| Jon Kabat-Zinn, Ph.D.
Founder, Center for Mindfulness in Medicine, Health Care, and Society
University of Massachusetts Medical School
"The Healing Power of Mindfulness: Living Your Life as if it Really
Matters"
May 4, 2001
Jon Kabat-Zinn, Ph.D.: I like to think of the word "healing" in
the relationship to curing, as coming to terms with things as they
are. What healing is is a process through which we come to terms
with the actuality of our situation in the present moment. Now,
the beauty of healing is that healing is possible even in the absence
or the very improbable likelihood of a cure -- that the work of
healing can be done right up to our last breath.
There
is no moment that is not appropriate that in some way embracing
the actuality of things that does not mean we have to like them
or that Im talking about passive resignation by any stretch
of the imagination. Im talking about an active embrace with
all of the faculties that we can bring to bear on how things are
right in the present moment; to come to terms with things as they
are. Why? Because in the process of dropping-in on the actuality
of things, then, in that acceptance, we can unlock our potential
to grow. And, sometimes the body has its ear to the rail and is
listening in those moments when we actually accept rather than continue
to struggle or fight with things as they are. And then, lo-and-behold,
the next moment, things actually can shift and change because as
long as we are breathing, our perspective on our patients is that
and we say this to people when they are referred to the Stress
Reduction Clinic, no matter what it is that they are referred for.
And we take people across a very wide range of chronic medical conditions
and even sometimes acute medical conditions. I like to say to people,
"from our point of view, as long as youre breathing, there
is more right with you than wrong with you, no matter whats
wrong with you." We do not have a very good track record with the
dead. There are other people who specialize in that kind of thing,
and thats something else. But for us, we really want to engage
with people who want to move-in on their life while its happening.
And that includes what I come to call the "full catastrophe" of
life.
The
entirety of the human conditions the good, the bad, and the
ugly -- the things that cause us so much pain and so much suffering
and where it does feel sometimes like there is no way out and that
I am stuck and trapped. Whether it is in this body or in this mindset
with these demons, with these feelings of inadequacy, with these
feelings of unworthiness . . . whatever it is when we begin to feel
that there is not possibility for growing. Those are interesting
moments if we are willing to stand inside them. So, from the perspective
of the meditation practice of any kind, meditation is embracing
things as they are through our capacity to pay attention, to actually
become aware of things as they are.
The
first thing to become aware of when you start to pay attention this
way is that virtually every aspect of our experience is colored
by our past experience and by our ideas and thoughts and opinions
about how things are and about what that means for the future. So,
for instance, if you have a chronic back condition and youve
been through three neuro-surgeries and you have not only not gotten
better, but gotten worse, thats a huge thing to have to deal
with. Or a cancer diagnosis: that one day you felt totally fine
and the next day you have Leukemia or a tumor is discovered. Those
are moments of huge turbulence and a complete turning upside down
of ones life an ones sense of self and ones sense
of meaning. And medicine, from the very beginning, has really always
been about the embracing of the person who is suffering with compassion
and with empathy and with the intention to serve from the deepest
place of ones self as a healer or as a physician, as a teacher.
That means in some way, recognizing the sacred privilege of being
able to work with people who are in pain and suffering. And do what
it is we can for them, using all of our greatest diagnostic methodologies
and treatment interventions, but at the same time recognizing that
we are dealing with a whole human being, and that our first calling
is to at least do no harm. And, if we dont recognize the person
as a whole human being, were already in some way doing harm.
Probably
all of you have had the experience at one point or another of going
to some figure of authority (whether it be a physician or a teacher
or anybody else) who did not accord you their full attention while
you had some heavy issue that you needed to communicate about. How
does that make us feel? No matter how good they are in the technical
issues, if there is a certain way in which they are not attending
to you if they are not present for you does that not
feel horrible inside; complete experience of being disregarded?
And so, that has always been an element of the art of medicine.
The art of medicine is honoring the sacredness of the encounter
between the physician, or the healer, and the patient, and knowing
that there is certain element of mystery here, that I can do so
much and I cant do anymore, but I will stay with you until
the end, no matter what that end is.
