Barry Farrin [email protected].au

Mindfulness, Psychotherapy and Zen Buddhism

Introduction

This talk draws on my personal experience as a Zen Buddhist student and teacher and my work as a psychotherapist working mainly in palliative care, cancer care, grief and loss, anxiety, stress and depression.  I have practiced meditation since the mid seventies and began training in psychotherapy in 1978 and in the ten years until 2009 I was active in palliative and cancer care. During those years I have worked face to face with many hundreds of people and have had numerous contacts with people in therapeutic groups, mindfulness meditation training groups, and have conducted training for many dozens of  Zen students. This talk draws on my experience while working with these client groups and in training new Zen students in mindfulness meditation. Two major themes will be explored in this talk; the first is the history, philosophy and psychology of Zen Buddhism: and the second, the appropriation and use of Zen Buddhist meditation and mindfulness meditation, in emotional and psychological disorders. The use of mindfulness meditation will be explored in the treatment of common mood disorders of stress, anxiety and depression in patients with cancer, other life threatening and chronic illness and pain. The traditional “Buddhist view” on “suffering” will be expanded to include the modern interpretation of personal suffering, which is often interpreted as stress, and distress and emotional problems and will also include the more severe psychological pathological conditions. This talk will discuss the place of Zen Buddhism and mindfulness meditation in psychotherapy and finally, the promise of “awakening” and the end of suffering according to the Buddhist tradition. I first need to define how I work with people who are struggling with a life-threatening illness.

My Definition of Psychotherapy

During my years working in palliative care and cancer care I dramatically changed my ideas on psychotherapy and developed my own definition of psychotherapy that seemed to be more applicable and worked more effectively with clients who had a potential life-threatening illness. I include many ideas in my definition, about self determination, love, optimism, quality of life and hope. I am not always working to effect a behavioural change in my clients and often I do not always try to solve their problems as such. I often chose to work with their issues of life and the “meaning making” that they are engaging in as they struggled to make sense of their predicament. People who have been diagnosed with a potential life-threatening illness need more than “a quick fix” for a problem which is often “unfixable”. Often, I have no goal other than to allow the client to determine their own direction and allow them the space to say the unsayable.  I allow this space to grow in the “therapy room” which gives the client the authority to determine their process; and their response to their deep internal suffering in this safe and supportive environment. My approach to therapy has been defined by the group of clients I began to see when working in cancer care and chronic illness.

Discussion

Buddhist meditation was once regarded with suspicion by the medical and psychological profession. In the last thirty years this suspicion has given way to an embracing of mindfulness meditation by the above professions. However, mindfulness meditation is not a panacea treatment for all the emotional ills of the twenty first century. People with mild to severe psychiatric disorders who are dissatisfied with modern psychological treatments may approach meditation as a substitute treatment for their suffering. They may suspend other psychological talk therapy or drug treatment, and this can lead to difficulties for people who have a major psychosis. Meditation can also be contraindicated in some emotional conditions, acute extreme anxiety and early depression unless the patient is under one on one care.Without the deep personal experience of many years of mindfulness meditation, untrained and inexperienced meditation teachers have no awareness of the difficulties people might encounter when first learning mindfulness meditation. The long-term benefits of mindfulness meditation are enhanced when mindfulness is practiced within a Buddhist spiritual perspective. Mindfulness meditation as it is practiced by the psychological community has been isolated from its roots in Buddhism; to appear to be scientifically verified, and this isolation may limit the effectiveness of mindfulness meditation Dawson, G. (2006). Often patients are not fully instructed in the proper techniques or the clinicians have limited training and knowledge of the different styles of practice.

This talk will now examine the Buddhist roots of mindfulness meditation and highlight why mindfulness meditation increases it’s efficacy when practiced within a Buddhist philosophy.

Short History of Zen Buddhism

The Four Noble Truths

Zen Buddhism and all the schools of Buddhism are well established in Australia and the western world. Buddhism did not exist before the Buddha decided that the ascetic Hindu practices of India 2500 years ago did not provide him with the answers to life’s questions. During his years of practice, the Buddha discovered the Four Noble Truths; 1) life is suffering, 2) there is a reason for suffering, 3) there is a way out of suffering, 4) the way out is the “Eight Fold Path”. His first sermon was based on this discovery. This four part process will be explored later in this discussion. The “Eight Fold Path” is the way to liberation.

