Experiencing Meaning, Purpose & Wholeness through Meditation

     “All individuals during the course of their life, are faced with uncontrollable outcomes, undesirable events, and uncertainties. Some of these events may involve questions regarding the relationship of the individual to the cosmos’s seeming chaos; how to create (or discover) life’s meaning; understanding issues of good and evil; developing a stable, positive identity while recognizing the inevitability of illness, decay, and death. These issues represent, to a greater or lesser degree, that which is unknown, uncertain, ambiguous, even chaotic in the world. And these situations and issues, which are seemingly out of control, or appear beyond human control, may cause feelings of existential stress, frustration, surprise, fears, and vulnerability. 
     Psychological research has shown that meaning and purpose, whether as an independent construct or as part of a sense of control, are important for both emotional and physical well-being. Although not often directly examined, most Western medical therapeutics and psychotherapies are based on an assumptive belief system that views the universe as random and purposeless. 
     The spiritual context of meditation, whether theistic or nontheistic, challenges that belief system. One of the aspects of the meditative experience within the esoteric core of all contemplative religious traditions is an experiential view of the universe, at its deepest level, as a sacred, whole unity. The ineffable, nondualistic experiences of profound unity – meditation as an altered state – which has been called the ‘still completeness’ and the heart of religion, have been described in individuals’ encounters with the noetic across many different spiritual traditions.”

       Shapiro DH. Examining the content and context of meditation; A challenge for psychology in the areas of stress management, psychotherapy, and religion/values. Journal of Humanistic Psychology 1994; 34(4): 101-135.

hapster   www.dpreview.com

Psychological Health & Sense of Control - an Expanded Understanding

     “… one component of psychological health historically has been defined as the individual’s ability to have a positive sense of instrumental control, efficacy, and competence.
     (Shapiro conceptualized) four different modes of control: positive assertive, positive yielding, negative assertive (overcontrol), and negative yielding (too little control). Psychological health involves reducing the negative modes (overcontrol & too little control) and increasing & developing the two positive modes of control (positive assertive & positive yielding). Results have shown that a sense of control from both positive modes can affect both physical and emotional well-being; that meditation increases the yielding, accepting mode of control; and that the longer a person has meditated, the more this mode increases. Independently, Rothbaum and Weisz were developing the concepts of primary control (change the environment) and secondary control (change the self to fit the environment).
     Both of these models have applicability to stress management and psychotherapy. They offer a version of the R. Niebuhr (Serenity) prayer by suggesting that individuals can learn not only the dominant mode of instrumental control prevalent in Western psychology, courage to change what can be changed, but also the sense of control through yielding and acceptance that can come from meditation (as well as other techniques) – to accept what cannot be changed. Further, the self-exploration of meditation, alone, or in combination with Western therapy, can be helpful in ‘gaining the wisdom to know the difference.’ Finally, depending on the context and belief system about the nature of the universe, meditation can facilitate positive yielding & accepting, either within secular assumptions about the nature of the universe and/or from religious assumptions in which one lets go, surrenders, and trusts control to a benevolent Other, or the essential ‘isness’ of the universe.”

       Shapiro DH. Examining the content and context of meditation; A challenge for psychology in the areas of stress management, psychotherapy, and religion/values. Journal of Humanistic Psychology 1994; 34(4): 101-135.

Nguyen Anh   www.dpreview.com

Mentoring: Nurturing the Maturity to Embrace Life - both Suffering & Wonder!

      "The paradox is that as integral to life as suffering is, it is matched by wonder. By wonder I mean the awe and gratitude invoked in those moments when we come alive to the intricate luminosity, beauty, power, and vast grandeur of the universe (or some tiny part of it) and the amazement we feel that we are in any measure privileged to behold it. By wonder I mean also the sense of Mystery that cannot be exhausted even by our most magnificent forms of knowing, including the awe-ful ambiguity that arises from any reasonable assessment of the complex, dynamic, and confounding character of life. (By the time we reach young adulthood, we) have a readiness for soaking up such wonder, especially if it is distinguished from the various forms of artificial high that exploit this readiness. This dimension of wonder, too, is a fact that any worthy faith must be able to enfold.
     Ironically, contemporary life also offers a good many ways to be insulated from truth – both the scope of suffering and the opportunities for wonder. A good mentoring environment, however, provides an initiation into both. When ... invited into both suffering and wonder, then contradiction and dissonance proliferate, raising big questions and activating the imagination in its search for meaning and faith**. I recall how Joan Baez once said, ‘I do not know whether it is worse to bring a child into this world and submit him or her to the disease we call society, or to refuse to bring a child into this world and thus rob him or her of one glorious red sunset.’ If young adults are steeped in images that grasp both the suffering and wonder of their time, they may gain faith that can be sustained because it cannot be in a certain sense surprised. A great mentoring environment skirts neither suffering nor wonder; rather, it holds them in a dynamic paradox.”
       ** Multiculturalism and “… religious pluralism … is a fact of our common life. It has become all the more essential to honor these realities by understanding faith in its broadest, most inclusive form as the activity of making meaning that all human beings share.”

       Parks SD. “Big questions, worthy dreams. Mentoring young adults in their search for meaning, purpose, and faith.” John Wiley & Sons, San Francisco, 2000.

     See also: http://healthyhealers.blogspot.ca/2012/11/cracks-in-armour-great-gift.html

Udayan Sankar Pal   www.facebook.com/UdayanSankarPal

Existential Challenges - Approach with Scientific Curiosity OR Avoid the "Elephant in the Room"?

