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15.04.2015

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While I am a Buddhist minister, I am also a licensed social worker with a specialty in mental health and drug and alcohol treatment. When a mental health professional diagnoses a disorder, they are looking at something on a totally different scale. Yesterday, I was working with a client with a antisocial personality disorder and he summed it up nicely, “I have been dealing with this my whole life and I just don’t understand what is wrong with everyone else.” When working with people with significant mental illness issue, it is often like trying to teach a man with broken (or no) fingers how to type. A monastic is a Buddhist practitioner who has dedicated himself to the perfect teachings of the Buddha.
This monastic was speaking off the cuff without any real basis of what the NHS was saying nor understanding the mental condition of the person he was talking to about this subject. Bipolar disorder being diagnosed more and more commonly today: There is a genetic component but environmental factors also contribute. The danger is that a monastic has no training in mental health to effectively understand what the individual is dealing with to help guide and support him. I have dealt with many lay-practitioners and monastics who also advocate Buddhist meditation for the solution of physical health conditions. From Freud to today, the philosophy and teachings of Buddhism (and the Buddha) have been a reference for understanding the nature of the mind. A good Buddhist practice can be a cornerstone to a foundation of good mental health, but it cannot be the entire foundation.
Finally, speak with your mental health provider on how you may use the strengths of your Buddhist practice to support your mental well-being. Born Joshua Hudson, Reverend Sumitta (his ordained name) finished a twenty-year career as a military photo-journalist, and became a Licensed Social Worker with continuing studies in Mental Health, Healthcare Advocate, and Buddhist Minister.
Again though, this is because that therapist is more trained and more familiar with the typical Western lifestyle.
Buddhism would be effective if Westerners were more in line with it from the get-go, otherwise there is too sharp a divide from regular daily life for a person to get the full benefit from it.
Daily meditation, regular satsangs, and knowing there is a spiritual community that offers support is still really, really helpful. I do agree that there are many visitor and users of Buddhist sanghas work in mental health, and there is a lot of great worth from Buddhist practice for personal development.
Very well-written article, it is not often that I read about this topic from the perspective you’ve presented but your argument is well thought out and easy to follow.
I felt much pleased to share this true statement of a Nagis survivor of Burma in 2008 when the survivors were out of help from professionalized mental health support.
I certainly agree that those mental health supports that have Buddhist approaches often find great success. Enter your email address to subscribe to this blog and receive notifications of new posts by email.
This article first appeared in Turning Wheel, the journal of the Buddhist Peace Fellowship, and was later reprinted in Not Turning Away: The Practice of Engaged Buddhism, ed.
I used to live in a state mental hospital, the kind you see in the movies: red brick buildings sitting on a lone hill, screams emanating from the barred windows, people wandering around the well-manicured grounds talking to themselves. Over the next 10 years, I worked in a number of other positions in the mental health system. On this bright spring day, I drove to his house in the ancient, rattling agency car and caught a glimpse of snow on the MacKenzie Mountains in the distance.
I got a glimpse of his hands; the skin was peeling off and it looked like he had burned or poured some chemical on them. I lectured to him about taking his meds, and I told him that I was concerned for his safety. I no longer work in the mental health system, and it’s been a long time since I’ve had to choose between calling the police to commit someone to the hospital or letting them self-destruct.
A Buddhist perspective calls for us to apply our understanding of interconnectedness to this issue. In working with Joe, I noticed that there was a distinct difference between his “normal” craziness and the kind that got him into trouble.
The biomedical system, the predominant approach to illness in the West, has done an excellent job of making us believe that the most effective (and often the only) way to treat mental illness is with medications. A socially engaged Buddhist perspective will lead us to inquire about our obligation to treat not only the person but also the environment that has contributed to the conditions that create suffering. Restoring mental health does not mean simply adjusting individuals to the modern world of rapid economic growth. Another key to deepening our understanding is to listen to the people who are really the experts on this subject: those who have received services from the mental health system.
A number of consumer-run groups and organizations also offer innovative treatment and support services. Thank you, Genju and Seiho, for taking the time to read the article and for your thoughtful reflections….


