USE OF MEDITATIVE TECHNIQUES IN PSYCHIATRY

Rama P. Coomaraswamy, MD

  “Meditation, if properly understood and taught, is a powerful complement to the biopsychosocial model of psychiatric treatment”

		Joseph Arpaia, M.D., Psychiatric Times

 "In reality the ego is like the clown in the circus who is always putting in his oar to make the audience think that whatever is happening is his doing."  

		Freud 

Current Psychiatric literature is replete with references to the beneficial effects of meditation in its various forms on the psychological well being of patients. This “meditation” includes within its aegis various forms or practices ranging from Yoga, Mantra repetition (often described as “concentration meditation,” which blocks out negative thoughts), and “open meditation” which “allows one to keep one’s awareness on whatever changing phenomena arise in the mind, thus lowering psychological defenses to formerly repressed material.” These efforts are not infrequently supplemented with breathing techniques and even with psychodelic drug ingestion. 

What characterizes these efforts is that such techniques, drawn from various religious backgrounds, is the fact that they are used in a setting that is quite foreign to their origins. This is not to deny their therapeutic value in certain situations, but to point out that their use is in many cases similar to the symptomatic relief of a cancer patient without truly treating the underlying disease. They can relieve some of the symptoms, but hide the underlying condition which goes as it were untreated.

The fundamental reason for this is that the average therapist has a different vision of the nature of man - what man (and this includes women) is -  than the religions in which these techniques were developed. If one has a view of man based on the Decartian duality of mind (psyche) and body, such techniques will inevitably be applied to the psyche (and in part to the body as in yoga). However, the great religions have a tripartite view of man which holds that above both body and psyche (which includes our thinking processes), there is in man a Spirit, a spiritual center which is divine. If this is true, any therapeutic effort towards integration must take into consideration not only the body, the psyche, but also this spiritual center. The purpose of meditation is to integrate all three and not just the lower two. Psychiatrists may be uncomfortable with the concept of a spiritual center within every human being, but experience tells us that there is in every person a supra-individual source of truth or guidance which goes beyond the delimiting nature of the classical super-ego category, and indeed, it not infrequently becomes clear that patient’s problems may revolve around their inability to resolve conflicts between this inner source of Truth or Direction and the desires and thoughts that arise in their psyche. The only hope of bringing happiness and contentment to the patient is to line up these three components, the Spirit, the Psyche and the Body in such a manner that what is “higher” controls what is lower. Putting it in different terms, if the body runs the show - gluttony or sexual drives for example- than chaos results. Similarly, if anger, greed or the other passions are the center of the patient’s life, chaos once again reigns. Only if the Spirit of Truth controls the psyche, and the psyche in turn the body, is their any hope of peace. Though it must be added that it is not just a matter of “lining up” these components, they must be lined up to some purpose. The purpose of religion is not just to create a contented couch potato, but rather, to line up these components for some still higher purpose - namely to know, love and serve that Truth which lies within us - and not just within us, but also outside of us. 

The practice of meditation as understood by psychiatrists and psychologists has no necessary connection with what is truly spiritual. Putting it in simple terms, the fact that the patient may feel better is not at issue. The spiritual life does not aim at making us feel better, though this of course may be one of its results. The spiritual life, which aims at transforming the individual, has as its ultimate aim the sanctification and  “deifying” of the individual. This is not of course an easy process. As Perry Whitall has said, “Only the temple of God can receive God, namely, a soul predisposed by grace, grounded in doctrine, purified of sin, transformed in will, established in virtue - and all this with the aid of an adequate ritual or traditional affiliation.” This requires, not only certain personal qualifications, but individual effort because our natural appetitive instincts, as a result of our fallen nature are fixed upon the world. Without a volitive effort, spiritual inspiration, and direction, one cannot hope to interrupt the centrifugal tendency which drags us down and prevents our integration. Thus it is that we have the admonition: “Make perfect thy will,” and go forth with “purity of heart.”
The fragmentary nature of spiritual practices, without the necessary protections of traditional strictures and supports, is not without significant dangers. One hears little of the psychiatric consequences that have occurred to people who become deeply involved in such meditative practices such as repeating mantras, the meaning of which they hardly know, to say nothing of the possibility of self-hypnosis with consequent delusions. But reports of such are certainly available in the literature. The emptying of the mind as advocated by some clearly allows for negative forces and influences to enter and dominate the thinking of the patient, as for example when individuals proclaim that they are themselves god!. The fact that there may be some psychosocial benefits in no way avoids the possibility that such individuals can damn their souls in serenity. Of course, one realizes that many psychiatrists would deny the existence of a soul, to say nothing of the possibility of it being damned.

