Becoming the healers we already are

Michael Kearney, MD, Radhule Weininger, PhD,Buddhist Contemplative Care Conference,

Garrison Institute, November 7, 2014.

“Although the usual dictionary definition of “health” is, roughly speaking, “free from sickness,” we should look at health as something more than that. According to the Buddhist tradition, people inherently possess Buddha-nature; that is, they are basically and intrinsically good. From this point of view, health is intrinsic. That is, health comes first: sickness is secondary. Health IS.”

Chogyam Trungpa

Gautama’s Enlightenment

Gautama’s EnlightenmentWhat is suffering?

Gautama’s EnlightenmentWhat is suffering?

What is the relief of suffering?

Gautama’s Enlightenment

“It was then, in the crucible of his unwavering attention that the realization of dependent co-arising swept over him.”

Joanna Macy

“Coming to be, coming to be!Ceasing to be, ceasing to be!At that thought, brethren, there arose a vision of things not before called to mind, and knowledge arose. Such is form, such is the coming to be of form, such is its passing away. Such is cognition, such is its coming to be, such is its passing away.

And I abided in the discernment of the arising and the passing away.”

The Mahapadana Sutta

Implications of Gautama’s Enlightenment

For understanding of the nature of reality

“The process nature of reality became clear. He beheld the flowing interaction of all things as they arise, as they provide occasion and context for each other’s emergence and subsiding….All aspects of our world and all factors of our lives subsist, he saw, in a dynamic web of interdependence. But these currents of relationship are not visible. To the physical eye we look like separate projects walking around in separate bodies.The Buddha called this interconnectedness paticca sammupāda, dependent co-arising.”

Joanna Macy

All is change

Implications of Gautama’s Enlightenment

For the nature of the self

ANNATĀ - “no self”

Western

Self as particle

Western

Permanent, solid, separate

Eastern and indigenous

Self as wave

Eastern and indigenous

Impermanent, fluid, interconnected

cross section

Porous and fluid

Interactive and interdependent

Mutually Conditioning and co-arising

ANNATĀ

no-permanent-solid-separate-self

ANNATĀ

Yes – self… as process, as relationship

Implications of Gautama’s Enlightenment

For the nature of suffering and the relief of suffering

The Four Noble Truths

The truth of suffering

The truth of the cause of suffering

The truth of the end of suffering

The truth of the way out of suffering

The Four Noble Truths

“We create our own bondage by reifying and clinging to what is by nature contingent and transient. Being caused in this way, our suffering is not endemic. It can cease. The causal play can be reversed. This is achieved by seeing the true nature of phenomena, which is their radical interdependence. This is made possible by cleansing perception through meditation and moral conduct.”

Joanna Macy

Journal of Pain and Symptom Management, Vol 33, No 4, April, 2007

MethodologyPhenomenological study: 21 patients with life-threatening illness who were experiencing either existential anguish or, conversely, the experience of integrity and wholeness, were interviewed in an attempt to identify “inner life” and “existential” contributors to subjective suffering and well-being in advanced illness.

Themes Common Across Cases: Suffering/Anguish

1. Sense of disconnection from self, others, phenomenal world, ultimate meaning

2. Crisis of meaning; an existential vacuum; inability to find solace or peace

3. Preoccupation with future or past

4. Sense of victimization

5. A need to be in control

Themes Common Across Cases: Integrity/Wholeness

1. Sense of connection to Self, others, phenomenal world, ultimate meaning

2. Sense of meaning in context of suffering3. Capacity to find peace in present moment4. Experience of a sympathetic, non-adversarial connection to

the disease process5. Ability to choose attitude to adversity; open to potential in the

moment greater than need for control

The Four Noble truths

Suffering as clinging, contraction, isolation

Healing as letting go, deep connection, relationship

Implications of Gautama’s Enlightenment

For what we can do to heal another’s suffering

Implications for healing

Healing (in contrast to curing) is not something I personally do for another. Healing is what naturally happens when we (the other and I) become part of the fluid, interconnected, impermanent, ever changing process that is reality. So it is no longer about congratulating ourselves when things go well or blaming ourselves when they don’t. We do our best. We contribute to the process. Then something happens that is, ultimately, beyond in our control.

Implications for healing

What is in control is to set our intention, choose to do what we think is in the best interest of the other, and let go of outcome. Aware of the interconnectedness of all things, we cultivate the conditions where healing may happen. Then, together, we wait in compassion, and with curiosity, to see what emerges.

What does this look like in the face of another’s suffering?

Bodhisattva

THE BODHISATTVA IS ONE who HAS REACHED ENLIGHTENMENT AND COULD ENTER NIRVANA BUT INSTEAD CHOOSES TO RE-ENTER SAMSARA OVER COUNTLESS LIFETIMES UNTIL ALL BEINGS ARE SAFE, UNTIL ALL BEINGS ARE HAPPY, UNTIL ALL BEINGS ARE FREE

chenrezig

Bodhisattva

An archetypal energy we each have within

Albert camus

Dr Rieux as bodhisattva

• chooses to stay in the world of suffering, even though he could leave

• Motivated by bodhichitta; the desire to help unconditionally, prioritizing the welfare of others

• Acts with equanimity; treats everyone the same; knows how little he can control the outcome; does not take it personally

How can we hold this at the bedside?

We need a psycho-spiritual container

Psycho-spiritual container

3 essential building blocks:1.Awareness of interdependence

2.Mindfulness

3.compassion

Compassionate pause Process

1. Notice the body2. Choose to pause3. Exhale to relax4. Notice our feelings in the face of the other’s suffering5. Practice self-compassion6. Abide for a moment in experience7. Turn again to the other with kindness

meditation