There is a sorely needed expansion of mental health issues in the areas of social engagment and chapliancy. Interesting to hear that in other countries, families deal with it differently and don’t overmedicate and hospitalize. Enter your email address to follow this blog and receive notifications of new posts by email. As a practice, it has been proven over the past 2,600 years that the Buddha truly understood the nature of the world and his enlightened teachings have been the path for countless others to understand the nature of dukkha (discontentment) and how to reduce or eliminate that dukkha in our lives in order to be fully engaged with the world around us. If you have thought of practicing Buddhism and you (or your friend) suffer from a mental health condition, I highly encourage you to read this article and understand more clearly what Buddhism can and cannot do for you. In the same way, people who suffer from mental illness seek help because they have found their lives to be unmanageable and the distress they feel to be unsustainable.
This is because mental illnesses created from brain chemistry, extreme trauma, or developmental-based world views require more than just sitting. Some lay practitioners and monastics have come to the mind that Buddhism has science behind it to prove that it can cure nearly anything. His world extends to the tools and understanding he has: The existential understanding of suffering and the end of suffering. While there are some Buddhist practices that do have physical therapeutic help, using them without first seeking the help of a medical professional first is unwise. Many of our modern therapeutic theories and practices are rooted or informed by Buddhist practices. I am a Buddhist minister with training, and there are others who are well trained and educated in neuro-science, psychology, etc. If you feel that your mental health provider is not creating a good therapeutic relationship or providing the care you feel appropriate, speak to them about it.
Spiritual and mindfulness practices are often significant tools to have on the path to mental wellness. My job as a music therapist brought me inside those walls every day, and for a while, I lived in the hospital dormitory with other staff.
Joe replied that all he needed was a pat on the back and a cup of coffee, but it seemed to me that we were beyond that point. Still, as I walk through downtown San Francisco and pass a young man talking to himself in tortured tones, I know that some other mental health worker is faced with these same impossible choices. As socially engaged Buddhists, we can reframe these questions to encompass a larger perspective. Mental illness is no longer an individual matter, a case of one person’s psyche gone awry, but rather it sits in the context of our society and culture. But you don’t often hear about the horrific side effects of these medications, sometimes worse than the symptoms they are intended to treat, and the fact that drug prescribing is still essentially a guessing game. Since then, I have learned about other kinds of treatment approaches, some of them even rooted in Buddhist practice. A growing number of these people identify themselves as “consumers” and “survivors.” Collectively, they make up a movement similar to other social movements that address issues of institutionalized oppression.
You can find out about some of these by contacting the Support Coalition International and the National Association for Rights Protection and Advocacy.
I struggle with a family member who has mental problems, and I too have seen the way they are treated when they go into hospital in times of crisis. Nevertheless, lately I have seen a marked increase in conversations of people who seek Buddhism to be a panacea solution for mental illness and this sometimes troubles me because it shows a misunderstanding of Buddhism and mental health. I have seen people use Buddhist meditation to stop their cravings for cigarettes (nicotine addiction). They require expertise that moves beyond a spiritual leader or community (which are often therapeutic) and requires expertise in those who understand how to treat this level of distress. To that end, it is very tempting for a soldier returning from Iraq, wanting to avoid dealing with a therapist, to seek a Buddhist temple to solve his PTSD problem. A temple is not a drug and alcohol rehabilitation facility that understands the nature of addiction, just as a Catholic church isn’t. You may need to work with more than one mental health provider before you find the one that is able to help you work through your issues successfully. In the friendliest voice I could muster, I told him that he needed to stop because the city fire code prohibited burning and the neighbors might call the fire department. His housemates, who looked like they’d had just about enough of Joe, moved around discreetly behind us and left the house.
My presence was only agitating him more, so I returned to the office and worked out a plan with my co-workers to get him into the hospital.
Emotional suffering and mental distress may be a universal experience, but the ways they manifest are unique from place to place. I also saw him go into spirals of psychosis when he felt socially isolated and not seen by others.


