Thursday, September 27, 2007

"How should I answer that question?- Buddhist wisdom on how to answer questions mindfully.

A cartoon my son sent me when I first started this blog.

Have you ever got into a situation where you were not sure what to say when somebody asked you a question? Have you ever regretted after answering a question and pondered on it .... may be I should have answered it differently? Well, I have. Not once, but numerous times. In a previous post I have already discussed how to be mindful in speech (see below). In this post I will examine the different methods of answering questions skilfully based on Buddhist wisdom. As I was searching for this in the Buddhist literature, I came across a very short but a fascinating disclosure by the Buddha. This was called Pañha Sutta.

This sutta explains four skillful ways of answering questions:

1. There are questions that should be answered categorically, for example, yes or no answer.

2. There are questions that should be answered with an analytical (qualified) answer. You explain the answer in detail defining and redefining the terms.

3. There are questions that should be answered with a counter questions.

4. There are questions that should be put aside.

Buddha went on to say that "any persons who is practicing Dhamma (Buddha's teachings) will be skilled in the four types of questions: hard to overcome, hard to beat, profound, hard to defeat. He will know what is worthwhile and what is not, and will be proficient in recognizing both. He will reject what is worthless, and will grasps what is worthwhile. He is called who is prudent and wise"

Could we apply this to our daily lives? It will not be easy, but we can try. Let me share with you some of my personal experience. A common mistake I make is trying to answer questions analytically when the answer should be a simple yes or no. This was an old habit of my mine that came with my training. This has got me in to lot of trouble in the past. Now I am a little more mindful on this. The other problem was I often failed to recognize the questions that should be put a side. This still happens and I have to be more mindful on this.

Now how can we use the above outlined methods of answering questions practically? Most people ask question genuinely because they don't no the answer. You can choose method one or two outlined above to answer them according to the knowledge you already have. Some people ask questions when they already know the answers. The reason is they want to test you. If you mindfully listen (see previous posting below) you may be be able to catch this early enough. In this case you may want to use method number three or four. Yet another group of people asks questions to get you to start an argument. Be very mindful with these questions. You definitely want to use the method number four here. Where else could you use the method number three? This could be used when you want to avoid answering a question. A simple example is when somebody ask a question like; how old are you? You may want to ask a counter question like, how old you think I am? But the real question may be more complex than this.

If you are mindful enough you will soon realize whenever we get in trouble trying to answer questions it is because we are not skilled in the above methods. You may not be able to see this or practice this at once as your mind has already been conditioned over time. As we know humans are creatures of habit and it will take a some practice and effort before we become fully skillful in answering questions wisely. Therefore don't be afraid to make mistakes. Always try to contemplate on the mistakes you have just made. Please don't dwell on it. Acknowledge the mistake, forgive yourself and lean from it. There isn't always a "perfect answer". It is how we approach the question which more important than the answer itself.

As I said in many of my previous postings, you just don't have to accept these methods of answering questions, just because you read it here. Try it out for yourself at the next opportunity you get. Questions are not hard to find. The right answers are more difficult to come by. However, if you are skillful in the methods of answering questions that is all that matters. This will hopefully keep us all out of trouble!

Pañha Sutta

See other related posts:

"Don't talk if you can't improve on silence"- How to be mindful in speech, Buddhist perspective for a productive life.

"Just shut up and listen" - How to be a mindful listener -A Buddhist perspective

Sunday, September 23, 2007

"Just shut up and listen" - How to be a mindful listener -A Buddhist perspective

How long do you listen to another person before you start interrupting? How fast do you start formulating your thoughts, thinking about what to say, even before they are done speaking? Do you often interrupt the person to give your own opinion before they are done? Be mindful next time when you listen to somebody. What percentage of the speech do you actually remember? Its not easy is it? It is much easier to be a good speaker, but it's much more difficult to be a good listener. Most of our problems in life, at home and at work happen because of this. We do not listen mindfully to the other person. We may jump to a conclusion very quickly, and we often become judgemental too quickly.

One research study (see below) examined different parameters of emergency medicine residents taking a medical history. The study concluded that only 20% of patients completed their presenting complaint without interruption. In other words 80% of the patents were interrupted during their initial presenting complaint. The average time to interruption was only 12 seconds!