The Eight Fold Path

This path or the “middle way” aims to avoid extremes. The practice of the “Eight Fold Path” is to end suffering. This path develops: 1) Right Understanding, 2) Right Thought, 3) Right Speech, 4) Right Action, 5) Right Livelihood,6) Right Effort, 7) Right Mindfulness, and 8) Right Meditation or Right Concentration. On this path that ends suffering, the aim is to discover our “Buddha Nature”. This path uses mindfulness meditation as an important element in awakening to Buddha nature, which is inherent in every human being. In Zen meditation, students begin by practicing stage 7) and stage 8) right mindfulness and right concentration.

After many years, Indian Buddhism was exported to China. Zen or “Chan” as it is known in China came into existence at about 600 CE. Zen was then exported to Japan just before and during the early 1200 CE, then to USA, Europe and to Australia in the twentieth century. There are other Schools of Buddhism in Australia; the two largest being the Theravada school from South East Asia and the Tibetan school. Theravada Buddhism spread to South East Asia and Mahayana Buddhism spread to Northern Asia and China, Korea and Japan.  Buddhism came to Australia with the Chinese in the nineteenth century and was introduced by members of the Theosophical Society and other enthusiasts in the early twentieth century. There are many similarities and some obvious differences in the resulting philosophy of these schools. Buddhism changed as it moved through the world as it adapted to the many cultures of the Asian countries. The fortunes of Buddhism waxed and waned over the centuries as it encountered other religions, and in some areas of northern and southeast Asia Buddhism has almost vanished.

Most schools of Buddhism but not all, practice meditation. All schools acknowledge the Buddha as the founder or historical leader. Zen is a part of the later Mahayana school of Buddhism that developed from the schism in Buddhism after the death of the Buddha. Zen places emphasis on personal experience in meditation. Zen was established in Australia in the mid 1970’s by visiting teachers, Robert Aitken and Joko Beck. Buddhism is now the second largest religion after Christianity in Australia.

Dogen and Zen in Japan

Dogen Zenji (1200-1253) was one of the Soto teachers who pioneered the establishment of Zen in Japan in the late 11th and early 12th century. There were other Rinzai teachers who pioneered Zen teaching before the turn of the 12th century. Dogen Zenji is acknowledged as the father of modern Soto Zen. This Zen school, the largest in Japan, emphasises Shikantaza meditation (Just sitting). Dogen Zenji wrote extensively on Soto Zen in Japan. His writings are highlighted by this verse and he writes;

                “To study Zen is to Study the self.

                  To study the self is to forget the self.

                  To forget the self is to be enlightened by the ten thousand dharmas

                  And to be enlightened by the ten thousand dharmas,

is to free one’s body and mind and those of others.

                   No trace of enlightenment remains, and this no trace continues

                   endlessly.”

“This studying of the self”, is the internal journey that Zen meditation facilitates in the student and this journey allows students to get to know themselves; to know their thoughts, emotions, and to be aware of their physical sensations. This process asks the students to turn inward to discover their conditioned self. This study of the self is through Zazen, (Zen meditation). Zen Buddhism is based on the premise that there is a transmission of truth beyond words. This transmission “of truth” is discovered during meditation practice and the application of other skilful means (Upaya). The student is encouraged to discover the facts of Buddhism for themselves. Zen practice allows the student to break free of the “illusions of self” in order to “wake up”. Zen helps students create internal space which allows them to let go of the definitions of who they think they are. Some schools of zen, practice less mindfulness meditation, and place more emphasis on Koan study to develop this awareness.

The Rinzai Zen School uses “Koan” practice to help the student to cut away the conditioned responses from the past and to get in touch with the here/now. Koans are intellectual conundrums that force the student to find a new non-intellectual way of solving problems, and this helps the student shed their concepts and conditioning. When the student works on koans with their intellect they find they cannot find a solution and eventually they let go of their intellectual reasoning and allow their intuition to find the answer. Joshu’s “Mu” is the classical Koan;

             A monk asked Zen Master Joshu “Does a dog have Buddha nature or not”. Master Joshu answered, “Mu”.