Let us for a moment consider just what meditation is. Webster's Dictionary defines meditation as "to keep the mind or attention fixed upon" something. It is defined by the Catholic Encyclopedia as "a form of mental prayer consisting in the application of the various faculties of the soul, memory, imagination, intellect and will, to the consideration of some mystery, principle, truth or fact...." The closest Hindu term is dhyana_the literal meaning of which is "concentration." It should of course be remembered, that as the Catholic Encyclopedia says, "the control of attention is the vital point in the education of the will." While Hindus are somewhat less prone to exact definitions, that of Swami Sivananda, a recently deceased exponent of Hinduism, should suffice. He tells us "it is a continuous flow of oil. All worldly thoughts are shut out of the mind. The mind is filled or saturated with Divine thoughts, Divine glory and Divine presence." Meditation of course demands both discipline and hard work. A Hindu would certainly have no difficulty in accepting the definition given by the Catholic Encyclopedia.

Take for instance the repeating of a mantra or ejaculatory prayer - for that is what a mantra is. Most mantras are based on, or include a divine Name. The purpose is not to exclude negative thoughts, but rather to have the individual be permeated with the essence of the sacred Name which as it reverberates through the psyche and body has a transforming effect. One becomes united with the Name, or more precisely, with what the Name represents, for as all the great spiritual traditions teach, the Name and what is Named are one and the same. It is not a question of keeping negative thoughts at bay, but rather of being absorbed in the positive nature of the Name repeated. If spiritual masters insist on concentration, it is never concentration as an end in itself, but in order that one can direct one’s full attention to the subject and end of meditation.

Nor does meditation consist of thinking “beautiful thoughts” or lowering our psychological resistances. The ultimate aim is well outlined by Avram Davis who comments on Jewish meditative techniques are pertinent. “people often equate meditation with a trancelike state or with simple relaxation. Trance and relaxation are splendid conditions, but generally speaking, Jewish meditation is no so interested in inducing these alone. Meditation will indeed often produce a relaxed state or lowered blood pressure, but these are not the central reasons for meditation, since meditation is neither a drug nor hypnosis. Instead, meditation is meant to transform us from a state of ignorance to a state of wisdom, from a state of bondage (be it psychological or personal) to a state of being free.” Teachers of true meditation “present strategies to annihilate ego. This is an ultimate desire of the meditative path, for herein lies the infinite bliss of God,” for, as Issachar Baer (an 18th century Hassidic teacher) said, “the essence of serving God is to understand that...you are simply a channel for the divine attributes... and that you have no independent self.”

In a similar manner, Sri Raman Maharshi, a man (deceased during the last century) whose eminent sanctity is recognized throughout India, comments on meditation that “only the annihilation of the ‘I’ thought is liberation.... If the ‘I’ is not let go, meditation will end in sleep.” Sri Ramkrishna taught that “in meditation one must be absorbed in God. By merely floating on the surface of the water, one cannot reach the gems lying at the bottom of the sea.”
The Bhagavad Gita similarly states: “There let him sit and make his mind a single point: let him restrain the motions of his thought and senses, and engage in spiritual exercises (yoga) to purify the Self” (VI:12).

