For the past 500 years health and healing health and healing have been viewed from a biological perspective. In modern times we have inherited and built upon this perspective. Our medicine can be appropriately called a biological or outer medicine. The unfolding of this viewpoint has led to extraordinary accomplishments in the diagnosis and therapy of disease that each of us will surely use in our lifetime. However, our exclusive focus on biology has also handicapped our ability to pursue the full potential of health and healing that’s available to humankind. It has done so by denying and devaluing the role of the mind and consciousness in health and disease.
It’s no accident that we’ve taken this outward turn in our understanding of health and healing. It was a decision made a long time ago in ancient Greece. At that time the early development of philosophy, logic, reason, and science was guided towards an examination of the outer world and away from the inner experience. Only a denial, it was thought, of the inner experience could assure that reason and logic would not be “contaminated” with subjectivism – our inner experience that was considered too plagued by personal and inaccurate attitudes and judgments. So our capacity for reason and logic took an outward turn away from the subtle and deeper mysteries of consciousness that for millennia had guided man in his quest from well-being. For good and for bad this choice has structured and defined our modern day view of health and healing.
Whatever the rhetoric, our view of health continues to be focused on our biology. Disease is seen as a physical abnormality expressed through physical symptoms, and health is viewed as the absence of disease or physical disability. This highly conditioned and socially supported perspective is our default, our instinct. It is where we put our resources and it’s what motivates us to attend to our health. It’s also, regardless of the rhetoric, the focus of practitioners – conventional and alternative. We must be honest here. Try as we have its been difficult to remove the millennia of conditioning that has focused our attention on biology as the critical factor in heath and disease.
Teach Them About Health
On a recent trip to Asia I asked a very wise spiritual teacher what specifically he would suggest be taught to healers and the general public as regards health. His answer was, “Teach them about health.” At first glance it didn’t seem like much of an answer. But as with most things that initially seem like riddles it’s merely a question of discovering the deeper meaning and then a paradox becomes a truth. So what was the meaning of his answer?
From the spiritual perspective, or we could say the perspective of higher consciousness, health means something very different than we’ve become accustomed to. Seen from this perspective those of us enmeshed and glued to an exclusively biological understanding of health are confused when it comes to understanding what an authentic and far-reaching health actually is. When he said “Teach them about health.” he was not speaking about what we call health. What we call health the wise ones call suffering.
He wasn’t speaking about health as those moments in life when we’re seemingly free of disease or distress, but about a kind of health and well-being that is profound, pervasive, enduring, and continues through the adversities of disease, aging, and death – profound because it touches the very depths of our being, pervasive because it moves through body, mind, and spirit, and enduring because it is stable and unchanging. He was speaking of the personal realization of the innate happiness, peace, wholeness, wisdom, and tender loving-kindness that is the essence of our being. He gracefully and with clarity admonished me to teach about health because few of us have had more than a glimpse of this human capacity for far-reaching health and well-being. Unaware and confused about our own possibilities we accept a culturally acquired biological view of health that regardless of its accomplishments has become an obstacle to further advancements in health and healing.
This teacher spoke to the boundless opportunity to attain the full possibility of human health that has in modern times become contracted, unrecognizable, and incomplete by our limited biological view. To attain this precious, immeasurable, and uniquely human health we must take a giant leap that takes us beyond our exclusive biological viewpoint. This leap is characterized by an inward turn towards a contemplative inner medicine.
The View from Within
Contemplative medicine views health and healing from an inner rather than outer perspective and relies on its own remedies that are innate to a developed consciousness. In this manner the term Contemplative Medicine has a double meaning. First, that human life and its circumstances can be legitimately and appropriately viewed and explored through the perspective of consciousness much as we have in modern times explored human life through the material perspective of biology. And second, the development of consciousness and our inner capacities are themselves the remedies of a contemplative medicine. Contemplative medicine is simultaneously a perspective and remedy.
The basis of contemplative medicine is contemplative theory which proposes that disturbances in consciousness and the resulting mental disharmony correlates with, contributes to, or is itself the source of both mental distress and physical disease. In actuality it is likely that each of these ways of describing the important role of consciousness in health and disease are at work, to one degree or another, in all aspects of mental and physical health.