Now
theres another element here that is becoming more and more
possible with the development of all sorts of new lines of evidence
in the past twenty to thirty years. Understanding that human beings
are actually extraordinary living systems that are capable
of learning and growing and that we sit on top of vast immeasurable
inner resources for learning and growing and healing across the
life span. But, no one ever told us that. That could be introduced
into the partnership between us as clients, or customers, or patients
the recipients of health care, or disease care, because to
a large degree we have a disease care system, not a health care
system. We dont even know what health is. In addition to those
interactions that can happen between the physician and the patient,
imagine if the patient were invited to participate in his or her
healing by tapping into (and learning if one didnt know how)
those deep inner resources for learning and growing and healing
and potentially for transformation so that no matter what dimension
of the full catastrophe of being human was up for you in this moment,
that you had the sense that it was workable, in partnership, and
that you had some degree of sacred responsibility for yourself.
The
army understood this big time when they hired some expensive Madison
Avenue firm to come up with the slogan, "Be All You Can Be." Thats
really what its about realizing that a lot of the time
we diminish ourselves, a lot of it through our own fear or through
our own scars that weve acquired over the course of our lifetime
that allow us to actually believe that we are less than we truly
are. Of course we dont show that to the world most of the
time so we put on a some kind of mask and make it look like we are
just totally with it. But sometimes there is a feeling of loss inwardly
or a feeling of emptiness inwardly that is not so healthy. So, the
notion of mindfulness-based-stress-reduction is that hospitals could
actually create healing environments where people could be referred
by their physicians to do that interior work of looking deeply into
themselves by paying attention; not the interior work of becoming
a Buddhist or becoming anything else except maybe more yourself.
And that, to my mind, is a worthy work and the hardest work on the
planet I would say as well.
Our
experience with over 12,000 patients at the University of Massachusetts
Medical School over the past 21 years that weve been running
this program is that people take to this like ducks to water. We
train people fairly intensively in meditation practice. It is not
some kind of dime store-Donald Duck and Mickey Mouse Band-Aid-type
thing. This is like really living your life as if it really mattered
if your health, if your well being, if your sanity really
mattered. What would you give to tap it in its fullness? Would that
not actually be a worthy lifetimes worth? And is it, in fact,
not something that could be lived, embodied in such a way that it
did not prevent you from doing everything else, but that it in fact
enlivened everything else that you are and did. From that perspective
you might say that the doing that we do can come out of our being
(if we had any familiarity whatsoever with being).
I want
to point out a few interesting things, etymologically speaking just
to sort of tie this together. One is that the words, "medicine"
and "meditation" sound alike when you think about it. In 1979 when
I proposed bringing yoga and meditation into the mainstream of an
academic medical center that was almost conceived like the Philistines
were at the door. We were going to tear apart Louis Pasteur and
Cochran and all of the incredibly hard-won struggles to move towards
a scientific basis of medicine and now all of the sudden you got
ringing bells and meditating and were all going to be a bunch
of weirdos that stand on our heads! But I like to ask the medical
students, "what is the root meaning of the word medicine and doesnt
it in fact sound like the word meditation?" In fact they are deeply
connected. The word "medicine" comes from the Latin, medico,
which means "to cure," but the European root of it means, "to measure".
So what does medicine, or for that matter, meditation, have to do
with "to measure." The way we think of measure is that I get out
my measuring tape and I hold up this external standard and I measure
how wide the arms of a chair are. Thats not the meaning of
"measure" thats being pointed at. Whats being pointed
at is the more platonic notion of measure that everything has its
own right to inward measure. We speak of sometimes the "measure
of the man." Everything has its own right inward measure. So medicine
would be the restoring of right inward measure when its disturbed.
We
can update it and think of it as homeostasis or dynamic health.
Because our health, thats what I meant when I said that we
dont know what health is, the health of a 20-year-old is very
different from the health of an 80-year-old and sometimes 80-year-olds
are a hell of a lot healthier than 20-year-olds, even well 20-year-olds.