You can see that there is no intellectual way of solving this riddle. Over time these koans help turn Zen practice into a personal journey of discovery. However, meditation is consistently used in Zen practice. This is the journey that the Buddha undertook 2500 years ago.

Mindfulness Meditation

Mindfulness meditation can be described as a way of paying attention and was originally practiced by the Buddha. Mindfulness involves bringing your attention to the internal and external experiences in the present moment in a non-judgmental way.  Some mindfulness meditation practices focus on breathing, walking, sensations in the body and sounds and others focus on being aware of thoughts and emotions. When emotions, sensations, or cognitions arise the students should observe them non-judgmentally. These wanderings of the mind into thoughts, memories and fantasies are noted briefly and then attention is returned to the present moment (Baer, R. 2003).

Mindfulness is defined in the (Shambala Dictionary of Buddhism and Zen 1991) “as performing consciously all activities”. One is encouraged to have an attitude of pure observation and notice sense data and thinking. The intention of mindfulness is to bring the mind under control. This practice will bring insight into the unsatisfactory nature of all existence. Malcolm Huxter (2009) states that the goal is to pay attention in an objective fashion to the arising and passing away of all conditions of mind and body. Harris, R. (2006) defines mindfulness as: “consciously bringing awareness to your here-now experience with openness, interest and receptiveness.” There are many types of mindfulness meditation practice and some don’t work for some people. The mindfulness practitioner/therapist needs to have a depth of experience in mindfulness meditation to find the right technique for the client.

Influence of Kabat-Zinn on the Acceptance of Mindfulness Meditation

Mindfulness meditation and other interventions that use mindfulness skills are becoming popular and clinical interventions based on mindfulness skills are also being written up in clinical studies. Jon Kabat-Zinn’s (1990) book, “Full Catastrophe Living” brought mindfulness to the notice of the non-Buddhist population. Many hospitals and clinics in the United States are offering stress reduction training. Perhaps mindfulness meditation has been taken up by the modern psychological community because it has been shown to be so effective in treating stress, anxiety, depression and intractable pain. Kabat-Zin uses mindfulness and Yoga in what has come to be known as Mindfulness Training and Stress Reduction. The most popular method of mindfulness training is called Mindfulness Based Stress Reduction (MBSR). This was developed as a method of working with resistant pain, anxiety, and stress and is fully explained in his book. Participants are asked to notice their thoughts and feelings without becoming absorbed by them.  The idea is for the participants to realise that most sensations, thoughts and emotions rapidly change and are transient “like the clouds in the sky”.

Effectiveness of Mindfulness Meditation

Many clinical studies show mindfulness meditation to be effective in decreasing levels of mood disturbance, and to help reduce stress (Carlson, L, E, Ursuliak, Z, Goodey, E, Angen, M, Speca, M, 2001). In a review of mindfulness meditation Baer, R.A. (2003) found significant improvements in chronic pain, and in anxiety and panic disorders. Good results were reported in the control of fibromyalgia and people who practiced mindfulness had a faster clearing rate of psoriasis when used in conjunction with light therapy. Many of the studies quoted by Baer, R.A. (2003) suggest that mindfulness training for people with mild to moderate psychological distress show improvement.

Mindfulness Based Cognitive Therapy (MBCT) can be effective in preventing a relapse of major depression. People with a history of depression are vulnerable to recurrences of depression, if they start to notice mild states of anxiety, dissatisfaction and restlessness. These states may reactivate their depressive thinking. This approach uses mindfulness meditation as an adjunct to cognitive therapy. This therapy also helps clients to see more clearly the patterns of their minds, and this helps them recognise that their moods may be beginning to change in a “downward pattern”, and they need to take some action to head off a bout of depression. This knowledge helps participants cope with the thoughts that can lead to a relapse.  Clients begin to see how “depressing thoughts” come and go in the mind. And as they use mindfulness meditation they notice they have a choice of not fusing with these thoughts, and they notice when they don’t fuse with these depressing thoughts, they don’t become depressed (M. Williams; 2002), (R. Baer 2003).

