Psychiatry
and Meditation
Dr.
Dhananjay Chavan
In the world today, there is much confusion,
ignorance and controversy about psychiatry, meditation and the relationship
between the two. Health professionals and mental health professionals are not
even clear about the scope of their own field of expertise. Neither do they
have a clear understanding of exactly what meditation is. It is little wonder,
then, that the common man is puzzled.
Both
the words "psychiatry" and "meditation" carry mystical
auras. In fact, psychiatry is a very young science, barely a century old, while
many meditation techniques derive from the ancient past. Nevertheless,
sometimes the claim is made that meditation is not scientific. Actually,
meditation is a science, a methodology practised and
perfected centuries ago by the scientists of mind and matter, by the Rishis,
Munis, and Buddhas. After all, what is science? Science is objective
observation and analysis of data, and their application. Science seeks to know
the truth. We will see later in this article how, even by modem criteria,
Vipassana meditation is a perfect science.
People
think of psychiatry as a science dealing with abnormal minds. But it would be
more accurate if the word "behaviour" were
substituted for "minds" in this definition, for, indeed, this is what
psychiatry is' It is the study of abnormal behaviour.
Now, to define normality is a difficult task. Normality generally means
"average." Behaviour refers to vocal or
physical actions, i.e., vocal or physical behaviour.
In psychiatry and psychology, mental behaviour is
studied only by inference after it manifests in vocal and physical actions. The
aim of these sciences is to bring the behaviour of an
individual closer to normal (which most of the time means average).
We
might use a more modern definition of psychiatry: an application of
neuroscience to the problems of particular groups of patients. Initially the
scope of psychiatry was not well defined. As a result, psychiatrists were
dealing mostly with minor illnesses. During the 1960s and 1970s, many
psychiatrists in the West were practising
psychoanalysis. Their subjects were often people with minor psychiatric
problems; very rarely were they psychotic. During this period an impression was
created in some quarters that psychiatry can deal with all the problems of humanity.
But the reality was that psychiatry was not contributing to peace in the
general society in any significant way, except for helping a small number of
patients.
Reasonable
psychiatrists gradually realized that the boundaries of psychiatry are not coextensive
with those of all human mental activity. This realization is of immense
significance, since it helps both the psychiatrist and the common man to define
the scope of psychiatry. Failure on the part of the ordinary person to
understand the scope of psychiatry has led to various problems. For example, at
times a psychiatrist is called upon to help when the problem is not actually
psychiatric, stemming from the unreasonable faith and expectation that the
psychiatrist knows everything about the mind. In contrast to this LWeption of the psychiatrist's omniscience, there is the
other side of the coin: a lack of M. in the whole specialty, even on the part
of some health professionals, with the result that psychiatric help is not
sought even when it is appropriate and beneficial.
In
recent times psychiatry has emerged as a branch of medicine with more focus on
major psychiatric illnesses. This has redefined the role of psychiatry as a
biological science, and pychiatrists are now playing
the more appropriate role of specialists treating biological disorders which
are accompanied by behavioural disturbances. This
certainly does not mean that the psychiatrist’s role is limited to prescribing
medicine; he or she uses various other modalities of therapy as well. But more
and more, psychiatrists have started restricting themselves to their proper
domain: the treatment of major psychiatric disorders. These conditions are ones
which psychiatrists
are
better equipped and better qualified to treat. Psychiatrists are trained to
deal with "abnormal" behaviour. In cases
which are closer to normal (or average) behaviour,
the difference in effectiveness between psychiatric treatment and other
treatment modalities rapidly decreases.
The
World Health Organization is constantly trying to improve its diagnostic
criteria for psychiatric disorders. The new International Classification of
Diseases (ICD-10) is an Important step in that direction. Many efforts are
currently being taken to systematically demarcate the field of psychiatry. This
is to help psychiatrists concentrate on a specific sub-population, to assist
researchers in seeking to find remedies for various disorders, and to protect
people from improperly being labelled as psychiatric patients. However, the
boundaries remain fuzzy. Even a competent psychiatrist at times finds it
difficult to decide whether to try treat a particular individual, or to
conclude that the person is not in need of psychiatric treatment.
