For example, people come to the clinic with panic disorders, which are usually treated with medication. We don't address their panic or fear directly, we just teach them mindfulness, and they practice that over the course of the eight weeks. Their levels of anxiety and panic drop dramatically over the eight weeks and, according to our later study, for at least three years.
How do you explain that?
Well, something is going on here that reaches the organism as a whole. What it involves is basically training people to watch their thought process as a flow and to step back from it in the way that we were talking about before and not immediately hook the "I" onto it.
Now the people with panic disorder may or may not be experiencing fear at any given moment while they're practicing, because the mind is constantly changing and coming up with this or that. They're simply asked to observe, to be mindful, to stay in the body, and to watch what's going on in the mind, learning neither to reject things nor to pursue things, but just to let them be and let them go.
Because you've been training yourself in the meditation practice to stay in the present moment, and to calmly watch these events in the field of your consciousness, like waves coming up in the mind, you don't get so hooked by the emotional content and you aren't sucked into terror. You realize, "Well, those are thoughts, too," and you come back to your belly and back to your breathing.
In that way, you begin to experience what I mean when I say "your wholeness." You realize that you are more than a body. You are more than the thoughts that go through your mind. And you begin to realize that you're an elaborate universe that's very hard to describe or understand but that is quite miraculous. If you feel comfortable within it, even if you don't understand it, then you can live your life with a greater sense of control, especially in relation to situations that previously might have sent you spinning out of control.
A lot of people are going to think, "Why don't I just relax on the couch instead of doing this exotic, un-American thing? All that mumbo-jumbo about mindfulness—I mean, what in the world is going on?"
When you're lying on the couch and taking it easy, if you watch what's going on in your mind and body, you may discover that it's far from relaxing. You may be doing a lot of thinking, or daydreaming, or worrying, or fantasizing.
Most people don't realize that the mind constantly chatters. And yet, that chatter winds up being the force that drives us much of the day in terms of what we do, what we react to, and how we feel. Meditation is a way of looking deeply into the chatter of the mind and body and becoming more aware of its patterns. By observing it, you free yourself from much of it. And then the chatter will calm down.
When you start focusing on your breathing, for instance, you're giving the mind one thing to do: just ride the waves of the in-breath, then ride the waves of the out-breath. There's nothing magical about it. But as you continue, you'll begin realizing that it doesn't take long before the mind wants to go someplace else. It doesn't want to just stay with the breath. It doesn't want to just experience one thing. It wants to go to a lot of other places, and it wants to think about the future and the past.
Meditation is a discipline for training the mind to develop greater calm and then to use that calm to bring penetrative insight into our own experience in the moment. From that insight comes greater understanding and, therefore, greater freedom to conduct our lives the way we feel would lead to the greatest wisdom and happiness. Now that sounds like a big mouthful, but it turns out that it's a very practical thing to do. It's not at all un-American. In fact, Thoreau went off to Walden Pond, as he said, "to live intentionally, to live deliberately," so that when death came, he wouldn't discover that he hadn't lived. Doesn't that make sense?
Is the purpose of meditation to slow the mind down?
I would say that there is no purpose in meditation. As soon as you assign a purpose, you've made it just another activity to try to get someplace or reach some goal.
But third-party insurance companies are not underwriting the cost of your patients being here for no purpose.
That's true. The people in the program were all referred by their doctors in order to achieve some kind of improvement in their condition. But paradoxically, they are likely to make the most progress in this domain if they let go of trying to get anywhere and just learn through the practice of meditation to experience their moments as they untold.
What does that have to do with stress and healing, which is why they're here and why they're reimbursed?
It may turn out that the deep physiological relaxation that accompanies meditation is, in itself, healing. When I set up this program back in 1989, the idea was to explore the possibility of creating a clinical service in a major medical center that would catch people who were falling through the cracks of the health care system and to challenge them to do something for themselves as a complement to whatever their medical treatments were.
The idea was not to cure them but to help them access their deep inner resources for healing, calming the mind, and operating more effectively in the world, and to help them develop strategies and resources for making sensible, adaptive choices under pressure, coping with stress, feeling better about their bodies, and feeling more engaged in life. We wanted to see whether these inner resources would have any effect on their chronic medical condition and it turned out that they did, and that people improved in many ways.
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