Disturbances in consciousness and mental disharmony occur at increasing levels of subtlety. What are most apparent to us are the coarser levels of mental distress. The underlying and subtler levels are unapparent until we reflect upon and analyze the deeper sources of mental distress. For our purposes we’ll consider three of these levels. These can be identified as – coarse afflictive emotions, dualistic thought, and the subtlest, a loss of awareness of our essential being.
Coarse Afflictive Emotions
Of the three disturbances in consciousness that lead to mental distress we are most familiar with afflictive or disturbing emotions. Unfortunately and unnecessarily we have become accustomed to them as a routine part of daily life. These emotions range from mild to severe and are subject to moment-to-moment change. They occupy a significant amount of our mental life and compulsively draw our attention. Examples of afflictive and disturbing emotions include anger, hatred, strong desire, attachment, excessive pride, jealousy, confusion, doubt and so on. When persistent they appear as chronic worry, anxiety and mood disturbances that directly impact upon physical well being through the mind/body interface.
Dualistic Thought
Contemplative theory asserts that the underlying basis of coarse afflictive emotions is a disturbed and confused mental life. The evolutionary shift from instinctive to rational thought has been a remarkable and positive one for humankind. However, rational thought is still a limited and incomplete development of consciousness and as a result can be the basis of troubling and afflictive emotions as well as a powerful tool for understanding the natural world.
Innate to thought is the division into subject and object – mind and body, I and you, and I and it. Whenever a thought arises the thinker of the thought arises simultaneously. It’s unavoidable. This dualism is of great value in understanding the natural world but presents a very difficult and new psychological and spiritual dilemma for modern man whose dominant mode of being is now mental. What was once a unified living experience becomes two – the whole is broken into two parts – thinker and thought, perceiver and perceived. After years of living in this way are now accustomed and habituated to this break in connectedness and its many consequences. Only infrequently, with delight and nostalgia, do we experience a glimpse of the oneness and unity that once was. This cognitive duality – subject and object – and its accompanying afflictive mental life is absent from both an instinctual consciousness that acts without thought and a fully developed consciousness that transcends thought.
Dualistic thought is a core characteristic of cognitive activity. It is the essence of a mental/intellectual life. However, it disrupts the experience of a unified self that is interconnected to and in relationship with the whole of life and in its place substitutes a thought-based mental self that separates us from the rest of creation. This disconnection from the whole leaves us feeling alone, separate, and insecure. As a result, the now dominant mental “I” – what we call our personality or ego – invariably gives rise to a subtle inner disharmony that is a direct result of the feelings of separation and aloneness that are innate to the cognitive aspect of consciousness.
In this way mental distress and afflictive emotions are an outgrowth of the confused aspect of dualistic thinking that mistakes the mental self for our essential self. According to contemplative theory the remedy at this subtle level of inner disharmony is an expansion of consciousness that allows a deeper understanding of the mental “I,” and its role in producing afflictive emotions. Understanding the precise nature of the mental “I” softens it, undermines its dominance, helps to alleviate a self-imposed isolation and separateness, and in this manner diminishes the related afflictive emotions.
Loss of Access to Our Essential Being
At an even subtler level contemplative theory proposes that an over dominant mental life not only leads to the isolation and aloneness of dualistic thought, but simultaneously separates us from the source and essence of our being – a luminous, open, primal and healing awareness. We mistake our “I,” our personality, as the source of our being. As a result, enmeshed in an afflictive duality, we simultaneously lose access to the deepest and authentic aspect of self that heals at the source. In this way our overactive mental live obscures our essential nature. This loss of access to our luminous non-cognitive awareness and wisdom serves as the root source of mental and physical distress. The remedy or healing, according to contemplative theory, is attained through inner development and the expansion of consciousness that becomes the cause for the ensuing re-union with the core of our true and essential nature.
This is the manner in which contemplative theory, at three progressive levels of subtlety, understands the mental and physical suffering of humankind and offers its remedy of consciousness and wisdom as a complement to the biological perspective and its therapies.
An Example: Heart Disease
Viewed from a biological perspective heart disease is seen as a disorder related to high cholesterol, elevated blood pressure, genetic tendencies, and other physiological abnormalities. As this viewpoint is biological so are the usual remedies in the form of diet, exercise, and medications. This is an accurate, appropriate and yet limited view of heart disease – limited because our nature is not merely biological and thus the understanding and treatment of heart disease or any other ailment must involve mind as well as body.