Everyone
suffers from various kinds of misery. When confronted with problems in
business, one person might become angry very easily, while another person is
inclined to sadness. In such instances, the individual may well not have a
psychiatric disorder. He or she might benefit as much from the advice and
support of a friend or relative as from psychiatric intervention. Even so,
everyone's life is bound to have challenges, and suffering occurs again and
again.
What
does any person do when faced with life's problems? Every individual encounters
the suffering that results when unwanted things happen, when wanted things do
not happen; when one gets what one does not like, or loses what he likes. Where
should one look for the solution?
Mind
is the principal factor. We have to study it-probe it to its depths in order to
master it-in order to solve our problems. This is precisely what the science of
meditation is all about. Meditation is the science of exploring the entire
phenomenon of mind and matter. Psychiatry studies mind only indirectly and only
to the extent that it renders itself observable by its manifestation in vocal
and physical actions. In the science of meditation, the mind is studied
directly. This science has been extensively practised
in India since ancient times.
It
is true that all actions have their origin in the mind. But not everything that
arises in the mind manifests as a vocal or physical action. Physical actions
which appear to be similar might originate from quite different mental
volitions. For example, a person who freezes when he sees a snake might have
two entirely different reasons for this action. He may be extremely frightened;
or he may be very calm and is staying immobile so as not to frighten the snake,
or so as to observe the snake. Similarly, a person who gives a coin to a beggar
may be giving it out of compassion; just to get rid of a nuisance; or because
others are watching him and he does not want to appear to be a stingy person.
So the first problem with
the psychiatric approach is that it is very difficult to derive conclusions
about the mind from vocal and physical behaviour. The
mind must be studied directly. Another problem results from what is known as
"Cartesian dualism," the arbitrary separation of mind and matter. For
a long time the specialized medical profession studied
the body but excluded study of the mind. And when psychiatrists started
studying the mind, in whatever manner, they ignored the body. Today the
importance of a holistic approach is widely accepted. But there is neither a
satisfactory method of enquiry, nor proper understanding of the interaction of
mind and matter, with the result that there are many theories, but few facts.
The mind-matter phenomenon is not being properly studied.
These
problems are solved through the proper understanding of meditation. The term
"meditation" has a variety of meanings. In English, the term is
loosely used to refer to thinking about something. Dictionaries define it as
"contemplation": to exercise the mind in contemplation, to focus on a
subject of contemplation; to ponder, muse, or ruminate. When we refer to
meditation here, we are not using the term in this pedestrian sense.
The
Enlightened One, Gotama Buddha, used the word bhavana to
describe practices of mental development. This word can be translated roughly
as meditation. It refers to specific mental exercises, precise techniques for
focusing and purifying the mind. When we use the word "meditation"
here, we use it in this technical sense. Almost all Indian languages have
specific words for different meditation practices because India has a rich
tradition of these disciplines. Such words as dhyana, japa, traa.taka,
saadhandaa, vipassanaa, (vidarshanaa), bhaavanaa, etc.,
refer to different kinds of mental practices. Broadly speaking, meditation is
an exercise in the concentration
of
mind on various objects. Since concentration of mind is the prerequisite for
any task, it is a very important factor in the exploration of the mind-matter
phenomenon. There are many possible objects of concentration: visual, auditory,
imaginations, verbalizations, etc.
The
Enlightened One gave us a wonderful object of concentration, our own natural
respiration. Unlike other objects which are either external or do not have any
direct relation to our mind and body, this is an object which has many
advantages. It is internal, and constantly present from birth to death. It is a
tangible reality, even if a gross one. It is both conscious and unconscious,
intentional and unintentional. Its rhythm is so intimately connected with the
mental state that any defilement arising in mind, even the slightest agitation,
disturbs the rhythm of the respiration. We cannot find any other object of
concentration which is so intimately connected with the mind-matter phenomenon
and yet renders itself so easily to observation.
But
concentration is not the goal of meditation; it is only a tool. A tool for
what?