I decided to try train my own "monkey mind" (see previous posting below) in my clinic. First I researched some of the Buddhist teachings on how to be a mindful listener. After reading and understanding some of the Buddhist texts, I tested it out.

I used clinic patients to observe how mindful listening can increase the efficiency of a medical practice. Previously I used to interrupt patients within the first minute of taking the history. This time I changed my approach in taking histories. I gave full attention to the patients history without any interruptions until they were done. The results were amazing. To my surprise it did not take much time for most patients to give a full history, contrary to my previous thinking. A small change like being fully mindful when taking a history made a big difference in my practice. I got a lot out of the history and was able to diagnose illnesses very quickly and accurately. With mindful listening I was also able to in manage office time more efficiently. You may want to try this at home or at your workplace. I believe this simple technique can be very useful in other medical practices as well. Mindful listening works! It is your turn to test this. It is very simple. Just shut up and listen!

In the Buddhist texts I found an very interesting teaching of the Buddha. This was called Sussusa sutta. This sutta explains the process of listening mindfully, as taught by the Buddha. This disclosure was mainly taught by the Buddha to teach his disciples how to listen to Dhamma (his teachings). But I think it can also be applied in other situations in life as well.

There are six steps in the process (see the diagram above)

When listening:

1. Listen with full mindful attention.

2. Try to remember what was told.

3. Investigate for yourself.

4. Discard what is not useful to you.

5. Accept what is useful to you.

6. Apply to your life.

How can it help your family life and work situation? It helped me. Well, don't just accept it. Test it out for yourself!

Sussusa sutta

Saturday, September 15, 2007

Who will drink this medicine?

"One who drinks deeply of Buddha's teachings lives happily with a peaceful mind"- Buddha

Buddha can be regarded the greatest physician who lived on earth. He like any other great physician, diagnosed the illness, found the cause for it, explained how to get rid of and then prescribed the medication needed to overcome the illness.
Buddhist teachings are regarded as the "medicine for the mind". In an earlier posting I discussed Buddhism as the ultimate psychotherapy and how Buddhist practices will lead you to attain the ultimate happiness, that the Buddha called the "Bliss of Nirvana". This is the inner happiness of the unconditioned mind. This happiness comes only "within, not without".

In reality we are all "patients" to a certain degree. If you think for a moment we are constantly struggling in this world running away from pain and seeking pleasure. It is the pleasure for our body and our mind. Nobody can honestly say that they were never unhappy, sometime in their lives. We all get sad and feel depressed at certain times. Some times we can get into more serious situations like clinical depression, in our lives. Some people go further down this road and even get suicidal thoughts.
What is the reason for this? It is because we looked for the answer in the wrong place. We look for the answers to our problems in the outside world. We will never think even for a moment that the real answer is within us. The Buddha only directed us to look inside of us. The answer is always there. We only did not see it. Why is that? It is because our minds were already conditioned. This Buddha called "Avijja" in Pali language. In English it is called ignorance or delusion. In this part of the world we may want to call it "stupidity". It sounds like a simple problem but is it very hard to see. That is where the Buddhist teachings and practices come in. Buddhism tells you "how to do it" rather than "what to do". This is the basic difference in the Buddhist teachings compared to other religions. There is only one medicine for the mind to be free from all the suffering and pains. This is "The Four Noble Truths".

Now who will drink it? To explain this I will tell you a metaphor that is applicable today.

Imagine that somebody is gravely sick and is about to die. There are many possible scenarios.

1. The patient is in a place that there is no doctor therefore he dies.

2. The patent does not look for a doctor and he dies.

3. Patient looks for a doctor and he does not find one and he dies.

4. The patient refuses to go see the doctor and he dies.

5. The patent goes to a doctor but he does not get the right medicine and he dies. (In this case the doctor may be sued).

6. Patient finds the doctor and he prescribes the right medicine to save the patients life. He brings it home and does not drink it in time. Why didn't he drink it in time? This is because he refuses to drink the medicine until all his questions are answered. He has many questions like, is the doctor qualified? Is the medicine pure? Which company makes the medicine? Where was the bottle made? And so on. These are irrelevant questions, as his time is running out. He dies before all his questions are answered.