     “In a qualitative study of dying patients experiencing a dramatic quality of life (QOL) response to their illness – either ‘profound anguish’ or significant ‘equanimity and peace’ – shared themes within the group were identified at each of these extremes. Themes identified at the ‘anguish’ QOL extreme included: a sense of isolation, an absence of meaning, preoccupation with the future and the past, a sense of victimization, and a high heed for control. Common themes at the ‘peace’ end of the QOL continuum were: a sense of connectedness to something larger and more enduring than the self, meaning discovered, presence in the moment, a sympathetic connection to suffering, and a capacity to remain open to a present potential that is greater than the need for control. ...

     Four potent existential challenges haunt us throughout life: death (existential obliteration), isolation (the unbridgeable gap between self and others), freedom (the unnerving absence of external structure), and meaning (in a world of uncertain meaning). These threats are intensified in illness, yet they lie beyond the clearly drawn limits of our current medical concerns.
     We surely must broaden our scientific curiosity and assess these noteworthy experiences and research findings. The rewards to be garnered by adopting a more inclusive perspective are great. Dame Cicely Saunders reminds us, ‘The way care is given can reach the most hidden places and give space for unexpected development’.”
        Mount B. Healing, quality of life, and the need for a paradigm shift in health care. J Palliat Care 2013; 29(1): 45-8.

     Since "consideration of death affects people intensely, is a potent motivator of human behavior, whether or not such contemplation is made consciously," and since every one of us would choose 'equanimity & peace' over 'anguish,' what intelligent effective approaches to existential terror do we have in place, personally and as a profession, to ensure our best possible quality of life AND death?

       Niemiec CP, Brown KW, Kashdan TB et al. Being present in the face of existential threat: The role of trait mindfulness in reducing defensive responses to mortality salience. Journal of Personality and Social Psychology 2010; 99(2): 344-365.

Martha doing morning yoga - 'downward cat' pose

What Really Matters?

     "transcendence, enhanced meaning, hope, and a sense of being connected to something greater and more enduring than the self may significantly influence quality of life (QOL) by lifting one above despair and reducing, or even completely eliminating, one's suffering. Conversely, uncertainty, fear, and an experience of loss of control may amplify suffering even in the absence of physical distress. If we are body, mind, and spirit (however understood), these elements are both inseparable and interdependent, and their mix of influences consistently modifies all experience of health and illness. Nevertheless, such issues are largely ignored in the current science-based, disease-oriented paradigm."
       Mount B. Healing, quality of life, and the need for a paradigm shift in health care. J Palliat Care 2013; 29(1): 45-8.

     Normal human maturation naturally leads towards wisdom, and thus to experiencing transcendence, meaning, & a profound sense of connectedness or unity. However, this healthy developmental trajectory is easily arrested or derailed by existential angst, and it's manifestations: materialism, cynicism, workaholism, etc.
     Our personal, our families', as well as our patients' QOL would all greatly benefit if we more carefully nurtured our personal maturation.

Martha on her path

Concepts & Ideas versus Real Life

          “You cannot explain me with ‘isms.’
        They are very bad for an artist.
        What one must believe in is color.”              Marc Chagall

     We compulsively distance ourselves from reality by quickly putting things into categories, concepts, theories. How often do we cut patients, colleagues, friends & family members off with "yeh, yeh, I know"? Don't bother me with facts, I already have cherished opinions. We love the illusion of knowing & the illusion of having control over our rapidly changing, incomprehensibly complex universe. Pure delusion!
     And even the things we do know something about intellectually, we often lack the critical element: direct EXPERIENCE! Most of us need to learn to intentionally connect with, fully embrace & flow with the "full catastrophe" of life - see: http://mindfulnessforeveryone.blogspot.ca/2012/03/65-embracing-full-catastrophe.html
     And no, opening up isn't at all easy for us who've lived much of our lives hidden away, Howard Hughes-like, in the castle between our ears!

Gretel contemplating a nap

Helpful, Effective Attitude Changes towards Pain & Discomfort

     Rapid relaxation (RR) is a brief (~2 minute) set of suggestions, given immediately pre-operatively (eg while applying topical anesthetic), to reduce anxiety during local anesthesia & subsequent minor surgical procedures. RR is recommended for managing mild-moderate pre-op anxiety, which is almost universal. RR combines elements of hypnosis, meditation & good basic bedside / chairside manner. It empowers patients by giving them an attractive, immediate alternative to stressful catastrophization AND can markedly improve the quality of the surgical experience for both patients & clinicians.

       Lovas JG, Lovas DA. Rapid relaxation - practical management of preoperative anxiety. J Can Dent Assoc 2007; 73(5): 437-40.

     Palliative care, which “includes consideration of psychosocial & existential / spiritual factors in addition to the physical domain,” has been shown to have the “counterintuitive capacity to support an increase in quality of life even when introduced only days prior to dying.”
       Mount B. Healing, quality of life, and the need for a paradigm shift in health care. J Palliat Care 2013; 29(1): 45-8. 
 

     Similarly to RR (top), briefly telling research volunteers a little bit about mindfulness - specifically that they had the option to be OK with the discomfort of heat - just before applying the (experimental) thermal stimulus, changed the experience. Both the pain ratings AND brain activity were significantly reduced. In general however, benefits are proportionate to the amount & quality of mindfulness practice - see Study 1: https://www.mindandlife.org/the-contemplative-path-how-do-we-learn/

     When options are clear & perceived need imminent, human beings tend to choose wisely. Under duress, we often learn that a higher level of consciousness, and an associated higher quality of life, is (and always has been) readily available. 

     Hedy Kober PhD describes their experiments at Yale in an excellent (19min) TedX presentation (in English):