Tag Archives: 108Enso

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that’s a fact

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It’s been a bit of a fragmented week, hasn’t it?  I think I shared this on the Facebook Page: I’m in the clutch of data analysis for my Chaplaincy Project (has it been almost two years already!) and trying to let the Creative (Missing-in Action) Muse take charge of my life.  The final written project is not a huge volume of writing so, on the one hand, I’m not overly twisted about it.  On another hand, it is a challenge to pull together fleeting thoughts, aspirations, desires, and not let the ever-burgeoning ego swamp it all.  On another hand (remember Avalokiteshvara), it is fun to try to get a broth of Dharma and a thickener of applied practice to congeal into a tasty gravy.

I’m trying to be organized.  Having cleaned up the data which gave some interesting insights into the relationship between burnout factors, self-compassion, and spiritual congruence, I’m launching into the reams of articles on the Four Noble Truths, Dharma Seals, Koans for the Ill-informed (that’ll be me), and the current status of Mindfulness-Based Interventions.

This is an interesting edge, sewing together a seam of wisdom teachings and their practical applications.  More than that, it’s an attempt to create a robe that is a Western application of Eastern wisdom.  The issue of whether this has been a success or not is probably irrelevant.  There are camps and camp followers; ardent defenders of the faith and vocal lobbyists for the scientific method.  I tend to wander through both camps, adhering to neither but listening carefully for what might be helpful.  Mostly I hold to the belief that there is wisdom in both approaches, that they are supportive wings, and each can and has learned much from the other.

And then, sometimes, the data-gathers show there’s a long way yet to go.

A recent article by Grabovac, Lau and Willett in Mindfulness attempted to re-insert Buddhist Psychology into the foundations of Mindfulness-Based Stress Reduction.  Grabovac and her colleagues did a good job of putting the Three Dharma Seals (impermanence, suffering and nonself) into the service of explaining the mechanisms involved in mindfulness-based interventions.  Drawing partially from the Abdhidhamma, they worked out a pretty good set of visuals that lead us through sense perceptions, attachment/aversion, and the generation of suffering and nonself.  I found their understanding of the implications of nonself is a bit wonky, but that’s not as critical as what comes next.

About halfway through the article, they address the role of Ethics (sila) in the cultivation of mindfulness.  After listing the five precepts, Grabovac and colleagues make what is likely one of most faulty statements of the intent of a practice founded in sila.

(O)ne of the major purposes of the ethical guideline is to reduce the baseline amount of mental proliferation, thus aiding both concentration and mindfulness practices… Leading an ethical life, in the context of the (Buddhist Psychological Model),implies that the meditator experiences less guilt, doubts, worries, etc. that can often be a source of mental proliferation.

I’m no scholar of the Dharma but I don’t think one can get more off-track than this.  In effect, they reduce Buddhist Ethics to a utilitarian process of feeling good.  In terms of Kohlberg’s stages of moral development that makes Buddhist (and Mindfulness-Based) practitioners capable of not much more than the second level in which we choose the “right” thing to do because it gets us something in return.  What Grabovac and friends have missed is that sila plays an equal role (if not more so) to Wisdom and Concentration in the triumvariate model of practice.  It is more than just doing something to get something in return.  And perhaps, this is where I find the teaching of Mindfulness-Based courses to be inherently limited if we stop, as most courses do, at symptom relief.

The ethics of a Buddhist Psychological or Applied Model requires opening to our interconnectedness (non-self is the start point).  The practice of the Five Precepts (or Five Mindfulness Trainings of Thich Nhat Hanh) is more than about avoiding a poor rebirth or ensuring some Thing for ourselves.  To miss this places the whole translation of Dharma into Psychology on very shaky ground.  In fact, I think it just collapses.

It’s disappointing that researchers who put so much into developing a bridge between the two worlds would have missed something so critical and obvious.  And in a journal of some repute, it concerns me that readers not well-versed in Buddhist thought will take the diminishing of Buddhist Ethics to a utilitarian role as a fact.  I haven’t seen an open challenges to this part of the article.  Perhaps it will come soon.

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that’s no joke

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On my way to the dreaded mammogram, I had my five minutes of fame. A word about the mammogram first. It’s one of those annual things we have as a luxury of high funding from the breast cancer prevention lobby and a generous if lop-sided health care system. Demographics would say I’m not at risk but the statistics these days suggest anyone with a hormonal system is. (That includes you gentlemen.) Still and all, I’ve avoided it for the last four years, seeing it mainly as a waste of good health care dollars to make a glass plate sandwich of my boobs – although it is a good test of my skills with the Anapannasati Sutra. But I now have a new family physician who is much too young to be ordering me about but I’m going to let her because as a health care professional myself, I know I am the worst patient anyone can have.

So. On my way to the dreaded mammogram, I had my five minutes of fame. At the doors of the hospital, which is a lovely 10 minutes walk from my office, was a film crew polling patients about the health care system. The Canadian Medical Association Annual General Meeting is coming up and this was to be a feature at their gathering. They asked questions that were actually quite pointed about our health care system.

My answers in narrative form: The Health Care System is broken. That simple fact makes little waves in battle for dollars. There’s a lot of blaming and shaming with fingers fiercely pointed at organizational dysfunction. But under the egos that place research and body counts as gold standards for health care delivery are very frightened people who are staunchly protecting their turf. And in their fear, it is unlikely that they will see the futility of throwing more money into a broken bowl. What they miss is that efficacy studies – while I am a strong advocate of them – mean squat when the most vulnerable populations in our province are literally dying as they wait on long lists for care.

Do we need more money poured into the medical system? Not if it excludes mental health and long term care for the elderly. I obviously have a bias but it’s justified. Mental Health Services are only free if you see a Psychiatrist. And few people can because you have to have a family physician who refers you. (It’s a way of circulating those dollars.) These days fewer and fewer people have a family physician. Because, guess what? There’s a dirth of physicians. It costs too much to train them and there are too few spaces in medical schools for the number we actually need. Sure, you can see a Psychologist but unless you have one who will adjust their fees and, even if you do, you need an extended health care plan for what it costs. And, guess what? Fewer and fewer people have those because organizations can’t really afford them. And so the wheel turns.

Of course, there’s an obvious solution. Bring all the para-medical professionals under the umbrella of Health Care Services. Create a sangha of professionals who are willing to contribute as a community. It means seeing suffering as our communal diagnosis and treatment as our practice. It means taking on the desire to bring all beings out of their hell realms simply because that’s what we must do. But that also means letting go of our turf and the turf wars. It might even mean seeing each other as equals facing a common end point.

Likely? I don’t know. It’s the old joke: How many Health Care professionals does it take to change a light bulb?

We’ll never know because every time there’s one to be changed, the program ended last week because of funding cuts.

And that’s no joke.