Mindfulness Meditation Working with Fear, Grief and Loss

There is considerable evidence that existential suffering or the fear of death in cancer patients can be controlled by using of mindfulness meditation. This suffering is a “loss of hope” and the “appearance of non-relenting fear”.  There is considerable stress, anxiety, fear, and depression experienced with this state. Clients often describe their emotional state as “being in a flux and uncontrollable”. They talk about being “hyper-vigilant”; they “can’t sleep, think straight or focus on any other thing for days on end”. One client described the experience “as the most suffering he had ever experienced” and it gave him little rest. He suggested that the great physical pain from some treatments and the pain from some of the tests he endured were not as bad as the emotional suffering he had experienced while he was being treated for cancer. He could tolerate the physical pain but could not find relief from the thoughts of disaster and the emotional pain he felt from these catastrophic thoughts. Smith, JE. Richardson, J.  Hoffman, C. And Pilkingson, K (2005) found that MBSR programs improved mood, and sleep quality and reduced stress in cancer patients. Carlson, LE. Ursuliak, Z. Angen, and Speca, M. (2001) found mindfulness meditation was effective in decreasing mood disturbances and stress symptoms in a wide variety of cancer diagnoses, and stages of illness.

Huxter, M. (2009), a psychologist and practicing Buddhist, proposes that psychologists when using mindfulness for the treatment of the bereaved and the dying, should instruct their patients to focus their attention on the tangible bodily sensations they experience in meditation, so the strong mental states won’t overwhelm them, and they will benefit from the feeling of stability they feel when they meditate. This non-intellectual awareness allows them to investigate the mental and physical dilemma of feeling unable to go on, the total hopelessness, and the helplessness they may feel.

I have found in my own cancer care and palliative psychotherapy practice that mindfulness meditation can be useful for anxiety and depression and grief and loss. I often use a short five-minute non-meditation mindfulness practice to help clients find relief from the overwhelming feelings of grief. This helps them stop fusing with sad and catastrophic thoughts. Clients are trained to stop the mind from fusing with these thoughts and to continue to pay attention to their breath, their hearing and to what they observe. This exercise is practiced five times a day. This exercise will be further explained below under Acceptance and Commitment Therapy. I may also introduce a longer mindfulness meditation later which allows the client to facilitate the pain and sadness. This may help the client gain a different perspective by concentrating on the breath. Clients report that they see the thoughts of sadness and the feelings of panic and anxiety come and go. They say that they realise that these difficult thoughts and physical sensations are not permanent, and that they feel that they are getting some control over their life again.

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is a widely used therapy developed by the psychological community which uses the concept of mindfulness and Cognitive Behavioural Therapy (CBT) to train participants to quieten the troubling thoughts that often cause severe anxiety and panic. ACT does not use mindfulness meditation as such. Clients are taught to recognise sensations, thoughts and emotions as they develop what Harris. R (2006) calls the “observing self”. He suggests that they begin to see phenomena as separate from their self.He claims that ACT is effective in a diverse range of clinical conditions such as; depression, obsessive compulsive disorder, workplace stress, chronic pain, anorexia, heroin abuse, marijuana abuse, and even schizophrenia. He claims that re-admission rates for schizophrenia patients were reduced to only 50% over the next six months after treatment. The goal of ACT is to help participants engage in a rich meaningful life which is guided by their deepest values. ACT teaches valuable mindfulness skills to overcome the unwanted thoughts, images, feelings, sensations and urges, clients encounter as they attempt to create a rich meaningful life. Clients are shown how to control and reduce catastrophic thinking. This reduction in catastrophic thinking reduces stress/distress, anxiety and the recurrence of depression and consequentially reduces suffering.