Now let’s look at heart disease from a contemplative perspective. From this viewpoint the physiological disharmony that underlies heart disease co-exists with an equally significant internal disharmony or more simply stated mental distress. At the coarsest level the correlation between stress and heart disease is quite apparent. Scientific research has identified many of the underlying mind/body interactions that are instrumental in transforming mental stress into physiological disease.
The basis of overt mental distress is underlying afflictive emotions. As previously mentioned, afflictive emotions result from an over dominant mental life, the dualistic thought process and the accompanying loss of access to our essential self. Unknowingly we substitute for this loss an encapsulated mental self – our personality. This mentally fabricated self, no longer in contact with the resource and healing qualities of our essential self, is trained to look outward to the external world to meet the normal human longing for meaning, happiness peace, comfort, and security. However, this ceaseless outward striving is misdirected and cannot and can never satisfy these profound human longings. Disconnected and unaware of the only authentic and enduring source that can satisfy these needs – our inner life – we mistakenly search outside for what can only be experienced within.
This mistaken outer search leads us to false “gods,” temporary outer pleasures – materialism, consumerism, social status, relationships, achievement, and so on. But these outer sources of pleasure are impermanent and undependable. So we chase them more and more trying to catch what always eludes us. Eventually we become attached and addicted to these outer “pleasures,” protecting and defending our self against their loss. That is what we call an ordinary life. The result of a lifetime of this unseen mistaken effort is afflictive and disturbing emotions that become the basis of mental distress and chronic disease – heart disease included.
The contemplative viewpoint continues to analyze the problem of heart disease at increasingly subtle levels until a full understanding of the root source is attained – the loss of access to our essential self. Cutting the root of mental disharmony – our false sense of self – and reconnecting to our inner source naturally and effortlessly transforms our inner attitudes and outer behavior. Heart disease becomes a teacher rather than a mere curse. When considered from the contemplative perspective it provides new insights that can help to heal disease and transform our lives for the better.
Using this example we can see how contemplative theory assists us in gaining a broader view of the basis of mental distress and physical disease. This understanding enables us to cut the causes of mental distress and physical disease at their root source and simultaneously promote a profound human flourishing of body, mind, and spirit. Looking from two directions, the contemplative and biological, allows for a more expansive understanding and approach than either perspective alone. An expanded consciousness offers new understandings, new remedies, and new possibilities.
I saw this at work in my practice. An individual with heart disease, known or unknown to himself, is at the edge of a potential and essential life transformation. For a brief moment the sudden intrusion of heart disease with all its fears and anxiety is a “crack in the egg.” Time that was not previously available for self-care suddenly opens up. The ego drops its defensiveness and a tender vulnerability emerges often for the first time. Everything is primed for an insightful exploration of life as its been lived. As the poet W.B. Yeats said, “Things fall apart … the center cannot hold.”
There was a time that all I could do was to apply a diagnosis and medical remedy to this problem. An act that itself was helpful in dealing with the biological crises but slammed the door on this extraordinary teaching moment – a transformative moment that might not reappear for decades if left unnoticed. Now I can do more.
I can also apply a contemplative medicine to assist with this disease and honor the possibilities of a sacred and precious human life. I can spend the time deeply listening to the life that gave rise to the disease. I can ask questions that provoke self-reflection and new insights. I can offer reading materials or other resources that assist with exploring consciousness and spirit. I can provide specific practices that offer direct experiences of the inner life and realizations of eternal and healing truths. What was at first glance a generic biological disease that received cookbook generic therapies now becomes a living experience of growth and transformation.
The goal is more expansive. We focus simultaneously on treating physical symptoms, cutting the root sources of mental distress, preventing further disease, and promoting a hardy and future life of profound and enduring health, happiness and wholeness. Life changes and heart disease becomes the door that opens a healthier and happier future. This is not a new age dream or fantasy. I’ve seen it over and over. Isn’t that what you and I would like for our own life?
Transforming Our Perspective
I was trained in the biological perspective and practiced internal medicine for many years. I continue to remain in awe of its understandings, technologies, and therapeutics. But long ago I realized that its approach was partial and limited. It could not address the more subtle aspects of human suffering, disease, or health. These are inner rather than outer. For me, the inward turn was a second medical education that began with developing my own inner life. It’s my second medical education that taught me the understandings and practices of a contemplative medicine, perspectives that can stand aside biological medicine.
