Saturday, August 14, 2010

Mental Health and Meditation...if you're hurting

Get help.

But I do think Kyle's post here  and Petteri's post here needs a response. It's not like I strongly disagree with them, but I do want to put my 2 cents into this.  My response goes like this:

  •  Meditation, at least the mindfulness-based koan and shikantaza of zazen should not, in and of itself, be causative in inducing extreme mental states.  Rather I would say that the environment, the teacher, the belief system of the subject, and underlying mental health issues have probably a much bigger role to play here.
  • Thus it is not surprising that the article Petteri quoted consists of ancedotes. Then again, when we get to "transpersonal psychology" I think it's safe to say that we're standing a little out of scientific method land.
  • The reason I wrote the first two bullet points was my skeptic radar pinged loudly when I started reading Kyle's article.  Now I've seen my fair share of ...um...how to say it...disturbed people...in my years in zendos.  Hang around one long enough and a mentally disturbed person is almost guaranteed to show up.  And this is not surprising: Buddhism promises a path to the transcendence of suffering, and by gum, the mentally disturbed are nothing if not suffering. Two plus two... So why was my skeptic radar pinging loudly?
  • It's because real scientific studies show that therapeutic methods based on mindfulness are more effective at treating some kinds of mental disturbances than antidepressants.  It's also because such techniques are correlated with enhancing cognitive function.
  • But that's to say that strong medicine can be strong poison if not used skillfully; hence the issues of
    • Getting an ethical teacher who is not immovable, and aware of mental health issues
    • Making sure the setting isn't like some weird Large Group Awareness Training. (Did I write "Genpo Roshi?" No. I did not write that.)
    • And make sure you're at a point in your life where, even if you're feeling suffering (who isn't?), you're not at the point of doing something dangerous.
  • What Kyle and Petteri say is quite true: if you've got mental health issues, get them treated. Not only is there no shame in that, as Kyle said, but in reality, if you think you are covering them up well from others, you're only fooling yourself.  Trust me, everyone who knows you wishes desperately you would see the writing on the wall.  Dare to share your feelings with others.
  • Having said that, though, I can tell you that I have been quite down emotionally in my life, and my practice has been invaluable to me, and I know that's true for others as well.  Moreover, I've known people whose family had had very serious mental health issues, and they weren't always impressed with the results.   Regarding  mental health, "treatment by professionals" has had a very checkered history of effectiveness to the point that there's lots of people who think Tom Cruise might have a point when he goes psychotic raving about psychiatry.  
  • Even today, when it comes to some forms of behavioral disturbances, such as addiction,  most treatments in the US provided by most professionals are more akin to putting the leeches to someone thanto providing a treatment that is safe and effective.  And more Buddhist teachers should be aware of that. Yes, folks, even when it comes to professionals, caveat emptor. 
  • Buddhist teachers are not trained mental health professionals, unless of course, they've been trained to be mental health professionals. 
  • And finally, as I wrote here, don't forget:  The power of a belief, of a certainty that things are "this way" and "not that way" seems to have a profound effect on the incidence of particular types of mental suffering.  Even in the dark hard times we all experience in meditation, one should try to keep in mind that this is stuff the mind is throwing up to you, and as far as the present moment is concerned it has all the import of an itchy foot.  Hard to keep in mind, I know, I know.  But when once you have had the experience of the waning of such dark feelings and memories you realize that transcendence is possible.  For some it might take skillfully realizing that some kind of counseling or medication is needed before this state can be reached.  But usually, much more frequently, it's going to wane by itself. 

4 comments:

Kyle said...

Well now, I can't say that I disagree with you here at all...which was a bit of a surprise. :) Perhaps some clarifications on my part are in order.

I, along with many others much more qualified to study such things have wrote in the past, about programs such as Kabat-Zinns MCBT, that evidence has shown mindfulness based therapies to be extremely effective compared to anti-depressants and traditional psychotherapy. When I talk about not dismissing traditional psychological medications and professionals, I meant that in a more acute crisis sense, rather than as a long term solution. Working a suicide hotline, I understand the importance of being trained how to deal with extreme emotional states. But I do agree, modern psychology has a long way to come, and it takes a very skilled psychotherapist to treat patients effectively.

I do think that we both probably agree that even bare standard traditional treatments for the very seriously ill mental patients is way more preferential than coming to a zendo and plopping down on a cushion. Buddhist meditation shouldn't be the first course of action.

As for the causality of inducing extreme mental states, I should have clarified that obviously pre-existing, usually more serious mental conditions, diagnosed or even latent, is the tinderbox, gasoline and pile of wood all rolled into one; meditation is only one of many matches that can ignite it. That said, extreme fear and volatile emotions can occur in anyone during practice, but probably never to the point of psychosis; but I wouldn’t rule it out 100%

I've volunteered at a mental hospital and at a suicide hotline, so I've seen my share of the mentally unstable. It might be argued that someone with serious mental issues that fall under the delusional category probably wouldn't reach that far into practice to experience psychotic breaks, moreover, that really anything could set off an episode when we are dealing with that kind of disease. My worry is those on the fence between typical depression/anxiety and the more serious conditions coming to a Buddhist practice in hopes it will cure them.

Anyways, I don't disagree with anything you say here really, and mentioning the BigMind Genpo Mind-Screw in my post most certainly crossed my mind. It does go to show the importance of a good ethical teacher and that a new student understands that Zen, well Buddhist meditation in general is not a joke, that there is something definitely too it, not to be taken so lightly…(but ultimately that’s the good news)

Mumon said...

Kyle,
Your work with the distressed is truly laudable; I have no other words for it.

I'm not of that temperament.

Yes, I agree:

even bare standard traditional treatments for the very seriously ill mental patients is way more preferential than coming to a zendo and plopping down on a cushion. Buddhist meditation shouldn't be the first course of action.

Can't be said often enough.

Kyle said...

I have to be honest, I only spent one month of Saturdays in the hospital volunterring before I quit. I just wasn't able to cope with the stuff I was seeing...but I was 18 at the time.

Mumon said...

Kyle:

Still that's better than where I was @ 18.