Here
we encounter the third problem of the modern scientific approach, that of
defining the problem itself. The four Noble Truths of suffering are very
simple, logical and universal: suffering exists; it has a cause; this cause can
be eradicated; there is a Path to its eradication. Yet these universal truths
are not appreciated by many modern psychiatrists because psychiatry focuses
more on the "why" than on the "how." This attitude of
searching for meaning while ignoring fundamental mechanisms of reality serves
to obscure, rather than enhance, the study of the problems of the human mind.
The
Enlightened One was a true scientist, the greatest scientist of mind and
matter. He not only explored the mind and matter phenomenon himself in its
entirety, but he showed the way to do it so that other people could come out of
their misery. He taught a method to observe how the mind works, how mind and
matter interact. He taught Vipassana.
Vipassana means to see, to see in a special way, to observe inside. It is
objective observation of the internal reality. It is development of insight
into one's own nature. It involves no assumptions; rather, mere observation. It
is a practical way of understanding our problem of suffering and solving it. In
the same way as the problem is universal, the remedy also is universal. In
Vipassana we learn to observe our sensations objectively. Sensations are the
meeting point of the intimate mind-matter interaction. Though sensations arise
in the body, they are felt by the mind. While observing the sensations, we
start understanding how the mind works. Each of us becomes a scientist of mind
and matter. We get direct knowledge. The Enlightened One described four fundamental
processes of mind: consciousness, perception, sensations, and
conditionings. No one need accept these processes intellectually;
they become clear once we start experiencing the truth within.
As
we learn to observe the sensations inside, it becomes experientially clear that
it is towards these very sensations that we keep continuously reacting. The
sensations are the basis on which the old conditionings, the patterns of
reaction-craving and aversion-develop. This profound discovery was the kingpin
upon which the liberation of the Enlightened One rested. It is our conditioning
which makes us suffer again and again, and this conditioning can be eradicated
by the practice of objective observation of the sensations. By practising Vipassana we learn not to develop new
conditionings of craving and aversion towards the sensations; and as a
consequence, we start to eradicate the old conditionings. The practice is a
process of gradual eradication of mental defilements. Hence, it is a process of
eradication of misery.
This
non-sectarian scientific technique is useful in enabling one and all to live
better lives, happy lives, peaceful lives. For many who undergo a ten-day
Vipassana course under the supervision of a competent instructor, the course is
a life-transforming experience.
The
practice of exploring mind and matter at the deepest level is not easy. It
requires a certain mental and physical stability. A sincere seeker who wishes
to undergo the training in Vipassana meditation needs to have a minimum mental
and physical health. Generally all but those with
severe psychiatric problems are fit to undertake a course. (It is advisable to
contact the management of the Vipassana course in advance if an applicant's
mental suitability is in question.)
Vipassana
is the universal remedy to the universal malady of misery. But this does not
mean that psychiatry has no role to play in helping the suffering humanity. For
those who are so deranged as to be incapable of taking up the delicate task of
Vipassana meditation, psychiatrists have an important role to play.
Psychiatrists can help in alleviating suffering of people with mental illness.
Except from the small section of the population with severe psychiatric
disorders, Vipassana is useful to one and all.
The
scope of psychiatry is limited to a small population. Vipassana meditation is
universal in scope because it encompasses all aspects of human mental activity.
Psychology purports to study the entirety of human mental activity, but as we
have already discussed, it is the "science of behaviour,"
and therefore, limited. Behaviour in this context is
defined as anything a person does that can be observed in some way. The
contention is that behaviour, unlike mind, thoughts
or feelings, can be observed and studied. The catch here is that the observer
is always an outsider, another person. Modem psychologists believe that behaviour is the only avenue through which internal mental
events can be studied.
Any
person who takes a ten-day course in Vipassana can easily see the fallacy in
this approach of modem psychology. He knows from his own experience that
internal mental events can be observed directly. Every Vipassana meditator
becomes a true psychologist unto himself. And through this pure science of
self-observation, he starts coming out of misery.
May
more and more people walk on the Path shown by the Enlightened One. May more
and more people learn to observe the reality within. May all beings be happy,
may all beings be peaceful.
Sincere thanks to Phramaha
Witoon Thacha for retyping this article.