So where do we begin? We begin with a clear recognition that biological medicine is partial, limited, and can never in itself bring an enduring end to all suffering or promote our fullest capacity for health and healing. This is not a renunciation of biological medicine but rather an affirmation of the truth of the multi-dimensional nature of the human experience and the unique human capacities for consciousness and healing that are attained through inner development.
It sounds obvious and easy but it’s not. When it comes to health and healing our minds are highly trained to think biology and respond to physical symptoms. Consider a deeply ingrained habit. Consider how hard it is to change. When we try the pattern usually pops up again and again in a new outfit. It is where we instinctively turn when things get difficult. It is where we place our energy and resources. It is only when we develop a profound recognition and wariness of what does not work that we surrender old patterns of belief and action and move in another direction.
Consider the following example. In our efforts to reform conventional medicine, to broaden its reach, the directions we’ve taken consist of the approaches of alternative, complementary, and integrative medicine. We think these reforms are something new, innovative, and finally address the limitations of biological medicine. But when examined carefully it’s apparent that the underlying philosophy is much the same. The focus is still on practitioners, biology, and external supplements and remedies. Have you ever been to an alternative practitioner that engages you in the development of your inner life? If so, your experience is rare. There is nothing wrong with expanding the our medical tool kit, but when this is mistaken as a fundamental transformation of our limited biological approach it further hinders our possibilities to shift our attention inward and formulate a broader vision of health and healing. This is an example of how old and powerful ways and perspectives unknowingly reappear in new disguises.
We can only begin when we have gained sufficient frustration and wariness with what doesn’t work. When we are ready to let go of partial and incomplete understandings that do not allow us the fullness of life and health we are finally ready to move forward. At this time the proper teachers and teachings will appear. Once we begin our own experiences will provide the faith and inspiration to continue and expand our efforts. And when we finally touch, for however briefly, the gold-like essence of human life it becomes a profound and irresistible truth that permanently re-orients our life and our vision of health. We then find our self on the direct path to the greatest of human possibilities – a perfected health of body, mind, and spirit.
The Progressive Development of Consciousness
It is not my purpose here to set out the full scope and range of contemplative medicine but rather to make the case for its importance as the next evolutionary leap in our long path towards a comprehensive medicine. However, I would like to briefly outline some of the key points in the development of a higher consciousness that serves as the basis of contemplative medicine.
It’s important to know at the onset that we cannot develop our inner life by our self any more than we can build a bridge without teachers, knowledge and hands on experience. We require well-trained and inspired teachers and time-tested teachings. This in itself is difficult because a culture that has denied the interior aspects of the human experience has neither allowed nor fostered the development of such teachers. Fortunately there is an increasing availability of competent teachers and teachings to assist us in gaining access to our inner life.
Second, we need to engage in the study, reflection, and practices related to developing a larger consciousness. This is the only way we will know with certainty both the process and its fruits. And this requires patience and discipline. Here is a very brief overview of the steps involved in inner development – the basis for a contemplative medicine for our self and others.
Step #1: Taming and Calming the Mind
Without exception all of the great traditions and sages have informed us that accessing an authentic and enduring health, happiness, and wholeness begins by calming the mind and training it in attention and moment-to-moment awareness.
Why? The busy and chattering mental life of the ordinary person leaves no room for learning, reflection, or insight. There is the story of a wealthy merchant who visits an Eastern master to request the great teachings of life. The sage pours a cup of tea for his visitor but does not stop when the cup is full. The tea continues to flow over the sides of the cup with little concern expressed by the teacher. Confused and annoyed the merchant cries out “Stop! Stop!” The sage replies, “Your mind is like your cup, it’s too full to receive anything else.”
Much the same can be said for ourselves. Our mind is always full of chatter. It’s filled and endlessly distracted by a continuous flow of thoughts, feelings, and images. We constantly chase after these mental movements unaware that we are being pulled from one to another with very little if any control over the constant activity of our mind. If you question this, just stop for a moment, place your attention on your breath and see how long it will stay there until you are automatically pulled away by an unrelated thought, feeling, or mental image – perhaps a few seconds. Try again if you wish.