Psychiatric treatment requires environmental change and psychiatrists must participate in efforts to change the environment, but that is only half the task. Windhorse, for example, is a treatment community in Northampton, Massachusetts, that places the cultivation of attention to body, mind, and environment and the development of compassion at the center of its philosophy of healing.
The Psychiatric Consumer and Survivor Movement challenges us to think outside of the medical definition of “mental illness” and to consider human rights concerns and how economic and political realities affect people living with a psychiatric disability. The National Empowerment Center, for example, offers an audiotape and training designed to help people with psychiatric disabilities handle the experience of hearing distressing voices.
It’s easy to get tangled up in debates about the “myth” of mental illness, to use Thomas Szasz’s phrase.
I have seen people use Buddhist practice to deal with sadness (not to be confused with depression).
A Buddhist lifestyle would probably be very useful, but it could never be a solution to the condition. It is also tempting for those who have seen the quality of their lives improve from Buddhist practice to endorse Buddhism as the only solution necessary. I witnessed the revolving door of patients going out of the hospital and into the community only to be readmitted a short time later. He was a large man in his 40s, with a nose ring, homemade tattoos, and a diagnosis of paranoid schizophrenia.
Though he usually gave me a warm greeting, this time he glared at me and growled, “I have to do this.
I found out from them that he had been up all night flushing large objects down the toilet and keeping his housemates awake. Eventually, I found that subsequent training as a cultural anthropologist and my Buddhist practice helped me to understand those experiences from another point of view.
By way of illustration, a 1980 study by the World Health Organization found that the incidence of the bundle of symptoms known as schizophrenia was about the same in nine different countries, but people in developing countries without formal mental health services recovered more quickly than people in areas that had hospitals and medications.
The biomedical model, with its focus on biological causes, also tends to cut off dialogue on other conditions that can affect mental health. The first Windhorse center was established in 1981 through the Naropa Institute in Boulder, Colorado, by Jeff and Molly Fortuna and Dr. Their suffering is often rooted in just the being and existence of mortality: the suffering that comes from wrong view, clinging to an impermanent existence, etc. And most suffers of bipolar disorder are co-occuring with other disorders that must also be addressed. Buddhism, as a practice of dialectic conversation and mindfulness training, is full of rich therapeutic tools that the mental health community has adopted to help people. My work required me to come up with treatment plans for the “rehabilitation” of my clients, but I kept wondering how being avoided, feared, pitied, locked up, and medicated to the point of oblivion affects a person’s mental health, beyond any psychiatric challenge he or she faced. He’d spent most of his life in the Oregon mental health system, a good part of it hospitalized for psychotic episodes that were worsened by his use of marijuana and harder street drugs. If I called the police, they would handcuff him and load him into the squad car like a criminal, in full view of all the neighbors. It was clear to me that it wasn’t simply the whims of his psychiatric condition that dictated his mental state. The explosion of bombs, the burning of napalm, the violent death of our neighbors and relatives, the pressure of time, noise, and pollution, the lonely crowds—these have all been created by the disruptive course of our economic growth. Medication may or may not be a part of treatment, but when used, it is within the context of other health-enhancing practices such as nutrition, stress reduction, rest, and exercise. Perhaps the best contribution we can make as Buddhists is to ask the questions differently and to offer our understanding of the endless web of conditions, biological and otherwise, that are part of the joy and suffering in each of our lives. I had lived a fairly conventional, privileged life, and my knowledge of drugs was limited to a few puffs on a joint (I did inhale). In the hospital (which was located in the same building as the county jail), he would be stripped of his clothing and possessions, locked in a small cell and tied down and forcibly injected with Haldol, an antipsychotic drug notorious for its wretched side effects. And yet, after three years of working together and getting to know each other, Joe and I had developed a strong bond.
I knew the things he loved best—going fishing and drinking coffee—and I was lucky enough to work for an agency that realized the therapeutic value of developing genuine, trusting relationships with our clients. If I didn’t call the police, he might end up, as he had in the past, standing in the middle of a highway and daring people to run him over. So Joe and I did plenty of fishing and coffee drinking in between more mundane tasks like finding him a safe place to live and straightening out his Social Security benefits.



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