up that approach to happiness.

Kisagotami was a young woman whose first child died suddenly somewhere around his first birthday. Desperate in her love for the child, Kisagotami went from house to house in her village, clasping the dead child to her breast and asking for medicine to revive her son. Most of her neighbors shrank from the sight of her and called her mad, but one man, seeing her inability to accept the reality of her son’s death, directed her to the Buddha by promising her that only he had the medicine she sought. Kisagotami went to the Buddha and pleaded with him for medicine. “I know of some,” he promised. “But I will need a handful of mustard seed from a house where no child, husband, parent, or servant has died.”

Slowly, Kisagotami came to see that hers was not a unique predicament. She put the body of her child down in the forest and returned to the Buddha. “I have not brought the mustard seed,” she told him. “The people of the village told me, ‘The living are few, but the dead are many.”‘ The Buddha replied, “You thought that you alone had lost a son; the law of death is that among all living creatures there is no permanence.”

Kisagotami’s story resonates, not just because of our sympathy for the horror of losing a child or because of our fear of a world in which such tragedy is possible, but because we all, like her, feel that our situation is unique and that our emotional pain requires relief. In the privacy of our own minds, we are aggrieved and single-mindedly self-centered. We still seek absolute gratification that is intolerant of frustration.

But the most difficult part of Kisagotami’s story for me comes when she lays her child down in the forest. Even though he has been dead for a long time, I still feel slightly aghast at the idea of her leaving him there. Yet this is precisely what the Buddha is asking us to do. He did not teach a method of recovering primal emotions or embracing some sort of injured child that lies buried within. The Buddha helped Kisagotami find happiness not by bringing her dead child back to life, but by changing her view of herself. The inner development he alludes to is a development beyond the private childish perspective of “me first” that we all secretly harbor.
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Happiness a la Buddha

The root cause of our unhappiness is our inability to observe ourselves properly. We are caught in our own perspective, unable to appreciate the many perspectives of those around us. And we are unaware of how insistently this way of perceiving drives us. Only through the uprooting of our own self-centeredness can we find the key to happiness. Buddhist meditation practice is one way to catch hold of this “me-first” perspective and begin to examine it. But it can happen in incidental ways. A teacher of mine, for example, remembers standing in line for food at a silent meditation retreat when someone suddenly spilled the large serving bowl of soup. “It wasn’t me,” he remembers himself thinking spontaneously. “It’s not my fault.”

Immersed in the quiet of the meditation retreat, he was all too aware that his reaction was patently absurd. Yet this is the kind of response we all have much of the time without being aware of it. Buddhist meditation is a way of coaxing the mind to deal with frustration in a new way, experiencing it as an interested observer instead of an aggrieved victim. Rather than responding to the inevitable frustrations of life with “Why me?,” the successful practitioner of meditation can begin to see how conditioned our everyday sense of self has been by the insulted response to disappointment.

Our True Nature

The first step to inner development is to find and hold the sense of a single, one-point perspective. This is the feeling that we all have that we are really the most important person in the room at any given moment, that no matter what happens the crucial thing is how it will impact me. You know the feeling; it’s the same one you have when you are cut off suddenly in traffic or are standing in line at the cash machine while the person in front of you makes one transaction after another. The visceral response is always, “Why are you doing that to me?” Similarly, when someone comes to therapy because they have been spurned by a would-be lover, there is always the feeling of “what is wrong with me?” In Buddhist meditation we seek out that feeling; we bring it into self-awareness rather than let it run our lives. When a person is able to do that successfully, there is often a sense of freedom.

A patient of mine, for example, recounted to me how he picked his girlfriend up at the airport recently and reached out to carry her bag for her after retrieving it from the baggage claim. She took the bag from him and carried it herself. Rather than take her action as a sign of self-sufficiency, he felt immediately rejected, as if she were not glad to see him. Once he learned to make that knee-jerk reaction of his the object of his meditative self-observation, he was freed from his obsessive scrutiny of his girlfriend’s mood. He then became more self-reliant, she felt more supported, and both were happier with each other.
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As the tendency to view the world self-referentially loses its hold, we begin to appreciate the Einsteinian world in which all realities are relative and all points of view subjective. Then, a happiness that has more to do with acceptance than gratification becomes available to us.

One particular meditation technique prepares the mind for a new, broadened perspective, that of naked–or bare–attention. The technique requires you to attend only to the bare facts, an exact registering, allowing things to speak for themselves as if seen for the very first time and distinguishing emotional reactions from the core event. So instead of experiencing a spouse’s suggestion as criticism or their withdrawal as abandonment, as so often happens within couples, one would be able to simply bear the experience in and of itself, recognizing any concomitant feelings of rejection as separate and of one’s own making.

As bare attention is practiced, many of the self concepts or feelings of self we harbor are revealed to be reactions that, on closer inspection, lose their solidity. My patient who overreacted at the airport was astonished at what he discovered upon closely examining his core sense of self. “This is it?” he asked. “This little feeling is determining so many of my actions? Am I really so narcissistic as that?” The answer, for most of us, is a resounding yes. Our sense of self, we soon find, is a house of cards.

A common misbelief people hold about meditation is that, in attacking reactive emotional tendencies, it encourages a stoic acceptance of unhappiness. Yet stoicism is not the goal. The point is not to become impervious but open, able to savor the good with the bad.