The Relationship between Mindfulness Meditation and Psychotherapy

Mindfulness meditation training has much in common with psychotherapy. Baer, R.A. (2003) contends that training in self directed attention as practiced in mindfulness meditation can result in a desensitization of conditioned responses and a reduction of avoidance behaviour. Baer, R.A. (2003) suggests training in mindfulness facilitates cognitive change in the participants, and they see their thoughts as temporary, without any real meaning and without representing an accurate reflection of reality. Mindfulness meditation is different to cognitive behavioural therapy, in that mindfulness does not include evaluation of thoughts as rational or distorted. Instead mindfulness meditation helps participants to observe their thoughts and to note the impermanent nature of these thoughts and not to evaluate them.Cognitive behavioural therapy procedures usually have a clear goal to change behaviour or thinking patterns, while mindfulness meditation is practiced with an attitude of non-striving. Mindfulness is practiced toallow acceptance of thoughts and feelings and paradoxically the participant may experience a reduction of some symptoms.

Mindfulness Meditation without Buddhism

Dawson, G. (2009), a working psychologist and Zen teacher, contends that Buddhist practice will reduce the suffering and the general dissatisfaction that is found in all human beings. However, he makes the distinction that “meditation intensives are not appropriate for people with a history of psychosis, current major depression, a current drug or alcohol problem, or for people with a very fragile and disorganised sense of self.” He also contends people who go straight into a long meditation intensive without some meditation experience are at risk of having a distressing experience. Dawson, G. (2009) suggests that some psychological assessment of people wishing to attend intensive meditation retreats should be conducted before people attend these retreats. He suggests that some people be excluded from attending. He reasons that a number people who adopt an alternative health philosophy: one that ignores certain psychiatric conditions, may also attend meditation intensives in a mistaken belief, that all meditation retreats will benefit them. Some people will benefit from mindfulness meditation if it is slowly introduced and supervised. Dawson, G. (2009)suggests that people should attend controlled weekly meditation and short half or one day retreats before attending long intensive retreats.Unfortunately, meditation intensives are often run by people who have little training in Buddhism or psychology and have very little knowledge of the possible problems and contraindications.

The Acceptance of Psychotherapy in the Modern World

Psychotherapy has been recognised as one of many treatments for emotional illness, and generally the more extreme forms of psychosis and personality disorders. Psychotherapy has now been accepted by the community, for the treatment of life transition issues and other emotional issues. Many local communities have teams of mobile mental health workers and community health social workers. Psychology services are now available on the national health system and there are many community organizations providing counselling and relationship interventions. There are many support groups available for people with cancer, arthritis, MS, and many other issues. Counselling courses at colleges and universities are very popular and ordinary people are likely to seek counselling for grief and loss, unemployment and other life change issues. Mindfulness meditation has gained favour in this milieu of “wellness treatment” as an effective treatment for anxiety and stress and other conditions outlined in this talk. Buddhism has also become very popular during this period and is now the second largest religion in Australia.

People are often attracted to Buddhism because of their personal suffering and Buddhism’s promise to reduce suffering. It is understandable that mindfulness meditation has become popular because of these reasons. Dawson, G. (2009) highlights how meditation is the engine of Buddhism and without Buddhism: meditation may well become a useless piece of philosophical belief. He states that meditation may be used in 1) Relaxation, 2) Mental Health, and 3) Spiritual Awakening. This “spiritual awakening”, which is a central part of mindfulness and Buddhism is not always discussed or explained to clients by clinicians. Dawson, G. (2009) also highlights that many meditation teachers are not aware of the contraindications of mindfulness meditation, nor do they have a deep understanding of Buddhism.

The teaching of “Dependent Arising” or “Dependent Origination”, as it is also known, is mostly ignored by psychological clinicians. Unfortunately for their clients this teaching is an essential teaching in Buddhism which underpins the correct understanding and use of mindfulness meditation. Having a deep understanding of the concept of dependent arising helps the Buddhist psychotherapist understand their clients suffering and helps them reduce their clients suffering. This is another Buddhist concept that is not taught to most people learning mindfulness meditation Kearney, P. (2001).