7. Only the wise man finds the doctor, gets the medicine, drinks it in time and gets cured.

In this metaphor the medicine is the Dhamma (Buddhist teachings). The sick man is the ordinary worldly being.

So do you think you are sick ? If the answer is "no" you may be enlightened. You are free from all suffering in this world and beyond. If the answer is "yes" browse this site you will find the medicine. But remember only you can drink it. Nobody can drink it for you or force you to drink.
"Just as the great ocean has one taste, the taste of salt, so also this Dhamma and Discipline has one taste, taste of liberation"-Paharada Sutta, Buddha

Please see other related posts:

Friday, September 14, 2007

How can mindfunless lead to wisdom?

"Mindful attention causes beneficial thoughts that have not arisen, to arise. It will also cause harmful thoughts that have already arisen to vanish. In the one who is mindful, the good that is to be will be realized" -Buddha , Anguttara Nikaya

Mindfulness with skillful effort will lead to clear comprehension. This may ultimately lead to wisdom. This is like an initial formula, when you first practice mindfulness. In Pali language this is called "Athapi, sampajano -satima". If you loose mindfulness (happens to me a lot!), whatever the wisdom you have already gained may come to your rescue. With wisdom you have clear comprehension and this will enable you to make more skillful efforts to be mindful again. As time goes by and your mindfulness practice gets stronger this formula will work more towards leading to wisdom. This is my own hypothesis according to the Buddhist scripts and my own experience. You will have to test it for yourself.

The transformation of mind through different stages leading to enlightenment is described by Buddha as the seven factors of enlightenment in Sathipattana Sutta.

The Factors of Enlightenment
1. Mindfulness
2. Investigation of Mental Objects
3. Energy
4. Joy
5. Calm
6. Concentration
7. Equanimity

If you want to read more about how this works go to the following link:

The Factors of Enlightenment

Please also see other related posts:

Practice-of-mindfulness-four-bases-of mindfulness

Related sutta:

Mindfulness and Clear Comprehension

13. Then the Blessed One addressed the bhikkhus, saying: "Mindful should you dwell, bhikkhus, clearly comprehending; thus I exhort you.

14. "And how, bhikkhus, is a bhikkhu mindful? When he dwells contemplating the body in the body, earnestly, clearly comprehending, and mindfully, after having overcome desire and sorrow in regard to the world; and when he dwells contemplating feelings in feelings, the mind in the mind, and mental objects in mental objects, earnestly, clearly comprehending, and mindfully, after having overcome desire and sorrow in regard to the world, then is he said to be mindful.

15. "And how, bhikkhus, does a bhikkhu have clear comprehension? When he remains fully aware of his coming and going, his looking forward and his looking away, his bending and stretching, his wearing of his robe and carrying of his bowl, his eating and drinking, masticating and savoring, his defecating and urinating, his walking, standing, sitting, lying down, going to sleep or keeping awake, his speaking or being silent, then is he said to have clear comprehension.

"Mindful should you dwell, bhikkhus, clearly comprehending; thus I exhort you."

(Maha-parinibbana Sutta-Last Days of the Buddha)

Sunday, September 9, 2007

Life is just like a "Morning Glory"- Mindfulness about life

"With these flowers I venerate the Buddha,

By this merit may I gain liberation.

As these flowers fade and wither

So will this body be destroyed"

Morning glory flowers at 8.30 in the morning in my garden.

The Morning glory flowers at 6.30 in the evening, the same day!

This is a common stanza Buddhists recite mindfully when offering flowers to Buddha. Impermanence is one of the key teachings of the Buddha. Mindfulness of impermanence is fundamental to Buddhist insight meditation (Vipassana meditation). I will discuss this impermanence and how it can lead to wisdom in detail in a future post.

Buddha encouraged us to be always mindful about old age, sickness and death. He said "you can run but you can't hide from it". Sounds depressing? Well, that is the reality. We all know that we are going to get old, sick and die one day, but it is hard to realize "inside". It is almost like a realization through wisdom that comes within oneself. How to be mindful in aging and death is well explained by the Buddha, in the Sathipattana sutta in the mindfulness of the body section.

See other related posts:
The four Bases of Mindfulness

Mindfulness-About-Life-"A lesson-From The Garden"

"Don't talk if you can't improve on silence"- How to be mindful in speech, Buddhist perspective for a productive life.