We cannot have pleasure without displeasure, and trying to split them off from each other only mires us more deeply in our own dissatisfaction. A recent incident involving an old friend of mine may illustrate the point. After breaking up his 10-year marriage, he sought psychotherapy at a local mental health clinic. His only wish, he told his new therapist in their first meeting, was to feel good again. He implored her to rid him of his unwanted emotions.

His therapist, however, had just left a three-year stint in a Zen community. When my friend approached her with his pain, she urged him to stay with his feelings, no matter how unpleasant. When he complained of anxiety or loneliness she encouraged him only to feel them more intensely. While my friend didn’t feel any better, he was intrigued and began to practice meditation.

He describes one pivotal moment. Terribly uncomfortable with the burnings, pressures, and pains of meditation, he remembers watching an itch develop, crest, and disappear without scratching it. In so doing, he says, he realized what his therapist had meant when she counseled him to stay with his emotional state, and from that moment on his depression began to lift.

His feelings began to change only when he dropped the desire to change them. This is a major revelation that is often brought on through the physical pain of meditation, which requires stillness within a demanding posture. My friend’s discovery is similar to the sensation cancer patients feel after taking morphine for chronic pain. They say the pain is still there, but it no longer hurts. So the sensation remains, but without the oppressive quality. Likewise, my friend learned to recognize his emotional pain, but was not oppressed by it.

Well-Being

Like many others, my friend was looking for that pervasive feeling of well-being and hoped that meditation (or love, money, success, alcohol, or therapy) would provide it. But well-being, which is not sustainable, is not the same as happiness. Happiness is the ability to take all of the insults of life as a vehicle for awakening—to enter into what the pioneer of stress-reduction, Jon Kabat-Zinn, has called the “full catastrophe” of our lives with an open mind and heart.

In pursuing a study of Buddhism and psychotherapy, I am convinced that a method of mental development exists that enables a person to hold feelings of injury without reacting destructively. Rather than immediately responding with rage or anxiety, a person can use feelings of injury to focus on the core sense of self that will prove illusive, nonexistent. If there is no self to protect, there is no need to react in rage or angst. Pleasure and displeasure can then be appreciated for the ways in which they are inextricably linked. Well-being becomes understood as an inseparable part of a larger whole that also encompasses catastrophe.

Happiness, then, is the confidence that pain and disappointment can be tolerated, that love will prove stronger than aggression. It is release from the attachment to pleasant feelings, and faith in the capacity of awareness to guide us through the inevitable insults to our own narcissism. It is the realization that we do not have to be so self-obsessed, that within our own minds lies the capacity for a kind of acceptance we had only dreamed of. This happiness rarely comes without effort to train mind.

To accomplish this we must first discover just how narrow our vision usually is. This is the function of meditation. Go ahead, close your eyes for five minutes and observe how self-obsessed your thoughts are. “When can I stop doing this?” you may think. None of us is very far from the eight-year-old child who can think only about who got the biggest piece of cake.

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Monks work to construct mandala (The Penn Online, Pennsylvania)

The Penn: Meditation, as practiced by the 10 Tibetan Buddhist monks visiting IUP this week, provides “stability and calmness” and opens the potential of one’s mind, said Eleanor Mannikka, Monday’s Six O’Clock Series speaker.

“What powers your behavior is your mind,” said Mannikka, an IUP art professor and 25-year practitioner of Tibetan Buddhism. “All the minds that human beings have are the most powerful tools in the universe. Without meditation you’re using a small fraction of your mind.”

Buddhists practice the teachings of Siddhartha Gotama — the Buddha — who after six years of meditation about 2,500 years ago, found the “middle path,” or enlightenment, in his search for the ways to avoid suffering and be happy.

Much of that suffering, Mannikka said, comes from attachment to worldly things, whether it’s material or a connection with others.

“[Buddha] didn’t say it’s love and compassion for your friends that causes suffering, but if you have an attachment with that love where you want good feedback … If you want something in return, you’re going to suffer,” she said.

Buddhism — the fourth-largest religion and only one with enlightenment as the goal — seeks to break that attachment through meditation, which must be taught by an instructor first-hand and “altruistic thinking,” Mannikka said.

In stages and with years of practice, one achieves enlightenment, “a state of emptiness” that comes from wisdom, ethical conduct and mental discipline, she said.

“Underlying everything in the entire universe is the basis of what we call emptiness,” which “cannot be described because it lies beyond concept,” she said. “It is very different for us to imagine that our minds can actually operate beyond concept.”

Eventually, those who meditate might experience “nanoseconds of what that emptiness is, and it is so mind-blowing. You would not believe that your mind can exist in that particular state,” she said.

For the master Tibetan monks, that transcendence may have metaphysical implications, she said.

“The Tibetans are notorious for doing things like walking through walls,” levitating or flying, she said. “This world that we see is illusory. … When the mind transcends the illusion of solidity in all objects, then solid objects cease to maintain their obstacle nature.”

Meditation typically involves controlled breathing, a focus on relieving tension and introspection.

“You don’t have to be a Buddhist to do the basic meditation. … When you think of yourself in that way, that you’re much bigger than this moment, that your life has meaning. It is then your job to fulfill that meaning,” she said.

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