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Buddhadharma : Spring 2009
buddhadharma: the practitioner’s quarterly SPRING 2 0 09 34 psychiatric world was ruled by psychoanalysts who believed that virtually all psychological problems and pathologies could be traced to earlier psychological causes. They threw up their hands in horror when antidepressants and antipsychotic medi- cations first appeared, claiming that the drugs merely relieved surface symptoms, while leaving the deeper causes untouched. Eventually they changed their minds as pharmacological suc- cesses multiplied, and especially when some long-analyzed but little-helped patients responded well to antidepressants, and subsequently sued their psychoanalysts for having withheld medication. It’s not that psychoanalysis is useless, but rather that by itself, it may be insufficient to treat severe psychologi- cal disorders. Likewise, meditation and spiritual practice may also be insufficient by themselves to address severe psychologi- cal difficulties. The Hell Realm of Depression The question of effective treatment is a crucial one, because the cost of inadequately treated mental disorders is extraordinary. For example, major depression ranks as the world’s fourth leading medical cause of disability, and for poorly understood reasons, its frequency and severity seem to be increasing. Yet most people with depression, including those who are spiritual practitioners, go untreated. This is a tragedy, because the suf- fering and debilitation of major depression can be horrific and heart-rending for all those who are touched by it. Consider the following statements from depression sufferers: I accidentally tripped over my cocktail table, breaking both of my legs. I want you to know that the pain that I experience from depression is so much worse than the pain associated with my breaking both my legs. The psychological pain I felt during my depressed periods was horrible and more severe than my current physical pain associated with metastases in my bones from cancer. Hearing these expressions of pain coming from the depths of people’s being reminds us that depression has been regarded as a spiritual crisis in some traditions, despite that fact that classical Buddhism makes little mention of it. For example, the noted Jewish Kabbalist, Aryeh Kaplan, was very explicit: “There is nothing that can prevent enlightenment more than depression, even for those who are worthy.” Most people today know someone who has been affected by depression, and therefore understand how severe and dis- abling depressive suffering can be. And for some time now, we have been hearing accounts about the relief that antidepres- sants can offer to those who have been struck with it. Buddhist practitioner Sheva Carr long resisted taking medication, but after doing so, wrote movingly: Do you know what it is like to be so sensitive that the air makes your eyes sore and so does sleep?.... To be so sensitive that food forges flaming fireworks in your gut?.... Whatisitliketogoon antidepressant medication?.... It is what it is like to be drowning daily and then suddenly find yourself floating face up to the sun. In spite of a growing body of research evidence indicating the effectiveness of medication, and anecdotal accounts of its benefits for meditators, there has been much debate in spiritual circles about the use of medication. What has been lacking, however, is actual research and data on spiritual practitioners themselves. So we and others have begun to undertake such research, and early findings indicate that when it comes to the use of medication by meditators, the evidence is lining up on the side of pragmatism. Brain and Mind Let’s look first at the relationship between mental states and brain states. We all know that changing the state of the brain— such as by hunger, a cup of coffee, or a tranquilizer—can have The majority of meditators in the study felt that they, and their spiritual practice, benefited significantly from taking antidepressants. The changes they described bear this out. fromTheinsTallaTion“TheBuddhisTmediCineTemPle,”CourTesyofThearTisTandhainesGallery/sanfranCisCo