Have you ever got in trouble for not thinking before you speak? How many times have you told yourself, "maybe I shouldn't have spoken like that". As for me, I have done this countless times. Well, can you do anything about it? Is it really possible to be mindful before you speak.? Are there any guidelines for skillful speech? These questions have been troubling me for a long time. I, therefore decided to explore Buddhist principles of mindful speech. In The Noble Eightfold Pathway, Buddha explains what mindful speech (Right Speech) means:

Abstain from:

1. Lying
"Abandoning false speech, he abstains from false speech. He speaks the truth, holds to the truth, is firm, reliable, no deceiver of the world....

2. Divisive speech
"Abandoning divisive speech he abstains from divisive speech. What he has heard here he does not tell there to break those people apart from these people here. What he has heard there he does not tell here to break these people apart from those people there. Thus reconciling those who have broken apart or cementing those who are united, he loves concord, delights in concord, enjoys concord, speaks things that create concord....

3. Abusive speech
"Abandoning abusive speech, he abstains from abusive speech. He speaks words that are soothing to the ear, that are affectionate, that go to the heart, that are polite, appealing and pleasing to people at large....

4. Idle Chatter
"Abandoning idle chatter, he abstains from idle chatter. He speaks in season, speaks what is factual, what is in accordance with the goal, the Dhamma (the teachings of the Buddha), and the Vinaya (code of conduct for the monks). He speaks words worth treasuring, seasonable, reasonable, circumscribed, connected with the goal...."

Is it possible to practice this in our daily lives? I think it is possible, but it is not so easy to be mindful every time before one speaks. In one of his disclosures Buddha says how to train yourself to be a skillful speaker (Prince Abhaya Rajakumara sutta). I have summarised the essentials of this sutta in the algorithm below.

Listen to:

"Religion of the Future"-Albert Einstein

The religion of the future will be a cosmic religion. It should transcend personal God and avoid dogma and theology. Covering both the natural and the spiritual, it should be based on a religious sense arising from the experience of all things natural and spiritual as a meaningful unity. Buddhism answers this description. If there is any religion that could cope with modern scientific needs it would be Buddhism. (Albert Einstein)

" Among the founders of all religions in this world, I respect only one man — the Buddha. The main reason was that the Buddha did not make statements regarding the origin of the world. The Buddha was the only teacher who realised the true nature of the world." (Bertrand Russell)

Some parallel sayings of Buddha and Einstein taken from a book (see below):

According to general relativity, the concept of space detached from any physical content does not exist.
If there is only empty space, with no suns nor planets in it, then space loses its substantiality.

Physical concepts are free creations of the human mind, and are not, however it may seem, uniquely determined by the external world.
All such notions as causation, succession, atoms, primary elements...are all figments of the imagination and manifestations of the mind.

Time and again the passion for understanding has led to the illusion that man is able to comprehend the objective world rationally by pure thought without any empirical foundations—in short, by metaphysics.
By becoming attached to names and forms, not realising that they have no more basis than the activities of the mind itself, error rises…and the way to emancipation is blocked.

In our thinking...we attribute to this concept of the bodily object a significance, which is to high degree independent of the sense impression which originally gives rise to it. This is what we mean when we attribute to the bodily object "a real existence." ...By means of such concepts and mental relations between them, we are able to orient ourselves in the labyrinth of sense impressions. These notions and relations...appear to us as stronger and more unalterable than the individual sense experience itself, the character of which as anything other than the result of an illusion or hallucination is never completely guaranteed.
I teach that the multitudinousness of objects have no reality in themselves but are only seen of the mind and, therefore, are of the nature of maya and a dream. ...It is true that in one sense they are seen and discriminated by the senses as individualized objects; but in another sense, because of the absence of any characteristic marks of self-nature, they are not seen but are only imagined. In one sense they are graspable, but in another sense, they are not graspable.