This automatic mental flow is not innocuous. It keeps us from being attentive to present moment experience and often enmeshes us in afflictive negative emotions that cause anxiety and distress that is felt in our body as well as our mind. We go over and over the same issues year after year unable to resolve exhaust or resolve repetitive and ceaseless mental activity, leaving no space to learn, grow, or create a larger health and life. Until we can address our busy mind, we are condemned to living in mind rather than in life, and experiencing the suffering that accompanies an overactive mental life.
The formula is the same whether it be the image of Christ in retreat for 40 days in the desert, monks in their caves or cabins, Buddha under the Bodhi tree, Hindu renunciants in the forest, or modern day individuals seeking the inner silence of prayer or meditation. Inner stillness clears the mind of incessant and conditioned mental activity. It silences past perspectives and beliefs. It opens a spaciousness, transparency, and clarity that allows for new understandings and wider perspectives to arise. Taming and calming the mind is the first step in cultivating wisdom, peace, happiness, and wholeness.
Step #2: Cultivating and Abandoning
The first step, taming and calming the mind, enables us to experience the stillness and awareness of our inner life. But because our culture supports and encourages an overactive mental life linked to a hectic lifestyle, it is difficult to sustain inner calm in our day-to-day experience. However, there is growing scientific evidence that our minds can be re-trained and that mental training can calm and stabilize the mind during practice as well as in day-to-day life.
As we work to further expand our understandings we simultaneously work at stabilizing the gains we’ve made. In addition to daily practice the way we enhance and stabilize inner stillness is by examining our life, choosing to cultivate those attitudes and actions that support our efforts and abandoning those that get in the way. In doing this we create the context, or let’s say the healthy soil, that will sustain and encourage full development during and after our meditation practice.
We begin by abandoning the attitudes and actions that obstruct the way to a larger health and life. In summary, the three things we must abandon in order to move towards a higher healing field are:
(1) The false belief that an outer material medicine alone can eliminate all sources of distress and disease and lead to whole health;
(2) The false belief that other people or outer objects can bring us an authentic and sustained well-being, happiness, and joy;
(3) All speech and actions that cause suffering to our self or others.
We don’t need to accomplish all of this on the first day! It’s a gradual process that begins when you are ready. Don’t be discouraged by fallbacks to old behavior. That’s how it is. Conditioning and habits are strong. But over the long term, your intention, supported by the right teachers and teachings, are far stronger.
For our purposes I am also going to summarize the attitudes and actions we must cultivate to support inner development. These include:
(1) Cultivating stillness and silence in our inner and outer life – at home, at work, and in our relationships;
(2) Cultivating a sense of loving-kindness towards others;
(3 Cultivating feelings of contentment and gratitude for our life and its possibilities.
Step #3: Experiencing the Mind’s Essence
For ordinary people such as our self we mistake the mind’s essence to be continuous mental chatter. When we observe the mind from our normal consciousness that’s what we see. And we “meditate” on this mental chatter all day! That’s all we see so we merely assume that that’s all there is to the mind. Only when we quiet the mind can we look beyond the chatter to see the real essence of our mind – which is no different than the core of our being.
So what is this essence I am speaking of? I can briefly describe it in words. Yet although you may understand what I am saying the real understanding of our core being can be only know through direct experience – at first this means through meditative practice.
The core of our being – of mind and heart – is empty of any of the activity of the chattering mind and it is thus also clear in the sense that our usual thoughts, feelings, and visual imagery do not obstruct the openness of the mind’s essence. This essence or natural ground of our mind is like space on a clear day. The clouds of mental activity are gone and what remains is an ever-present pure and luminous awareness – a “thatness” and “suchness.”
There is an openness, spaciousness, expansiveness, clarity, wisdom, delight, and peacefulness. All is as is uncolored by our mental perspectives. As a result there is a freedom from the known – a freedom of experience and possibility that replaces the enslavement to a runaway mind. All of these qualities are innate to the mind’s essence. They arise as soon as we can see our own basic nature. More cannot be said here.
Step#4: Stabilizing the Mind’s Essence and Developing its Qualities
If we choose to develop our contemplative capacities we will slowly but surely touch this sweet essence of mind. At first this is just a sliver of experience like the sliver of an early moon. But with time, study, reflection, practice, and the proper cultivation this sliver will grow and grow and progressively become our dominant experience. Patience is a major plus here.
