In the last few years, there have been a growing number of Psychiatrists and therapists who have been successfully treating their patients with meditation. Meditation can be a powerful tool in one’s possession to help heal and integrate a patient’s troubles into a well functioning and mentally stable member of society. I am personally convinced that the Buddhadharma itself is a path to wellbeing like no other. It encompasses parts of religion, neuroscience, psychology, sociology, and philosophy so seamlessly and effortlessly and at the same time, it stands alone in a category all unto itself. Buddhism is far more developed in the west now than the religious fad it was in the ’60s. Since then it has grown and matured such that in most major North America and European cities one can find many different Buddhist offers nearby at the stroke of a few keys and your favourite search engine. But in this day and age of fad treatments and rising health care costs can one expect to solve their mental health issues by just sitting on the meditation cushion and seeking solace in the welcoming arms of the well-meaning and altruistic Buddhists down the street? As with any big question, its answer has at least two sides that I would like to explore with you now.

I am blessed with many great friends and one of my favourite people in my friendship mandala is Franzi, she is a psychologist and works with people who have quite severe behavioural and mental disorders such as depression, psychosis, borderline, and schizophrenia. She had mentioned to me once or twice that she uses meditation in her practice and I thought that now was a good time to sit down with a good cup of coffee and have a chat with her. First I wanted to know how she used meditation in her treatment plan for her patients and how successful it is. For her openness to meditation in her patients was the first consideration. Many people would not consider it due to religious or cultural objections, and if there was openness the doctor-patient relationship needed to trusting enough to use it successfully. The next consideration was what meditation therapy was appropriate? The first of two main treatments was a simple awareness meditation designed to bring the patient into the here and now. For example, the patient was asked to walk through a park and find 5 things to touch, smell, and describe like fragrant flowers and colourful leaves. For many patients, this exercise was helpful to bring them into the here and now that you and I know, in a stable and easy way. This type of meditation was helpful especially for patients with PTSD. The second meditation uses breathing, or a basic Shine type meditation to relax and bring a patient into a calm mindstate. It is used with patients with depression of various degrees with good success as well, but this was almost never used in more difficult cases as many patients when relaxed were prone to mental disturbances arising uncontrolled and in damaging ways. Meditation was never used in Borderline and schizophrenia patients for this exact reason. Meditation was also never the only form of treatment and was always used in conjunction with traditional psychotherapy in its many forms, “meditation is only one brick in the wall.” or as my picture suggests one tile in the complete mosaic of mental health. I then asked her if and when she would ever recommend a patient to go to a Buddhist centre and to learn meditation. She would gladly recommend things like yoga and Buddhist meditation but only as an option for patients who were already quite healthy, never for patients with severe disabilities.

The last part of our conversation focused on Buddhist centres and how they could deal with patients who are walking through their doors at an ever-increasing rate due to the very high cost of psychological treatment in countries with little or no public health care such as the US. I was surprised to hear much the same advice from Franzi as from my Lama. Severely mentally ill people should not meditate and in some cases such as with borderline patients, the group itself would be in danger with the behaviour of the patient. It is well known that Borderline patients are particularly challenging for even the most experienced groups of medical professionals let alone for a group of well-meaning, altruistic, but completely untrained Buddhist practitioners. Moreover, the complex meditations leading to very relaxed and open states of mind are completely inappropriate for many patients especially when there is no supervision. Some meditations like for instance Ngondro are designed to slowly pull the carpet out from under the ego, this is done in a slow and methodical way that leaves a meditator less and less attached to disturbing emotions and the ego illusion. But one needs a healthy ego in the first place to start this. If this is done by an individual who has an impaired sense of reality it can and likely will be dangerous. Franzi was clear the group should talk about anyone in attendance in the centre who is under the care or should be under the care of medical professionals and find a kind way to ask them to leave, and maybe even have an outside person not from the local group but within the tradition to help. This is not an easy task I can tell you from personal experience as I have had to do this once myself it was extremely challenging to do in good style.

Now for the good news and the other side of the story. Everyone’s life can be profoundly improved if they are lucky enough to come in contact with the Buddhadharma. The trick here is that meditation is not a tool to take lightly. Now, strictly learning about things like the four noble truths, the eightfold path, karma, compassion, and Metta would be of benefit to anyone including the mentally ill. But here is the key and its a problem Buddhists have had since the very beginning and the answer is wisdom. Wisdom must be balanced with compassion and be used in situations where mental health is an issue. Compassion without wisdom is mushy and stupid, wisdom without compassion is cold and hard, here we need the middle way. What does this mean? If you have a mild depression from a bad breakup or are neurotic with your cell phone use as the rest of us, in other words, normal, please feel free to practice meditation in any way in which you like but if you have a chronic, diagnosable, or serious mental health problem, seek out and follow the best medical advice and treatment you can find and follow their professional advice. Do not come looking for it in a Buddhist centre, we are not capable and not trained to help you.

Buddhist centres should also educate themselves about the warning signs of mental illness and be prepared to wisely deal with uncomfortable situations. And any Buddhist centre advertising a course on “dealing with disturbing emotions” should be aware of the Pandora’s box that they are opening when eager customers walk through their the door.

Do you have anything to add or a bone to pick please feel free to comment below,

QP