I am so overjoyed at the growing interest in Buddhism. As a practice, it has been proven over the past 2,600 years that the Buddha truly understood the nature of the world and his enlightened teachings have been the path for countless others to understand the nature of dukkha (discontentment) and how to reduce or eliminate that dukkha in our lives in order to be fully engaged with the world around us. Nevertheless, lately I have seen a marked increase in conversations of people who seek Buddhism to be a panacea solution for mental illness and this sometimes troubles me because it shows a misunderstanding of Buddhism and mental health.
While I am a Buddhist minister, I am also a licensed social worker with a specialty in mental health and drug and alcohol treatment. If you have thought of practicing Buddhism and you (or your friend) suffer from a mental health condition, I highly encourage you to read this article and understand more clearly what Buddhism can and cannot do for you.
WHAT IS MENTAL ILLNESS?
People come to Buddhism to understand the nature of discontentment and how to end it. In the same way, people who suffer from mental illness seek help because they have found their lives to be unmanageable and the distress they feel to be unsustainable. But it is an economy of scale when we make these comparisons. Most Buddhist lead manageable and productive lives. Their suffering is often rooted in just the being and existence of mortality: the suffering that comes from wrong view, clinging to an impermanent existence, etc. These are the distresses and sufferings that every person has.
When a mental health professional diagnoses a disorder, they are looking at something on a totally different scale. Buddhism can be a tool for some disorders. I have seen people use Buddhist meditation to stop their cravings for cigarettes (nicotine addiction). I have seen people use Buddhist practice to deal with sadness (not to be confused with depression). Couples have used Buddhism to reframe and heal their relationships. Buddhism, as a practice of dialectic conversation and mindfulness training, is full of rich therapeutic tools that the mental health community has adopted to help people.
But what Buddhism is NOT, is a therapeutic model for mental health.
The distress and unmanageable states of mental illness often come from complex brain chemistry and/or developmental coping mechanisms that have created core values and self-images that make working in the world too challenging to ignore.
Yesterday, I was working with a client with a antisocial personality disorder and he summed it up nicely, “I have been dealing with this my whole life and I just don’t understand what is wrong with everyone else.” When working with people with significant mental illness issue, it is often like trying to teach a man with broken (or no) fingers how to type. This is because mental illnesses created from brain chemistry, extreme trauma, or developmental-based world views require more than just sitting. They require expertise that moves beyond a spiritual leader or community (which are often therapeutic) and requires expertise in those who understand how to treat this level of distress.
BUT “THEY” TELL ME BUDDHISM IS THE BEST TREATMENT FOR …
A monastic is a Buddhist practitioner who has dedicated himself to the perfect teachings of the Buddha. Some lay practitioners and monastics have come to the mind that Buddhism has science behind it to prove that it can cure nearly anything. This is “wrong view” in my opinion. Just as wrong as Christians who believe in prayer can cure cancer.
I did a quick Google and found some interesting forum conversations. I will quote one.
“Some years ago, apparently, the National Health Service in the UK found that meditation was the best way of treating depression, better than medication or counselling. Just sitting quietly for a few minutes and perhaps listening to a guided metta meditation on your ipod can be very helpful.” (Dammaloka)
This monastic was speaking off the cuff without any real basis of what the NHS was saying nor understanding the mental condition of the person he was talking to about this subject. First, the person in question was suffering from bipolar disorder, a complex disorder that is influence by genes as much as developmental experiences. Second, the NHS study suggests that depression patients use Mindfulness-Based Cognitive Therapy, which includes meditation under the direction of a licensed therapist, not self-directed sitting quietly. (Psychology Today)
Bipolar disorder being diagnosed more and more commonly today: There is a genetic component but environmental factors also contribute. This is not a disorder of mood swings, but of fundamental shifts in world view, attitudes, understanding of reality. Some of the treatment plans do include diet, exercise, being mindful, reducing stress. A Buddhist lifestyle would probably be very useful, but it could never be a solution to the condition. And most suffers of bipolar disorder are co-occuring with other disorders that must also be addressed. (APA)
The danger is that a monastic has no training in mental health to effectively understand what the individual is dealing with to help guide and support him. His world extends to the tools and understanding he has: The existential understanding of suffering and the end of suffering.
I have dealt with many lay-practitioners and monastics who also advocate Buddhist meditation for the solution of physical health conditions. While there are some Buddhist practices that do have physical therapeutic help, using them without first seeking the help of a medical professional first is unwise.
WHAT CAN BUDDHISM DO FOR MENTAL ILLNESS?
From Freud to today, the philosophy and teachings of Buddhism (and the Buddha) have been a reference for understanding the nature of the mind. Many of our modern therapeutic theories and practices are rooted or informed by Buddhist practices. To that end, it is very tempting for a soldier returning from Iraq, wanting to avoid dealing with a therapist, to seek a Buddhist temple to solve his PTSD problem. It is also tempting for those who have seen the quality of their lives improve from Buddhist practice to endorse Buddhism as the only solution necessary.
Unfortunately, someone with significant PTSD cannot just rewrite their trauma away in meditation alone. A monastic is not trained to understand the nature of that soldier’s issues. A temple is not a drug and alcohol rehabilitation facility that understands the nature of addiction, just as a Catholic church isn’t.
A good Buddhist practice can be a cornerstone to a foundation of good mental health, but it cannot be the entire foundation. The Buddha talks of the three poisons: aversion, clinging, and delusion. Those who are in severe mental distress should not avoid seeking mental professional help. They should not cling to absolutism of Buddhism being the panacea for all things. They should not create the delusion that they are able to see the whole self without assistance when they are ill.
I want to make it clear that not all monastics are untrained in mental illness. I am a Buddhist minister with training, and there are others who are well trained and educated in neuro-science, psychology, etc.
I also want to make it clear that not all mental health providers are the same. If you feel that your mental health provider is not creating a good therapeutic relationship or providing the care you feel appropriate, speak to them about it. You may need to work with more than one mental health provider before you find the one that is able to help you work through your issues successfully.
Finally, speak with your mental health provider on how you may use the strengths of your Buddhist practice to support your mental well-being. Spiritual and mindfulness practices are often significant tools to have on the path to mental wellness.