Theres a certain kind of mystery, here, while it is very valuable
to understand pathophysiology so that we can really understand what
goes wrong in this system, its also helpful to know what this
sort of outer-reaches of what the system is capable of are. And
that is in some way why we love the Olympics and Olympic athletes
and movement artists who can transport us with how they complete
a movement and defy gravity because in some sense they say you could
do that too, this is what the human body could do. Thats developing
our capacities to the highest possible level. Or imagine if we could
understand health enough to actually shift the scale in the direction
of the highest possible level of health and well-being, say starting
from infancy and moving right through into the very end of life.
We would honor health in every way, shape and form. Medicine is
the restoring of right in with measure using whatever powerful tools
are at our disposal to do that when it is disrupted.
What
is meditation? Meditation is the direct perception of right in with
measure. It is like already here. Your inward measure is already
here. And even if you are suffering from some kind of a chronic
illness or condition, there is a certain way in which that condition
is held in a larger wholeness. The right inward measure that we
attend to in meditation is things as they are. You say, "okay, this
is the measure now. This is how it is." We see that in even being
out of balance, because its dynamic, there is the potential
to bring it back into balance, that we can counterbalance it, that
we can actually flow with even huge amounts of pain and terror and
various elements of suffering in ways that liberate us from the
suffering, that actually you feel different, you feel free of the
condition even though the condition itself is not going to change.
Its an inner shift a rotation in consciousness
to understand that you are larger than your body, even if your body
is missing, say, an arm or a leg or a breast, or an eye, that you
as a human being are still whole. The word, "health," comes from
the root meaning "wholeness." So medicine and meditation, in fact,
both relate to a wholeness. It also has the dimension of "holy"
and "healing," so that they all come together in this way when we
begin to pay attention to how we are whole human beings instead
of just fragmented human beings.
Id
like to share a couple of poems with you, and I share poems mostly
from the western tradition so that you see that this is an element
that is in all cultures (and particularly in our culture). When
you are listening to a poem by Emily Dickinson, you have to listen
especially attentively because she does things with words and with
spacing that no one else did before her or after her. Listen carefully
with your whole being and kind of drink it in with your skin.
Me,
from myself to banish, had I art
Impregnable
my fortress unto all heart
But
since myself assault me how have I peace
Except
by subjugating consciousness
But
since were mutual monarch how this be
Except
by abdication, me of me
One
of the great questions of all the meditative traditions and all
of the psychological traditions and all of the philosophical traditions
is, how much do we abdicate our own wholeness? How much do we, in
fact, fragment and split ourselves off and look in the mirror and
say, "well, thats not me," because its not what you
want to see. Or whatever it is and whatever ways we disregard the
actuality of our being.
There
is another poem by Juan Ramon Jimenez who is a Nobel laureate and
great Spanish poet:
I am
not I
I am
this one standing beside me who I do not see
Who
I sometimes manage to visit
But
at other times I forget
What
were talking about is reclaiming our wholeness. The meditative
traditions have been developing interior technologies to explore
this terrain for thousands of years and they have come up with some
pretty amazing things. But they are really, in many ways, foreign
to our culture. Although, Native Americans would not consider them
at all foreign, native African traditions would not consider it
at all foreign. Some of them have to do with stillness, some of
them have to do with movement, some of them have to do with place,
but they all have to do with presence. They all have to do with
stepping outside of time. And what do I mean by stepping outside
of time? I mean stepping into the only moment that we are alive
in the present moment. A lot of the time, if you start to
pay attention to what is on your mind, you will see that it is all
over the place. Much of the time is spent in the future worrying.
Any of you notice that? You laugh, but it can be a torment. Its
not just worrying about ourselves. If you are a parent, you are
worrying about your children all the time. Or, we are worrying about
the past and how great it was when or why it is this way now. Again,
it can take a lot of our energy to pass over. The future has not
happened now. The only time we ever have to have anything be different
is this moment. But we say, "well, this moment Im busy, so
Ill do it some other moment." And twenty years go by. Twenty
years can go by just like that.