Dependent Arising

Dependent Arising is a major Buddhist insight that is not understood by many non-Buddhists. Students of Buddhism develop a deep understanding of dependent arising during their meditation practice. This concept of “causality” (cause and effect) and “conditionality” (how we are conditioned by our prior experiences) are central to understanding our personal suffering, stress/distress and other emotional states and other existential states of mind. Dependent arising is presented as twelve links that explain” conditionality” or how conditions that we encounter in life define who we think we are. These links are 1) Ignorance, 2) Karma–formation, 3) Consciousness, 4) Corporeality and Mentality, 5) Six Bases, Sensorial and mental, 6) Impressions, 7) Feelings, 8) Craving, 9) Clinging, 10) Process of becoming, 11) Rebirth, 12) Old Age and Death. This Buddhist concept is not easy to explain without a parallel practice of meditation and is really the central aspect of Buddhism.

In brief this concept, suggests that the “fixed state of nature” is one of ceaseless Change where everything that we encounter is in a state of change. This change happens according to specific conditions. The doctrine of Dependent Arising is central to the Buddha’s teaching and when we understand these laws completely we are awakened. Ignorance of “dependent arising” compels us to operate in an unskilful manner.

                       One who sees dependent arising sees the Dharma;

                       One who sees the Dharma sees dependent arising.

                                    (Majjhima Nikaya, tripitaka)

The Buddha personally experienced the hold that his past experiences had on his life. This is a basic teaching of Buddhism.  This principle also informs all Buddhist practices and includes Zen practice. The Buddha discovered that the process of “dependent arising” is going on in us, and he realized that these conditions cause a reaction or a response in us because we think there is the self, we must defend, or we might think that someone else caused a problem for us and then we defend ourselves. When there’s one thing present, there must be another thing present. The nature of conditionality is that there is not just one thing, but many things arise, at the same time Siff, J. (2005).

Say we look at our emotions for example: if we feel angry when someone says something that upsets us, we might feel or think that person caused that anger. The Buddha would say that the person did not cause the anger, but it was the way we thought about what was said. You heard the words and then you had a certain feeling which was unpleasant and that feeling caused a perception about yourself and that created an idea that someone, maybe, hated you and then maybe, you felt humiliated and then there was a lot of thinking about it. You somehow got really obsessed by it and that obsession got out of control and then you got angry Siff, J. (2005).

At some stage in your life you will become aware of personal suffering; perhaps from the emotional effects of a serious illness or the loss of a loved one or whatever, and perhaps this will cause you to reflect and maybe you will seek help at that time. Gordon, R. et al (2006) suggests that the Buddhist idea of dependent arising could help you understand how this is entrapping you. Dependent arising describes the process of change, and the impact on you can be observed. They suggest if you “awaken” to this process you may be able to eliminate the entrapment.

This process of “dependent arising” becomes clear as the student practices mindfulness meditation over time, but unfortunately it is this deep meditation practice that is often missing. Unfortunately, as well,for many people this process is not even explained or discussed by modern non-Buddhist therapists. The psychological community has developed mindfulness practices that ignore the insights found in the concept of dependent arising and most of Buddhist psychology. Much of the therapeutic literature on mindfulness meditation does not mention the Buddhist roots of mindfulness meditation and clinicians often combine these meditations with more conventional CBT or other therapy modalities. They report they are unsure of the effectiveness ofthe mindfulness meditation component.

Perhaps therapists who use mindfulness meditation as therapy should attend a few long mindfulness meditation retreats, so they can personally experience the process first hand. This personal experience would inform them of the difficulties and possible problems for clients. The clinician would gain knowledge from their own experience and appreciate why many clients don’t complete their mindfulness exercise at home and why they don’t continue to fully embrace mindfulness practice during their therapy. Practitioners really need to grapple with mindfulness to be able to teach it. This practice should be digested while doing it. Intellectual knowledge is not enough, even a deep intellectual understanding does not go far enough. Perhaps therapeutic effectiveness could be improved if clinicians had a better knowledge of Buddhist psychology and were able to attend long retreats and could get supervision from trained mindfulness practitioners.