The belief in an external world independent of the perceiving subject is the basis of all natural science. Since, however, sense perception only gives information of this external world or of "physical reality" indirectly, we can only grasp the latter by speculative means. It follows from this that our notions of physical reality can never be final. We must always be ready to change these notions—that is to say, the axiomatic basis of physics—in order to do justice to perceived facts in the most perfect way logically.
While the Tathagata, in his teaching, constantly makes use of conceptions and ideas about them, disciples should keep in mind the unreality of all such conceptions and ideas. They should recall that the Tathagata, in making use of them in explaining the Dharma always uses them in the semblance of a raft that is of use only to cross a river. As the raft is of no further use after the river is crossed, it should be discarded. So these arbitrary conceptions of things and about things should be wholly given up as one attains enlightenment.

If you want to learn more on this I recommend the following book:

Einstein A N D Buddha

Thursday, September 6, 2007

The Ultimate Psychotherapy -Through Buddhism

"All the delightful things of the world--sweet sounds, lovely forms, all the pleasant tastes and touches and thoughts--these are all agreed to bring happiness if they are not grasped and possessed. But if you regard them merely as pleasures for your own use and satisfaction and do not see them as passing wonders, they will bring suffering." - Buddha, Sutta Nipata

Buddhist teachings can be regarded as the ultimate psychotherapy to the mind. Some people call Buddhism the "science of the mind". It is also a therapeutic means of getting answers to life's difficult problems. Buddhism gives you the blueprint on how to get rid of life's suffering for ever. This is called the "The Four Noble Truths". This is the final pathway to get rid of all the difficulties and sufferings we endure in daily life. Buddha very clearly showed the path to reach this goal, the freedom from all suffering, called the enlightenment. He gave us all the tools and very clear instructions on how to attain this state of mind, the ultimate happiness. In his own words Buddha called this "the supreme bliss of Nirvana". He emphasised that this can only be achieved with our own diligent effort. No other person, not even Buddha himself can do it for you. It is essentially a "do it yourself project".

Now let us examine how psychotherapy is related to the history of Buddhism. Theravada Buddhism is the oldest surviving school of Buddhism today. If you look up the origin of word "Thera", it says in 1846, "medical treatment of disease," from Mod.L. therapia, from Gk. therapeia "curing, healing," from therapeuein "to cure, treat." Therapist formed 1886; earlier therapeutist (1816), especially of psychotherapy practitioners from c.1930s. The word "Veda" means knowledge. Therefore Theravada may mean "Therapeutic-Knowledge". Theravada Buddhists are found over 100 million worldwide. In recent years Theravada has begun to take root in the West.
How does Buddhism become an effective psychotheraputic tool? Basically Buddha teaches you to become your "own therapist". He teaches you very clearly how to examine your own mind step by step. It is like shining a flashlight on to your own mind and examining everything that is happening in your mind. He explains how these six senses, the eye, ear, nose, tongue, body and the mind (the sixth sense) connect you to the outside world. Then he explains and how to contemplate on the nature and the mechanism each of these sense bases. This is the basis of Insight or Vipassana meditation.

The best metaphor for this was one told by Ajahn Brahm, the abbot of Buddhist Society of Western Australia, in one of his meditation talks. He said when people watch movies you get caught up in all sorts of emotions. If the movie is sad you cry or if the movie is funny you laugh and have a good time. In past when people use to smoke in movie theaters if you look up you could see a cone of light going from the screen to the projector. If you look back and examine further you can see it is only a plastic film tape going through a lens and a powerful light. In real life this is similar to what happens. We get caught up in all sorts of emotions like greed, hatred, etc, but we really do not understand where and how it all starts. Insight (Vipassana) meditation teaches you how to examine the real "projector" in life instead focusing on the "big screen". I will discuss this in detail in a different posting.
Vipassana meditation, a Buddhist mindfulness-based practice, provides an alternative for individuals who do not wish to attend or have not succeeded with traditional addiction treatments. One study evaluated the effectiveness of a Vipassana meditation course on substance use and psychosocial outcomes in an incarcerated population (see the abstract below). Results indicate that after release from jail, participants in the Vipassana meditation course, as compared with those in a treatment-as-usual control condition, showed significant reductions in alcohol, marijuana, and crack cocaine use. Vipassana meditation participants showed decreases in alcohol-related problems and psychiatric symptoms as well as increases in positive psychosocial outcomes.