David
White. How many of you know who David White is? Hes a wonderful
poet and teacher (we sometimes teach together). He wrote a beautiful
book called, The Heart Aroused, and he works with corporate
America around issues of work and wholeness and soul. He just wrote
another book called, Crossing the Unknown Sea Work as
a Pilgrimage of Identity. Very beautiful. David White was working
with a group of AT&T executives and he had them writing poems.
One senior manager wrote a poem that went like this:
One
day I turned my head for a moment
And
it became my life.
You
know that one where you get caught someplace and then you forget?
This moment is always a time to come back and remember, rejoin the
membership in the wholeness that you are. No matter what has happened,
it is always possible for us to do that. If you stood in the present,
imagine what the effect would be on the next moment. It would be
huge because if you are not in the present moment, things come at
you, you dont quite know how to deal with them and then the
next moment has consequences because you were not really paying
attention. If you want the future to be different, the place to
work is here and now with things as they are. Then the body has
its ear to the rail and it responds, the heart responds, the mind
responds, and all of the sudden we get into dimensions that have
really been mapped for thousands of years. Its what His Holiness
talks about, the Dalai Lama. Lots of different spiritual teachers
talk about it, but when push comes to shove, they all go home at
the end of the day and you are still the same old person you always
were (and maybe some nice inspiration). The challenge, here, is
to do some disciplined work (and thats what it is work)
or a play. We challenge our patients to actually carve out some
time everyday to drop into being. Who has time for that? You have
to make the time. When I talk about stepping out of time, Im
talking about stepping into this very moment.
I dont
want this to be too weird, but if you are willing, lets just
drop-in on ourselves for a moment or two. I will actually ring some
bells. Notice how everybody is shifting? I love that! People kind
of know, "okay, Im supposed to look a certain way or feel
a certain way." My sense of reading the room is that people sat
up more. Kind of get a little more alert. We know that the body
actually has its own language. What I like to say is that for sitting
meditation, and sitting meditation is not what meditation is really
about. Meditation is about being entirely who you already are. There
is not place to go, there is nothing to get, there is nothing to
fix. It is about opening to the full spectrum of who you are right
now. And, understanding who you are right now and understanding
or seeing the interconnectedness of things. This brings up tremendous
compassion including self-compassion and also wisdom. But, you dont
have to go anywhere because you are already whole. If we recognize
that, the healing would be in this very moment and we move from
here.
So,
I will ring some bells. What I would invite you to do is to sit
in the posture that embodies dignity, whatever that means to you,
and to follow the sound of the bells, such as it is, into silence.
And
if you care to, you can allow your eyes to gently close (although
that is not necessary). See if you can allow your mind to alight
on the breath as if you were coming upon a very shy animal sitting
on a tree stump in a forest clearing, with that kind of gentleness.
Or as a leaf might flutter down to the surface of a pond and then
ride on the waves of the in-breath and the out-breath. Just give
your attention over to feeling the breath moving in your body. Let
that be center stage in the field of your awareness of this moment.
Just feel the full duration of the breath coming in, and the full
duration of the breath leaving the body without having to do anything.
You dont need to do take over the controls of breathing. Its
been doing it just great all morning. You are just basically surfing
on the waves of your breath with full awareness, riding on the waves
of your breath, feeling the sensations of the breath in your body
either at the nostrils or, more indirectly, the gentle expanding
of the belly on the in-breaths and the receding of the belly on
the out-breaths. This seems so simple. It is simple, but it is not
easy. The taste that I have given you is simply that a taste.
This is an incredibly rich adventure into this domain of the internal
landscape. But, mindfulness can be brought equally well to the outer
landscape as well, so that ultimately we understand that there is
no outer and no inner; there is no fragmentation whatsoever. We
can reside in our wholeness moment by moment. Or if we lose it,
we can come immediately back to it because it never leaves. From
that point of view, any moment is a great moment for dropping-in
on yourself, and any place is a great place for doing it, for being
yourself. In moments of great difficulty, of great stress, of great
trauma we can bring this kind of attention right to those moments.
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