From a Christian perspective one can quote parallel principles: “Nothing,” says William Law, “hath separated us from God but our own will, or rather our own will is our separation from God... the fall of man brought forth the kingdom of this world; sin in all shapes is nothing else by the will of man driving on in a state of self-motion and self-government, following the workings of a nature broken off from dependency upon and union with, the diving will. All the evil and misery in the creation arises only and solely from this one cause.” “It is a question,” asks Meister Eckhart, “what burns in hell? Doctors reply with one accord: ‘self will’.” Christ told Catherine of Sienna that “all sin derives from self will.”

It should be clearly understood that giving up self will is not a passive state, but rather a highly active one. Self will is the essence of egoity, of centering one’s reality in oneself. Pride is but concentrated self will. This does not mean that the individual should not recognize those elements in his own soul - the passions etc., - which are opposed to the Divine, for these are the “enemies” to be overcome and an unrecognized enemy can hardly be fought effectively. But the purpose of this is to allow the soul to “follow the footprints of Christ crucified, and thus, by desire and affection, and in union with love, make herself another Christ.”  The purpose then of meditation is to allow us to say with St. Paul, I live not I, but Christ in me.”

Let us consider for the moment Buddhist Meditation, as this is the most frequent referent for those who advocate such psychiatric supplementation. Buddhists hold that within each individual there is a Buddha Nature, a concept which is not unlike that of the Jeudeo-Christian concept of the Image of God in which we are all made. The aim of meditation can be said to be the return to the Adamic state when the Image and likeness were in concurrence. With the fall of Adam, the likeness was lost, and our task is to get this likeness back. It is this concept that the Dalai Lama explains: “Buddha Nature is the natural condition of mind and body purified of their habitual obscurations. Whether understood as a seed potential or a reality fully present, yet temporarily veiled, Buddha Nature is the promise, path and final result of the Buddhist practice and the foundation of Tibetan medical science....Buddhism offers infinite approaches to overcoming the forces of ignorance, greed and aggression that obscure our innermost potential. At the heart of all paths, however, lies the simple recognition that from the very beginning of our own individual nature is no different from that of the Buddhas. As the Dalai Lama explains: “Since time immemorial our intrinsic Buddha-nature has been obscured by the forces of ignorance, greed and aggression (or anger), as symbolized by the pig, cockerel and snake...These negative mental impulses obscure our limitless potential and are the root cause of our frustrating transmigrations through cyclic existence. Recognizing these three ‘mind poisons’ in their subtlest incarnations provides insight into the origins of all disease, for acknowledging their influence is the first step in developing wisdom. “The ultimate goal of Tibetan medicine is not only to restore the body and mind to a state of health and internal balance, but to remove the subtle physical and mental defilements that obscure our inner Buddha nature. To untie the knots of karmic conditioning and free the mind of self limiting patterns of thought and experience.”

It should be clear that traditional “psychology,” if such it should be called, is not in any way “scientific” as the term is currently understand. Its use of meditative techniques is aimed at breaking down the illusion that we are our transient ego or self and nothing more, and of freeing us from the passions which imprison us. In meditation, the restraining of our mindless impulses, allows the intellect to curb the passions of anger and desire that encompass it. Sometimes it assuages tempestuous anger with the gentleness of desire, and at other times it calms desire withe severity of anger. Then coming to itself, the intellect recognizes its proper dignity - to be master of itself - and is able to see things as they truly are, for its eye, made blind by the devil through the tyranny of the passions, is opened. Then man is granted the grace to be buried spiritually with Christ, so that he is set free from the things of this world and no longer captivated by external beauty. Meditative practices used in isolation and without any comprehension of their ultimate function will almost inevitably lead to the patient being “trapped” in their psyche, while the purpose of the spiritual life is in many ways to get people out of their psyche; to allow them to see that they must center their lives, not on feelings and past experiences, but on the Truth. Many cults also use meditative techniques in ways that inevitably trap their clients in the psyche which is evidenced by the bazaar convictions they induce followers to embrace. And worse still, through meditative techniques they are led to accept the guidance of such entities as Ramantha or other “spirit guides” - their number and names are legion.  To be trapped in the psyche is to fall into the bottomless pit of the ego. As the mystics repeatedly warn, the more we are in ourselves, the less God is able to dwell in us.