Suffering and the Four Noble Truths

Quality of life is diminished when people have depression, anxiety, or any emotional disorder. Mindfulness meditation is very valuable in treating these conditions and has proven effective in relieving the personal suffering people experience. Suffering or (Dukkha, Pali) is a central concept in Buddhism and lies at the root of the Four Noble Truths as was explored earlier in this discussion. This suffering not only refers to suffering in the sense of unpleasant sensations, it also refers to everything that is conditioned by our life and our response to life. Birth is regarded as suffering: ageing is suffering; sickness is suffering; dying is suffering; care, distress, pain, affliction, and despair are suffering. The Four Noble Truths state that life is full of suffering and we see from the definition of suffering that there is much distress and stress.

The reason that mindfulness meditation has been taken up by the modern psychological community is because mindfulness meditation has been shown to be effective in treating stress and anxiety. Modern interpretations of suffering have come to include stress, distress and include many contemporary emotional disorders. Zen Buddhism and all forms of Buddhism offer an end to suffering and this ending of suffering is attractive to those of us in the twenty first century. The long-term study of Zen Buddhism and other Buddhist schools offers more than short term relief of mood and emotional disorders.

Ultimate Reality and the Experience of Awakening, Kensho, and Satori

Long-term meditation of a Buddhist practice nurtures maturity and brings about a lower-profiled personal self, or the need to defend the self as if we are under attack. People increase their ability to accommodate the outside world. Zen Buddhist practitioners become less preoccupied with their selves and are more able to identify with other people in the world and other things of the world, and eventually they begin to identify with the universe itself. For some, the study of Zen allows; an acceptance of the reality of death, it helps with the letting go of loathing and longings, “it helps you focus on just this moment”, it helps soften biased opinions and idealistic notions of perfection, it helps develop patience, it helps in seeing the sacred in the ordinary, it helps in letting go of doctrines, it helps you become open and flexible, it helps in accepting of life’s opposites, and it helps you in showing responsibility and compassion to others. Austin, J. H.(2006).

Dogen (1200-1253) writes on awakening and Kensho;

“A person’ becoming enlightened is like the reflection of the moon in water. The moon does not get wet, nor is the water ruffled…..the moon and heavens are reflected in even a drop of dew in the grass”.

Robert Aitken Roshi (1996) states;

“There is enlightenment beyond enlightenment, passing beyond passing. Each milestone on the path may seem a be-all and end-all experience. Everything falls away. The everyday self disappears. Yet the path continues to open out. When you continue to practice you will find that you transform yourself and accept that everything in life is impermanent. Instead of taking yourself as reality; fixed and solid, you realise the absolute truth and you live freely.” There is no fixed you and no fixed world. You practice meditation to see who you are, and life, as it truly is.”

Conclusion

Clinical studies prove Mindfulness meditation to be at least as effective as any other psychotherapy treatment for anxiety, stress, and the prevention of the recurrence of depression. Good clinical results have also been obtained in treating a wide range of mental and emotional disorders. Many clinicians are now using mindfulness meditation regularly and there are many stress management programs conducted around the world each year. The appropriation of the Buddhist practice of mindfulness meditation for psychological therapy has been a welcomed therapeutic intervention and many clients are benefiting from these new skills. Mindfulness is also being used in more difficult mental health issues. Clients often feel that a gentle mindfulness meditation is less directive than other forms of therapy and this gives them back some feeling of control over their life.

The psychological community has begun to use Buddhist mindfulness meditation with great success and perhaps they would have more success if they could integrate other useful Buddhist skills into the practice of psychotherapy. Mindfulness meditation needs to be practiced for many years before clinicians really know about mindfulness. It is not enough “ethically” to do a weekend workshop or an eight week course and imagine that you know enough to teach mindfulness meditation and work effectively with it. Perhaps the clinician needs to work closely with people who know the most about mindfulness meditation; Buddhists who use mindfulness meditation daily in their own daily personal practice. Psychologists have a great deal to learn from Buddhists about suffering and the ending of suffering. Great care should be used when using mindfulness meditation in emotional and psychiatric disorders.  Clinicians should be thoroughly trained and experienced in their personal practice of mindfulness meditation before undertaking the training of their patients.

Author Barry Farrin [email protected]

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