As we stabilize this experience we will gain stability and full development of the qualities that are found in this transcendent aspect of consciousness – the core of our being. These qualities are the direct cause for the fruits of contemplative medicine – freedom from suffering, the flourishing of our personal lives with an unbounded health, happiness, wholeness, peace, and wisdom. These qualities are the remedies that heal at the source. And, we don’t have to wait until the end of our work for them to begin to show themselves. The fruits of inner development will begin to ripen as soon as you begin your efforts.
Very briefly, these are the four basic steps of inner development. They are the basis of a contemplative medicine, health, and healing.
The Mind Body Connection
It is only at our most coarse level of understanding that we speak of the mind and body as if they were separate entities. With a bit more subtlety we refer to the mind/body connection and its relationship to stress, relaxation and physiology. But as we develop a more refined consciousness our understanding goes deeper. We can see how intention itself, that is personal choice, can play a significant role in shaping the subtler aspects of physical existence. We discover that the body is highly plastic. Plasticity refers to the mind’s capacity to train and shape the brain and body through conscious intent. This includes immune function, brain activity, physiological functions, and perhaps we may in time discover that this also includes genetic imprints.
Contemplative medicine introduces us to the subtlest aspects of the mind/body connection and to the healing capacities that result from an expanded consciousness. In time it becomes clear that the mind and body are not connected at all – they are and have always been one. The ultimate and most subtle mind/body medicine is dependent on the attainment of higher levels of consciousness.
The Integral Perspective
The integral perspective helps us to unify our understanding of health and disease. It does so by positing that our seamless human life can be experienced four ways in day-to-day life: through consciousness, biology, our personal relationships, and through our interaction with the larger world around us. From this perspective any whole or comprehensive view of health and disease must consider all of these aspects of life that together bring about our personal experience. To deny any one is to limit our self to a partial healing and a partial health.
As we discussed earlier, our emphasis in modern times has been the development of an understanding of the biological aspects of life. This has resulted in achievements that have brought great relief from physical distress and extended the length of our lives. But denying the inner aspect of health and healing has simultaneously led to the modern day epidemics of stress related disorders, mental distress, and chronic disease as well as the loss of the opportunity to experience the peaks of human health and healing.
Why do we pick inner development – contemplative medicine – as our next major focus, our next leap in the millennia long evolution of the human capacity for health and healing? We choose this because biology and consciousness are the most basic aspects of our being. We’ve accomplished the latter and our task now is to do the same with inner healing. When we develop both our biological and contemplative approaches to health in unison they will become the basis upon which to build healthy relationships and a healthier world. It is the development of consciousness that is our new frontier in medicine. It will open the further development and transformation of all other aspects of our experience.
As an example consider our relationships. To move from dependent relationships, to partnership, to full emotional intimacy, and finally to a universal loving-embrace requires as its basis a progressive development of our inner life. We cannot move forward in our relationships without growth in consciousness. Once this occurs we discover that more peaceful, open, inclusive and caring relationships are increasingly possible. More conscious relationships enhance our physical health, bring meaning to our worldly experience, and serve as a supportive ground upon which to attain further growth in consciousness.
The integral perspective allows us to see the role contemplative medicine plays in driving the full development of all aspects of our being.
In Summary
In this brief outline I have attempted to convey the rationale and steps involved in the development of an expanded approach to health and healing. I’ve termed this approach Contemplative Medicine. This is a radical transformation in our thinking about health and healing. However, it is no more of a shift than has occurred in our movement from earlier more primitive approaches to our modern day rational based biological approach. In actuality the history of the man’s efforts to enhance health and alleviate disease are a series of evolutionary steps that are propelled by the limitations of the previous approach. Our time is no different.
Contemplative medicine is not a practitioner-based medicine. However, it is essential that practitioners develop the requisite knowledge and skills as they are, at times of disease and suffering, important and highly influential relationships. But each of us can engage the process of contemplative medicine by beginning the process of inner development – the expansion of consciousness that will propel us towards the next level of health and healing.
We are close, so close, to the peaks of human health and healing. It is this next step that is critical to this long process of human growth and discovery. It is this next step that in our time can take us towards the perfection of health.
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