Principle of Buddhist mindfulness is used in Mindfulness-based Cognitive Therapy and Mindfulness Based Stress Reduction (MBSR) programmes. These methods of psychotherapy are now used in evidence based medical practice for treating depression, anxiety and other related disorders. Current Canadian Clinical Practice Guidelines states, meditation as the third line of treatment for depression. Other principles of mindfulness meditation in Buddhist practice may be used in mainstream medical practice in the near future.

To read previous related posts click the following links:
Other Links:
Video about Vipassana Meditation in maximum-security prison Birmingham, Alabama, USA.
Staring at Death, and Finding Their Bliss
Vipassana Meditation in Northern Rehabilitation Facility, a minimum-security jail in Shoreline, USA

Learn about Mindfulness-based psychotherapy:

Wednesday, September 5, 2007

Can Mindfulness Help Cancer Patients ?

Studies have shown that mindfulness interventions can help improve psychological functioning, sleep better, reduce stress stress levels, enhance coping skills and well -being in cancer patients. These studies were conducted mainly in breast and prostate cancer patients. The reason for this may be a result of possible changes in hypothalamic-pituitary-adrenal (HPA) axis functioning.

One study showed improvement in quality of life that were associated with decreases in afternoon cortisol levels. Another study, showed possible changes in immune function, for example, increase in T cell production of IL-4 (Interleukin -4), that may cause a shift in immune profile from one associated with depressive symptoms to a more normal profile. A different study showed that MBSR programme was effective in decreasing mood disturbance and stress symptoms for up to 6 months in both male and female patients with a wide variety of cancer diagnoses and at different stages of the illness. If you want to read more about this please click the following links.

Buddha Lessons
A technique called 'mindfulness' teaches how to step back from pain and the worries of life

Adjunctive Psychological Therapy for Cancer:
What We Know and What We Need to Know

Monday, September 3, 2007

Mindfulness About Life- "A Lesson From The Garden"

Have you ever wondered why some die young and some live for a long time? When a young person dies people have questions like.....why now ?...... why him?......... Isn't he too young to die? These questions have been bothering me for a while. So, I decided to explore some of these question from a Buddhist perspective.

Today I went to my vegetable garden in the backyard and I saw something that got me thinking.....Since I wanted to share it with you I took a picture of it (see the picture above). The previous day there was a bad storm and some of the tomatoes were on the ground. But when I examined them very closely I saw many old, rotting tomatoes on the ground. Among them was a baby tomato, perhaps only few days old (red circle), and one young tomato beginning to be ripe. On the tomato plant there were many baby, young and mature tomatoes. When I examined carefully to my surprise I found there were still very few old tomatoes hanging on to the plant (not shown in the picture).

This made me to contemplate about life. As a physician I see this all the time. Very young kids die as soon as they are born. Young children and teenagers die of illnesses and other causes like accidents. Some people go on to live long lives. To death, age is no barrier. Buddha said "life is like a dew drop on a blade of grass"seen in the morning. When the sun shines the dew drops disappears. Buddha repeatedly encouraged us to contemplate in the impermanence of life. This may sound depressive but in reality if you mindfully contemplate it helps you to understand the true nature of our existence. In fact it makes us stronger and makes it easier for us to cope when a disaster strikes our lives.

There is a classic story that came to my mind about death, that took place in Buddha's time. This is the story of Kisa Gothami. When her new born son died she did not know the baby was really dead. So she ran to Buddha asking him to cure her son as she had heard that Buddha was a very compassionate person with a lot of powers. Buddha at once knew that the baby was dead. But he wanted to teach Kisa Gothami a lesson about death. He asked Kisa Gothami to find a handful of mustard seeds from a household where there had been no death in the past. She went knocking on all the doors in the village but she could not find a single house without a death in the family. Soon she realized the lesson Buddha was trying to teach her that no family is spared the occurrence of death.

The question that will come to your mind at this time is why some people die young and others go on to have long lives? Who or what determines this? What is the Buddhist explanation to this? Buddha said this does not happen just by chance or by a will or an act of a omnipotent power like a "God". Buddha explained the Karmic factors linked to premature death and other differences we see in people. This is like a "cause and effect" law. These karmic factors may determine why some people are always sick and why some people are healthy, and why some people are born rich and some people are born poor etc. If you want to learn more about this please click the following links.

Culakammavibhanga Sutta
Vipaka Sutta

Also see related posts: