Contemplative Healthcare | Contemplative Healthcare Talk on Meditation by Father Laurence Freeman Delivered on Friday, 4 March 2016 At the Star Performing Arts Centre, 1 Vista Exchange, Green, Singapore 138617. To the Hospital staff of SengKang Health, SingHealth  About the Speaker:
Born in 1951 of English and Irish ancestry, Fr Laurence Freeman OSB 1951 is a Benedictine monk. He was educated by the Benedictines in England and studied English Literature at New College, Oxford University. Before entering monastic life, he had work experience with the United Nations, banking and journalism. He learned to mediate with Fr John Main, one of the great spiritual teachers of modern times. In 1975, Fr Laurence Freeman joined Fr John Main in London and collaborated in the foundation work of what has become a worldwide network and community. In 1977 he went with Fr John Main at the invitation of the Archbishop of Montreal to establish a Benedictine community of monks and laypeople dedicated to the practice and teaching of Christian Meditation. Fr Laurence studied theology at the Université de Montréal and at McGill University. He made his solemn monastic profession in 1979 and was ordained to the priesthood in 1980. In 2010 Laurence Freeman was made an Officer of the Order of Canada by the Government of Canada in recognition of his work for global peace and inter-religious dialogue. Fr Laurence is the spiritual guide and director of the World Community for Christian Meditation (WCCM). He leads Meditatio, which is WCCM’s outreach programme, to bring the value of meditation in an inclusive and creative way to the worlds of business, education, medicine and inter-religious friendship as well as to the marginal and under-privileged. In the field of medicine, Fr Laurence has helped develop a training programme for clinicians in “Health and Meditation” with the Royal College of Physicians in Ireland in partnership with the Health Service Executive of the Irish Government. He is collaborating with Dr Barry White (Dublin) and Dr Peter Smith (Sydney) in establishing an international Faculty of Contemplative Medicine. The aim of this programme and the Faculty is to improve the health of patients and clinicians by supporting clinicians to embed the practice of meditation in their lives and use the benefits for a deep sense of peace, situational awareness and personal insight to improve their clinical practice and the system in which they work.
SESSION ONE - MEDITATION Introduction It is a wonderful pleasure and privilege to be here. Singapore has become a home for me in Asia and is a second home to me in many ways. I am a Benedictine monk and I have two monasteries, one within another: a physical monastery with walls and another monastery without walls which is a community that has grown up over the years through the practice of meditation. This is the 28th year that I have been coming to Singapore and I have been coming two to three times per year. Singapore is such a dynamic society that is growing, building more buildings and reclaiming more land from the sea and with new visions. It was a great pleasure for me to get to know Mr Lee Kuan Yew in his last years. I was fascinated by the role he played in the development of Singapore and it was wonderful for me to be able to meet him in the practice of meditation in the last years of his life. I find it very inspiring and delighted to be invited to make some contributions to the evolution of this new paradigm of Contemplative Healthcare which is also happening in other parts of the world. When a new model begins to develop it is always interesting to see how it springs up in slightly different ways but with the same spirit in different cultures at the same time. Contemplative Practice In this session I am going to focus on contemplative practice. "Contemplation" is a beautiful word. It has many different meanings. I like to begin by putting forward an excellent commentary from the I-Ching (易經) - the Hexagram 20 on Contemplation (觀) “The sacred rites in China began with an evolution, the cleansing by which the deities were invoked after which an offering was made. The moment of time between these two ceremonies was the most sacred of all; the moment of deepest inner concentration.” I thought of that when Dr Christopher Cheng spoke of the music that Yong Siew Toh Conservatory composed and we listened to as we entered the hall here. The importance of seeing the value of the silence between the notes is that, if there is no silence between the notes there is no music. If there is no space between the words on the page, it is very difficult to read and to make sense. So, this is one way of approaching the meaning of contemplation – that is leaving silent space between words, between actions, between signs, and it is fully integrated into the ordinary activity of life. That is one of the important things I like to share with you - the contemplative dimension of life and of consciousness, and that contemplation is a part of life. If we don’t respect the role of contemplation in life, life becomes quickly unbalanced and out of control.This is how the I-Ching continues with its commentary:
“It is by the power of deepest inner concentration that contemplation develops in great people, strong in faith, so that they can understand the mysterious laws of life and give expression to these laws in their own persons. In this way, there emanates from them the hidden spiritual power that of itself influences others without their being aware of how it happens.” Now, you are clinicians. You are concerned with relieving suffering, saving life, enhancing the quality of life and allowing people to live life to the full. To do that I think the contemplative consciousness or the contemplative awareness, in the way it is described by the I-Ching here, is extremely valuable. It gives you, even without your knowing how, that quality of relationship with community, of communication, empathy and compassion which is at the heart of the healing process. We will talk more about that and reflect on that later during the day, but I want to begin by emphasising the universality of this vision here, from the ancient Chinese tradition that I have quoted, and similarly, from any other of the great Western traditions.
Meditation This morning I like to be very practical and share with you a contemplative practice – the contemplative practice of meditation. It is not the only contemplative practice. There is a great range of them but it is a particular and universal contemplative practice that has touched and changed my life over the last 40 years, and which as I know, touched and transformed the lives of many people around the world. This is a universal wisdom and a universal practice. I think one of the things we need in the modern world are things that are universal; things that are deep, authentic, personal, real, but also things that have the capacity to leave us with a common ground of humanity. There are too many divisions, too many competitions, too many brands and too much sectarianism. What we need to heal the modern world is this experience of union, of unity, of communion, and meditation certainly is one. Music is another one. And I must say the healing arts that you practice as part of your profession are also one of those things that allow human beings to realise and to celebrate the unity that we are a single human family with a rich diversity of culture and tradition and wisdom, but fundamentally united. So I think meditation is a very important and central way to discover and realise this healing experience and unity in a divided and fragmented world. When I was first introduced to meditation, I was in my first year at university. I wanted to go and visit my teacher, John Main, Irish Benedictine monk, whom I met when I was in Boy’s School. I went to see him so that I can speak about problems you have when you are twenty. He was a very good listener and a very wise counsellor. So he let me speak and we discussed, and at the end of one of our conversations he introduced me to meditation. It was quite unexpected. I wasn’t asking about meditation and his way of describing it and presenting it to me was a very light touch. It wasn’t a heavy sell. It wasn’t “You got to meditate!” It was just an opening, like opening a window or drawing the curtains to let the light in when you thought there was only darkness. When he spoke about meditation it had a very immediate impact on me, but at two levels. At one level, it made no sense to me at all! I was studying English literature at Oxford, and I was very much on an intellectual search for the Truth, and meaning was very much in my head. I wanted solutions and answers at that level. So when he spoke about meditation as a way of going from the mind to the heart, and meditation as a way of leaving thoughts behind, I wondered what he was talking about! How can you stop thinking? If you stop thinking you are either drunk or dead! (laughter) So intellectually it made no sense to me at all. However, at another level, which was being awakened at that moment for me at that level which I hadn’t fully appreciated before, and which I can now name as the level of the heart, I knew what he was saying was completely authentic. It is not often in your life that you know for certain you are in the presence of authenticity, that you can just trust it. I also have this intuition that what he was saying was real, true and he put no demand on me. It wasn’t an obligation; it was not “You should do this.” It wasn’t like that at all. It was just discovering something wonderful that you haven’t realised that it existed before. You don’t know what it exactly is. One other thing happened as a result of that communication, and that was awakened within, is this hunger for the knowledge or experience that meditation seemed to promise. I really wanted to know what it was about. I said knowledge or experience. It was a useful word but it was a different kind of knowledge from the knowledge I was getting through books, or from my teachers, from dialogue, discussion and debate. It was a different kind of knowledge, but it was knowledge. It was experience but it wasn’t the kind of experience that you can just put on the microscope, nor the experience you could just analyse and define. So, it was knowledge and experience but it was a different kind, and that is what I mean by contemplation.
Finding Oneness Contemplation is knowledge and an experience. It is a process of discovery and finding oneness - that unity I was speaking about. You can say it is knowledge and experience of what is - the truth. Now, we say we know what the truth and what is. But do we? We make mistakes, we make bad judgments and our view of situations can be very distorted by our prejudices, our fears, our anxieties and our ego. We are more concerned with “How am I going to look in this situation?” rather than “What is this situation?” We can be very distorted because of competition, because of fear, because of stress, because of all sorts of delusion. So it isn’t so often that we actually do have experience and knowledge of what is. They are very special moments and when they happen we don’t need anybody’s approval. We know this is it - it comes with a sense of wonder, a sense of humility and a sense of joy. I felt, when I was first introduced to meditation, that I didn’t understand all these, and I don’t know if I do understand it even now (chuckle) … but I can talk about it as well as I could. But this knowledge and this experience is what it seems to me to be opening as a possibility, and I deeply desire a hunger for this. So I tried to meditate and I was a disaster - a complete failure! Sometimes people kindly introduce me as an expert on meditation but I don’t know what that means! I certainly believe in meditation. From my experience and from my knowledge I shared with others this journey for many years. But the kind of knowledge and the kind of experience we are talking about is not about mastery; not about becoming an expert. It’s not that you have to practice for ten thousand hours before you become an expert. I probably have done more than ten thousand hours of meditation easily but I don’t think the term “expert” applies to this kind of knowledge or this kind of experience. Many of you are experts in your particular fields, such as Haematology, Urology, and Pathology etc. You worked hard, you acquired knowledge, you got experience and that is of great value to the people you serve. This is a different kind of knowledge, and a different kind of experience, but it is completely compatible with the other kind of knowledge and experience that we deal with in daily life. Contemplation, as I have said, is part of life. It enriches and brings to the full potential and brings colour, meaning and clarity to everything that we find in our daily life. So that was my introduction to meditation. I tried to meditate and it was simple. John Main introduced it to me as a very simple practice. Meditation over the last forty years has to me become even more simple, not less. My own life has been about trying to practice and to share the simplicity of meditation. I wish I can say to you that simplicity is easy and that meditation is easy, but I can’t.
Learning Meditation I will be teaching a course on meditation with Mr Ng Kok Song at Singapore Management University, to the MBA students on “Meditation and Leadership”. We start tomorrow. At the beginning of the class I am going to introduce them to meditation. I imagine they will be in their late 20’s or early 30’s. They have taken time off to do this degree so that they can improve their value in the marketplace. Perhaps they also want time off to reflect on the meaning of their lives. One thing I am sure they all have in common is that they want to succeed, and to succeed better. Who doesn’t want to succeed? Who wants to fail? Failure is universally a bad thing; it’s like getting a flu. Nobody wants to get a flu or to get cancer, but, it is a part of life too in getting a flu and getting sick. We can learn from those unfortunate painful experiences. They are not unmitigated disasters. They are part of life. I’ll talk more about this in the second session. So is failure. This course that I gave in Georgetown University in the States and one of the students said to me at the end of the course a few weeks ago: “This is the only course that we’re told that it is okay to fail!” (laughter) So it is great that they got that because our approach to failure is a very important component of growth. If we don’t know how to fail and how to accept and understand what failure means, we won’t learn anything. If I were to try to learn Cantonese, I would be pretty certain that I’ll be in for many years of failure. I would probably be a permanent failure at it; I’d never be a master of Cantonese. However, I might be able to communicate and enjoy the learning process because it would give me access to a world of culture and communication that would otherwise be closed to me. So failure is a part of learning. This is a very important element in learning to meditate. If you think of meditation as a technique, knowledge or experience you are going to be a master of, then I would say: “Take up golf instead” because you will probably be more satisfied by your mastery of golf than you would in this way. So I like to speak a little bit more about the practice of meditation and then I would like to invite you to experience it and practice it together. Then we will have time for questions and discussion. The reason why it is important to have a meditation period here is because meditation is experiential. It is not theoretical. It is like learning a bike. You could look at all the YouTube videos in the world and all the manuals of cyclists. You could learn about all the mechanics of bikes but you will never know or learn what it is to ride a bike unless you get onto a bike and do it. I remember the first time I got on a bike, I was very young and I was all excited to get my first bike. I jumped on it and I imagined I would be able to ride it without difficulty and I drove straight into a lamp post and knocked myself out. Fortunately my brother was there beside me and getting a little bit impatient with me. He said, “Get back on.” So I got back on and fell off again repeatedly. One day I managed to keep my balance and I thought, “It’s fantastic, I can keep my balance.” It was a fantastic feeling of mastery, but I was still holding onto the bike with my hands like this. I wasn’t really enjoying riding the bike. Then I saw some older friends of mine showing off, riding their bikes without holding onto the handlebars. That made me realise I was still a novice. I have not ridden a bike for quite a while since but I am pretty certain I can get onto that bike now and ride it in Orchard Road without much difficulty. (laughter) So meditation is a bit like that. It is something we learn from experience and part of the experience is going to be the feeling for failure. If you do not like failure and do not like the face the learning process, then don’t meditate, because meditation is more than a technique that you master. It is actually a big word – discipline.
Meditation as a Discipline I was talking to a young woman the other day and who was coming over for a meditation retreat for the first time. She seemed to have got it and wanted to practice. I met her a few months later. She was among a group of meditators whom we have in London and I asked, “How’s it going?” She said, “It’s going well. I meet with this group every week and that has been really helpful to me to be able to meditate with other people. I am doing my best to meditate every day, like you said, morning and evening. Sometimes I do it twice a day for two or three days and I fall off the wagon and I give up for a few days or a week and I come back to it.” Then she said something that struck me very deeply. She said, “I am so grateful that I have found a discipline.” That is an expression of something very deep in our culture today - our global culture. We are a technological civilisation. Medicine has become increasingly a technology. The art of healing has, in many cases, been subordinated to the technology of Medicine. The discipline of meditation means that it is a process of learning. The word “discipline” actually comes from the Latin word discere which means “to learn.” So I would never learn Cantonese unless I accept the discipline of it. You would never have become the professional experts that you are if you have not had a discipline and applied yourself to your studies and to your practice, with many years of preparation, training and challenges in order to achieve your position now. You were quite prepared to accept your discipline of medical studies and the training. You were quite prepared to accept the discipline and to accept it over many years. You were quite prepared to practice patience. Why? Why did you feel attracted to a way of knowledge? A way of experience? A way of service? A way of compassion for your fellow human beings that you knew was going to involve many years of challenge - uncertainty, exams, long nights and periodic failures? It was because that was your calling and your vacation and that was what you wanted to do. Your commitment to the discipline of Medicine touches the very depth of your identity and your meaning in life. So the first thing I like to say about meditation is to see it as a discipline rather than a technique. There is a technique aspect to it but what may begin simply as a technique will evolve into a discipline as the practice becomes part of your life.
Meditation as a Wisdom Meditation is a universal spiritual wisdom. You find it in all the great wisdom of traditions. It has been subjected to rigorous medical, scientific, psychological and neurological research since 1931. That was when the first scientific study of meditation was published. Meditation has been around for a good deal longer than that. It is important for us to know that it does grow out of this long ancient wisdom of humanity. Of course, we can study it with the tools of science and learn something about it and about ourselves, but let’s not forget that it is essentially a wisdom practice, as the I-Ching understood. The word medicine and the word meditation have something in common, which is the prefix “med”. In Greek, that prefix suggests care and attention. That’s your work as clinicians: to give care, to be careful, to be caring, and above all, and this is what Contemporary Healthcare means – to give attention, personal attention. Machines can perform tasks, but only human beings can pay attention. So meditation is about care and attention. First of all, practiced for ourselves, meditation leads to a spiritual subtleness, a spiritual other-sensitiveness and a spiritual altruism which is the meaning of happiness. No self-centred, egotistic, self-referring or self-fixated person is going to be happy, but in a real sense we are caring for ourselves when we meditate. If we can’t care for ourselves, we wouldn’t be able to care for others. If we have no compassion for ourselves, we will not have much chance to be compassionate to others. Meditation then, is a work of attention. What are we paying attention to? We are letting go of our thoughts, laying aside our thoughts. That was what I couldn’t understand when my teacher first spoke to me about meditation. The work of meditation is to lay aside our thoughts. Thoughts continuously arise in the mind. We are continually dealing with a mobile and hyperactive mind, often a mind that is full of compulsive thoughts, sometimes even very negative patterns of thoughts that seem to control us and can’t get out of our head. We get stuck in certain feelings, certain moods or certain obsessions. The mind is a challenge when it comes to meditation. All the great wisdom of traditions says that the first thing we have to do is to help the mind come to a greater stillness with clarity and freedom. Think of the thoughts of the mind as like waves pounding on the seashore. Sometimes the waves will be very gentle, lapping on the shore in a quiet way. At other times it will be like a tempest or typhoon. Whatever kind of wave, or whatever kind of thought the mind is experiencing at the time of meditation, we gently let it go. It means we take the attention off our thoughts.
Meditation as a Technique Letting go of our thoughts is not as easy as it sounds. The mind is full of this continuous activity of waves of thought. There was an Anglo-Saxon king in the 8th century called King Canute and his advisers were telling him that he was a great king, so powerful and he could do anything he wanted to. He was wise enough to know that they were just flattering him and they continued to tell him that he was the greatest king ever. So he said, “Take me down to the seashore.” So they put his throne right at where the waves were coming in. He sat there as the tide was coming in and he said to the waves, “Go back” and the waves kept on coming. That was his lesson to his flatterers and courtiers that he didn’t have this supreme power. So it is not so easy to take the attention off the waves of our thoughts, but we can do it. This is the practical wisdom of meditation. There is a way for us to do this. The way I like to share with you, is the way that I practiced and the way I learned – it is a method of meditation, a discipline that you will find in different forms but you will find in all the great spiritual wisdom traditions - that is to take a single word, a meditation word or a mantra, and to repeat this word continuously in the mind during the time of the meditation. When the waves doesn’t obey you and go back, you return to the word. This is the discipline. It will also give you a new understanding of fidelity. I will talk about healing and faith later in the day. So we sit down, sit still, close our eyes and we begin to repeat the word gently, without force. This is not a big ego trip. So don’t use too much force. You use only enough effort to say the word. Stay on the bike. Say the word gently without force, say it faithfully. This means when your mind wanders, and you are thinking about your problems, your planning of what you are going to do, your reviewing or analysing what you’ve done, your thinking about what you saw on television last night or what you should do this evening. When those thoughts come and they attract your attention, you let go of the thought unfinished, unsolved and you come immediately back to your word, your mantra. That is how I meditate and how I would share it with you. Over time you will find that practice becomes more familiar. You will notice that it has a calming effect on the mind. The thoughts are still there but they are more in the background of your mind. They don’t interrupt you so often. At times you may even have meditation periods of great serenity. You may find that you have these times of clarity and peace. You will be in touch with your true nature. As the Dalai Lama says, “Our true nature is compassion.” So there will be times when meditation does bring you that great feeling of peace and harmony. At other times, you’ve got problems at work, you’ve got problems at home, you’ve problems in yourself and you will be full of problems and distractions. But the discipline of meditation and the simplicity of it is that you say your mantra throughout that meditation, whether it is a good meditation or a bad meditation. In fact, if you do that, you wouldn’t worry about whether it is good or bad. This is something else that you will discover here finally - this is one thing in your life where you are not being evaluated. You don’t have to evaluate yourself. You’re not being graded; you are not being measured. Your salary is not dependent on it; your reputation is not dependent on it. Here is a wonderful space where you can just be. This is what contemplation means. Meditation is a contemplative practice. Contemplation is about being. First be then do. You can’t do anything until you exist. Work on the quality of your being. Have the ability just to be. That’s what meditation is. Be yourself; be now – not in the past, not in the future and not in fantasy. Be now and be here. This is what contemplation means. It isn’t that fantastic a skill, if you would call it a skill, to bring to your relationship with your patients. You can be with them, here and now. You will do a better job of healing when you are in that kind of a relationship. Meditation is a very simple practice. It is the practice of paying attention, giving our attention, laying aside our thoughts or waves of the mind whatever they are, and even good thoughts. You may get some really good solutions to your problems during meditation, or some really beautiful lines of poetry, but if you want to be a meditator, drop them. Let go of those good thoughts as well and you will find something even more rich and wonderful.
Why Meditate? We see that meditation is more of a discipline than a technique. We will talk a bit more about the benefits and fruits of meditation later. So, why should you meditate? If you want a scientifically authenticated reason to meditate you may say I want to lower my blood pressure. It is good for the cardiovascular system and now it is also proven to be good for the immune system. It will reduce your stress and it will help you to sleep better at night. It will help you to deal with addiction. It is very helpful in recovery from depression. In all the research that has been done, one researcher said to me the other day, we haven’t found any negative side-effects. So, if that is your motivation in the beginning, why not? Begin in that way for that reason. But be open. Many of you have high levels of stress and anxiety in your life. So maybe your first goal is: “I don’t care about where meditation comes from, I just want to reduce my stress without having got to go on medication.” But then, what happens when your stress is under control? What do you do then? What is life about? What is life for? What is the meaning of life? Are you are actually enjoying life in this new stress-free condition you are in? Just be open to the experience of meditation will unfold for you. See what comes. It will be very interesting. It would be an experience that would transform your life and would bring to you the great question of meaning. There is no life purpose without meaning. How you make and express the meaning in your life is different for each of us. Some of you will have a religious or spiritual way of making meaning. Others will have different ways. So there is a meaning in the practice, and it is a daily practice. If you want to meditate and make some progress in it, I would recommend that you take up the practice as a daily practice and work towards meditating twice a day. It might sound setting the yardstick too high, but it is possible and many people do it. Many extremely busy and stressful people meditate twice a day. Early morning and early evening are the ideal times to meditate. We will talk about this later, but this is one aspect of the discipline. So, stand up and stretch yourself a bit ... (audience stands)
Mind-Body Connection Meditation is something that touches both the body and the mind. The word “attention” comes in relation with the word ‘tendere” which gives us the meaning of stretching. When we pay attention we are stretching and opening ourselves. So just stretch yourself a little bit, feel your feet on the ground. Your body is solid and has gravity. It is being pulled to the centre of the earth. You are on this planet, not just in your head; you’re also in your body. The body is always in the present moment. If you ask the body the right questions, it will always tell you the truth. The body never lies. The mind is a little trickier. We don’t know half the time what we are thinking, what we believe or what we want to do, because the mind is rarely in the present moment. Meditation as a contemplative practice is simply being in the present moment. So allow the body to being held to you in meditation by anchoring the mind. One of the most obvious ways in which the mind and the body are connected is through breath. Just be aware of your breathing. We breathe about 20,000 times a day. Just be conscious of about 2 or 3 of those cycles of respiration. You breathe in the gift of life, and, because it is a gift, you let go. Keep your attention on that cycle of breath. Don’t have to force yourself to breathe. Meditation is as natural to your mind and spirit as breathing is to your body. Allow the body to anchor the mind to connect the body and the mind. Relax your shoulders. Relax the muscles of your face. If you feel any tension in your jaw or forehead you can let it go. We are doing nothing more than to allow the body to stand as it is engineered, to stand and give ourselves the time to be in the present. Okay, you can sit down. (audience sits) So, take a moment to sit with your back straight. Put your hands on your lap or your knees; your feet flat on the ground. Relax your shoulders. Your body is feeling dignified, alert, but also comfortable and relaxed. Close your eyes lightly. Choosing the word you say is important because you stay with the same word all the way through the meditation from the beginning to the end and from day to day, with each meditation. In your mantra, the word becomes rooted in you and it becomes a wonderful companion as a contemplative friend. I suggest you choose a word that is not in your own language. I suggest you choose a word that has four syllables because that is easier to say in a rhythmic way. These are secondary issues but important. I would suggest taking a word that has a calming sound. The word I would recommend is a word whose syllables are actually universal syllables present in the meditation words or mantras of many traditions. It is a sacred word in my own tradition and the word is MARANATA. You say it clearly and articulate that word in the mind gently, remember faithfully, attentively and simply, not analysing ourselves, not evaluating but just doing it. We teach meditation to children and children teaches us how to meditate because they take to it simply. So we choose this word MA-RA-NA-TA and listen to the word as you say it. When your mind wanders and you get caught up in your thoughts, you can come back gently and faithfully to your mantra. Whatever word you choose stay with the same word. Give it your faithful attention. We will meditate now and end with a short discussion. (Silence 15 min)
In other words, meditation is not only good for you, but good for the people you come into contact with. It is time for questions now.
Questions: Audience: When you are in the period of meditation, it is kind of easier to focus the attention on the being, and then you stop and you carry on with life throughout the day. How do you carry the kind of contemplation throughout the rest of the day other than the period you are meditating?
Fr Laurence: That’s very important. If meditation were only valuable for the period you meditated, it would just like recharging a battery. There is more than that. It brings about a change in you, meaning if I recharge my mobile phone it becomes the same as it was before. With meditation we change. We certainly get energised. One of the reasons for meditating in the evening is that you will enjoy the evening more. So it does energise us and recharge us but it also changes us. We develop a contemplative mind, a mind that is capable of remaining still in the midst of activity, calm under pressure and clear when you are in a confusing situation. This isn’t by effort of the will. It is a natural process of change. You can say in some way it is a recovery of the natural nature of our mind, such as with children. Of course, we are not children but we recover it at a higher level of our development. It works because we are one person. At any time of the day or night, or any time of our life even, we are the same person. We are constantly changing but we are the same person. What happens is your meditation has an effect on you when you are at work or when you are doing anything else during the other 23 hours of the day. There is a change that takes place in you during that period of meditation. This becomes much more real of course when your meditation is regular. If you are meditating once every six months you may have to wait a long time before you see the benefits. But as you build a regular discipline in your life, the benefits become more evident. You may not even be the first person to notice it. It may be your husband or your wife who says to you, “You know, you are much easier to live with!” (laughter) Or your colleagues at work will say that you are very patient under those very difficult conditions! They may surprise you and you actually say, “I was?” There was once many years ago when we started the meditation service in London, a man who used to come every week to the meditation group. He was always complaining that nothing happens in his meditation. One week he didn’t turn up. So we thought - Ah, he’s given up! Just before we’re leaving he turned up and said, “I got delayed coming here because as I was leaving my house driving my car in the drive, some kids in the neighbourhood staged a little accident and they said I ran over their bike. They were saying you got to give us compensation or we will call the police." It was an unpleasant incident. He said, "Okay, call the police or call your parents." He handled the situation very calmly and the kids of course backed down. What then amazed him was that he realized how he dealt with the situation, because he said, “Six months ago, I would have exploded. I would have lost it completely. I just want to come and tell you something has happened with the meditation!” The other example, which is a more practical and more technical one is that you will find meditating in this way with the mantra that, at other times of the day, when you have interludes or transitional moments, such as waiting for the lift or in between appointments, you can find the mantra very naturally arises in your heart and it makes a connection with that peace which is within us. So it can be a great reminder and encouragement in the midst of our activity that we are still centred in this ground of being and experience of joy and peace. So I think it is a natural process but it becomes very evident. Thirdly, you may find and notice that there are some things that you do in your life which are unfruitful. People often say, “I don’t have time to meditate.” Somebody said that to me once. We were talking about how she used her time. She said she would come back in the evening. We were describing her routine and we asked, “What were you doing during the hour and a half?” She looked a bit embarrassed and said, “I play games on my computer.” So I said, “Wouldn’t that be a good time to meditate?” You will notice ways in which we fritter away our time on things that are not really useful. You will begin to realize, “I don’t really want to do these things. I am only doing them because I don’t know what else to do.” Or, it is just escape. We do lots of things and waste a lot of time just escaping. Stressful people can be particularly prone to this. So, your meditation will make you more mindful of how you are spending your time.
Audience: I have two questions. For beginners how much time do you suggest they spend in meditation? How do I know I am meditating and not spacing out and dozing off because I think there are moments that I thought I was in a quiet mind, but it was actually a sleepy mind.
Fr Laurence: I would recommend 20 minutes as a standard meditation time. I would suggest set the time, stick to the time and don’t cut it short. That would help you to develop a routine and a discipline. If you find 20 minutes absolutely impossible then do what you can … 15 min, 10 min, or 5 min or 30 seconds (laughter). The important thing is to establish a regular practice. If you were to meditate for just 5 min you will find you are just beginning to see the effect of calming the mind down. If you meditate for 20 min you are spending a good deal of that time to allow the mind to settle, to clarify and to lay aside your thoughts. Then you might go into a deeper tranquility and serenity towards the end. So, it takes time to bake a cake and you will have to respect the laws of your own mind and the laws of your own body. Do what you can, but do it in a disciplined way and a regular way. If you can only do 5 min, do it but maybe every week add one minute to it, so that you build up your resilience. Meditation will make you more mindful, more aware of your mind and your responses to things. So you will see the difference being in a drowsy state and being alert and an awakened state. Feeling drowsy is a very natural thing especially if you do not get enough sleep, or if you are meditating at the wrong time of the day, or if you are meditating after a big meal. Meditation as we know from the medical research is relaxing to the brain, body and muscles. As relaxation takes place, the tendency is for you to drift off. So you need to balance the relaxation with the quality of the alertness. The first way of developing alertness is your body - your posture. Sitting still is very helpful. It teaches you a lot, just this discipline of physical stillness. It teaches you to be alert.
SESSION TWO - HEALTH AND HEALTHCARE
Introduction I have learned a little bit about what is happening in the medical world globally especially through the connection I have with the Royal College of Physicians in Ireland where for the last three years I have been developing and expanding my programme for bringing meditation to healthcare professionals with the support of the government and the establishment of a Faculty of Contemplative Medicine which is being inspired by Dr Barry White of the College of Physicians. One of the things I have discovered is that a new paradigm in Medicine and a rediscovery of health is on the way. At the heart of this phenomenon is an important question about the meaning of health. What is it? How do we promote it? How do we understand it? This is the World Health Organisation’s definition of Health:
Have any of you experienced that? If so, for how many seconds? (laughter) I think it is an interesting definition but it is also completely unrealistic. What does it mean? It is about suffering; it is about pain; it is about death. Are we unhealthy when we are suffering since suffering is an inevitable part of life? So we want to relive suffering but there is a long period in the time of our life where there isn’t, either mental, physical or social suffering. So I think what is happening is that a new understanding and a new definition of health is emerging. Here in Singapore, we are seeing a particular and very inspiring awakening to this question. Why should we be even concerned about this question today? So that we know what health is? We have fantastic technology; we made unbelievable advances in the extension of life and the quality of life. Life expectancy is increasing by two and a half years every ten years. So why do we question the meaning of health? I think that is because we have made so much progress technologically, scientifically, medically but that progress has brought immense complications and dangers with it. One of the characteristics of modern world is the speed at which we are changing. As modern people we accept change. In ancient societies, change was regarded as dangerous and undesirable and everything was done to avoid change to keep the society stable and status quo. Today what makes us modern people is very much that we are caught up in change and we expect change and we desire change. But the speed of change has overwhelmed us. It is happening faster than what we can cope with, and faster than we can integrate the effects of it. So I think perhaps that is the basic reason why we need to understand the meaning of Contemplative Healthcare which is an alternative to that WHO definition. Modern Medicine perhaps began with the scientific method, Descartes and the Cartesian approach - the dualistic approach which has produced amazing results. For thousands of years a common form of medical treatment was blood-letting. I think the last textbook on blood-letting was actually written at the beginning of the 20th Century and as we now know it is completely and totally useless. It did not make anyone live longer or feel better. It was the great orthodoxy, the great assumption. Since then we have been able to achieve for example, 99% cure in childhood leukaemia. So the progress in the technology and scientific application of Medicine is not something we want to lose. We do not want to go back to the dark ages of blood-letting or a high infant mortality. But how do we deal with the complications and the dangers that have resulted from our very rapid development and change? What are these problems? Well, one of them is financial. Some economies are being threatened to bankruptcy because of the cost of healthcare - 15% of GDP in some countries. It is a very wasteful industry; 30-40% waste is not unusual. Then there are other aspects of modern Medicine which are causing concern to the medical profession. There is somewhere in between one and 400,000 avoidable deaths due to medical errors in the USA alone. 4% of all hospital admissions are due to medical errors. Only 50% of chronic disease patients are on the right treatment; there is 50% non-compliance with prescriptions. At the more personal level, there is in many parts of the developed world, growing public dissatisfaction with healthcare. More and more are feeling there is a lack of relationship with the caregiver and a lack of compassion.
Self-Care, Self-Compassion and Health of Healers Then of course there is the question of self-care. As a doctor- friend of mine said to me recently, “If a man comes to see me who is clearly overweight; he does no exercise; is drinking too much, smoking and he sits there and he says, Doctor, I am not feeling very well. What can you give me? So what do you give to somebody who is not going to take proper care of himself? Give him something to make him feel better and come back next visit? Or do you perhaps give him a gracious gift that you can give – which is the gift of your intelligent and compassionate attention? That’s what I like to speak about because I think that is a part of what I mean by Contemplative Healthcare. This is something that first of all, applies to the caregiver, to you. In many parts of the medical profession it is not unusual to find a rate of 50% of burnout, with high levels of stress, addiction and suicide among medical practitioners. So these are the complicated and stress conditions in which we find ourselves today, and in which the idea or vision of Contemplative Healthcare is making its appearance, and a difference. The speed of change, the rapidity of new diagnosis, new forms of treatment are happening so rapidly that it is difficult to incorporate them. The complexity in stress involved, in running the kind of system and understanding that a lack of awareness, a lack of simple presence is what means to this devastating loss of compassion at the heart of healthcare. I like to suggest to you that any understanding of health or the meaning of healing must involve this essential element of compassion. Without compassion there may be a cure but there is no healing. I like to come back to that distinction between curing and healing. Seventy percent of healthcare costs today are due to chronic disease. Many of the conditions that you have to deal with on a daily basis are due to stress and psychosomatic problems. As one doctor told me - someone came to see him with pain in the chest. He gave him all the tests and measurements and at the end of the day still unable to find out what is the cause of the pain. So he diagnosed him as “non-cardiac chest pain” and that makes the patient feels so much better! (laughter) We have to look at another area where compassion is particularly important, and that is the end-of-life care. So much of the medical procedures and treatments that are applied in the last stages of life are useless and futile. Perhaps the reason for that is simply that the definition of health implies that there is no death, there is no suffering and there is no loss. In other words, the human condition can achieve health in this Platonic and idealistic way. That is simply untranslatable into good medical practice. Any true healthcare has to take into account of our mortality, our suffering and the role of the caregiver and the clinician and does not end as the end of life approaches. It does not end when the power of science and technology seem to have failed. I think it is time with this new Contemplative Healthcare mentality to focus first of all on the health of the healers, on your health, on the health of the mind, body and spirit that you bring to your healthcare. This is where the importance of contemplative practice is so important. This is the programme we are involved in Ireland, Australia and in other parts of the world increasingly and that clearly is developing here. It is the integration of contemplative practice for the sake of the caregiver, of the clinician and of the medical profession. The importance of the vision of this Contemplative Healthcare is that it announces to embed a contemplative practice in the training and professional development of clinicians. This I think has to be an essential element for the training of future clinicians.
Meditation and Education We do similar work in the educational field as well. In our community and many others we are introducing the practice of meditation to young children in schools. The challenge is not actually to teach the children to meditate; the challenge is to teach the teacher. Teachers know how to teach and they will pass this on with their skills to the children in the classroom. Usually the teachers are amazed at the capacity of the child, both to do the meditation and also to like it – something they haven’t realised before. Children enjoy meditation. They ask for it. Now I am teaching children as young as 4-5 years old. As they finish one year and as they move into the next year they will ask the new teacher when will they will be doing their meditation. 70% of these children will report that they choose to meditate on their own, at home. One father was telling me, one morning, as a routine he takes his son to school. The son gets into the back of the car; the father turns on the engine and the radio and starts driving. One day the son says to him from the back seat, “Dad, would you turn the radio off please?” Father says, “But why?” He says, “I want to meditate.” Children don’t have to say why they meditate. You don’t have to convince them to. You just allow them to have the experience. What we can learn here from the example of the children is that meditation is natural, simple and self-authenticated. A great deal of scientific research has been done on meditation since 1931, the date of the first scientific study of meditation. Meditation has been around for a good deal longer than that. It belongs to the great wisdom traditions of humanity. You look at any of the major spiritual traditions you will find meditation at the bottom of it all. You go back to prehistory, to the Australian Aborigines, 40,000 years ago you see that they have a tradition called didgeridoo – a silent contemplative way of being. They will leave their village and their settlement. They will go and sit by the side of the river; they are river people and they will face the direction in which the river is flowing. They will not concentrate on their unsolved problems nor analyse them but they will sit in their silent, non-questioning awareness. It is very interesting to see how the White Australian immigrants, recognising how much harm they have done to the native indigenous people are being touched and taught by this ancient wisdom of the first Australians.
Attention If we look at what we consider to be the main religious traditions of our own times, we see that all of those religious traditions took shape in an amazing period of history - about 500 years B.C. This was the time of the Buddha, the time of the Hebrew prophets, the time of Plato and the time of Confucius and Lao Tzu. It is an amazing moment in human consciousness. What was happening at that time was the form that these different spiritual wisdom that then took shape as religious and spiritual traditions that we are familiar with today, were the main religions. What was taking place was the awakening of an interior awareness. The very idea of sacrifice, which was so successful to humanity from the dawn of history, began to change. It was seen no longer as an external practice – you don’t need to sacrifice people or animal or things to please gods or to keep the forces of nature friendly. Sacrifice became rediscovered as the work of attention – sacrifice of the heart. Where we place our attention is the most important element of human consciousness. We create the world by the quality of our attention – what we pay attention to and how we pay attention. That’s what makes the world we know. I was speaking to a doctor from the Cincinnati Children’s Hospital, which has the reputation of being the safest hospital in the world. She was the guru of the hospital’s medical safety. She has brilliant and careful methodology for improving safety in hospitals. She said that the number one ingredient of safety was situational awareness – being aware and attentive in the present moment. Any other technology or methodology that lacks this quality of awareness and attention would not produce the results. She was convinced of the importance of meditation in the new paradigm of healthcare. Being aware and pay attention in the present moment – this is the essential contemplative practice. This is what all of us in different cultures in the Axial Age, around 500 B.C., discover and describe in their own particular ways. The essential discovery was the power of attention. Meditation is a contemplative practice. There are different forms of contemplative practice. Different forms mean different people at different times. These different forms of contemplative practice, i.e. mindfulness and meditation etc. are completely compatible with each other. I think we need to have clarity about what attention means, about the different kinds of attention and the quality of attention. Essentially any contemplative practice that makes us more awake, or present is going to produce a radical shift in the way that healthcare is delivered. Without losing the immense beneficence that have been accrued in Medicine through scientific and technological advances, we will at the same time recover something of the essential art of Medicine - that human connection does not actually produce cures, although cure is possible sometimes but it also produces and develops healing.
The Wounded Healer One of the great myths of the ancient world is the myth of the Wounded Healer. I think this myth is of immense relevance to the development of the new paradigm of Contemplative Healthcare. The term Wounded Healer was developed by the psychologist Carl Jung. The pain of the wound of the healer can be his strength and where the healing power actually derives its strength and is renewed, but the sufferings of the healer are the source of the empathy they have with their patient. This suggests a different model of the healthcare professional - the doctor who is not pretending to be God, to know everything and have all the answers, try not to admit to his mistakes, scared of failure. This is a different psychological and personal model of the healer, but it is a much more acceptable and realistic one; one that is going to allow you in that role to flourish, not to have you to respond to unrealistic and fantastic expectations. The relationship with the patient is the medium of healing. You can cure with technology, with drugs, with machines, with procedures. You can bring cure and relieve suffering and we should continue to do that, but healing happens in a flash. It is in that flash of relationship between the patient and person caring for him. The danger is of course if the healer collapses into his or her own woundedness in the process of helping others. The transference that happens in the healing relationship is not controlled and the relationship becomes co-dependent rather than mutually beneficial, personal and sacred. The importance of developing that relationship with your patient depends upon your relationship with yourself. Carl Jung said that the central element in the therapeutic relationship is self-knowledge of the therapist. If we rely entirely on external technology and procedures, we may achieve high levels of prevention and cure, although with increasing levels of medical error, but the essential goal and purpose of Medicine which is healing would not be achieved. There will be an increasing sense of a broken relationship, a distant relationship or a cold, clinical, impersonal relationship between the person who is suffering and the person who is attempting to relieve that suffering. In the ancient myth of Chiron, a Greek myth, he was the centaur of human-half-horse. He was struck by a poisoned arrow shot by Heracles, but, because he was half-God he couldn’t die. He lived in extreme pain, extreme suffering and yet he became a great teacher and a great enlightened teacher. He was peaceful and civilised unlike other centaurs who were pretty lustful and unpleasant. He taught the great Apollo and he also taught the great medical founder, Aesculapius. He was a teacher of light, a teacher of healing. Eventually he was allowed to die, to escape the pain he was living in because he offered his own life in place of Prometheus. He offered himself. I think this reminds us of that essential quality of sacrifice that I was mentioning earlier, and a new idea of sacrifice that developed in human consciousness at that amazing moment in human history - that to sacrifice your self does not involve destruction or deliberate suffering. It is an exchange of self that you give yourself to the other, i.e. other-centredness. That is the essential ingredient of healing. Listen to one of the great Buddhist text, Guide to the Bodhisattvas Way of Life by Santideva:
There are passages in the New Testament, Old Testament, Hindu scriptures and the Koran which express that same universal human insight of wisdom – that the achievement of real health and happiness depends upon the quality of sacrifice of oneself to the other, in other-centredness, in compassion, and that is achieved by the gift of attention.
Quality of Attention Now let us bring this down to earth. I was visiting a hospital in London once and I arrived in tea time at 4:00 pm and this was the time when the nurses and nursing assistants were taking cups of tea to the patients. I was watching this and this was a busy time. Some of the nurses were doing it at such high levels of stress, without smiles and they were doing it as a job, duty and obligation and trying to get it over with as quickly as possible. They slot the tea in cup down to the patients who were terrified. Then there was another kind or way of giving that service. It was done by individuals who didn’t take any longer to do the job, but they did the same job in a completely different way. I think Contemplative Healthcare is concerned with not only what you do but how you do it. I’ll come back to this in a second. So these nurses brought the tea to the patient and put it down with a smile and said, “Here is a nice cup of tea, dear!” and they went on to their next job. Who do you think was made to feel better? What was the job of the carer, or caregiver? It is surely to make people feel better. That quality of attention, that quality of kindness – where did that come from? The other nurses who were tired, unhappy, distracted, not connected and not present to the people they were serving – they were not bad people of course. They probably didn’t want to be like that. They would like to be like the other ones, but for one reason or other, they couldn’t. So can we introduce into the training and the ongoing professional development of healthcare professionals? We can introduce something that will maintain that quality of kindness, compassion, presence and the safe, loving, mindful attention, which is also the biggest ingredient in safety as well? Well, I think we give because we think there is. There is something we can do, something we can introduce or inject into the healthcare profession and institution, that will make a difference and that will maximise the potential of the caregivers for compassionate and careful attention. That is a contemplative practice. So the first thing is simply to make it a part of training the doctors and nurses and others and make it available to those who have already begun their professional life. This is what we are doing in Ireland, through the Royal College of Physicians. We have programs that are now supported by the government. There have a waiting list in each of these programs that are immensely popular now. We can’t keep up with it; we have to wait for new teachers to emerge from among the medical practitioners themselves. What we do is to produce them through simple contemplative practice, with meditation.
Learning Meditation Learning meditation doesn’t happen in a six-week course. We have actually developed six-week introductions to meditation which we use all over the world, which is a very good way of breaking the ice, and a very good way of giving people exposure to the simplicity of the practice so that they can begin to assimilate it and make it part of their lives. But that isn’t the end of the learning process. The learning process goes on for the rest of your life. Part of the learning process is not only to give people the method or technique, but also to provide them with the support structure that is necessary for anyone. Every one of those great wisdom traditions that I mentioned has also developed the idea of the saṅgha[1] - the spiritual friendship, support group, the community or the meditation group which allows people, even after they’ve been meditating or doing that contemplative practice for some time to remain fresh and to remain continually growing and deepening in their practice. It is not about developing just sort of a quick introduction and technique. It is also about how people support each other and to learn from each other in their kind of connective way. So that is the challenge that Medicine faces today – to recover the essential meaning of health, and to see the role of human attention with great quality and capacity we have for relationship that comes to us only if we have the power of attention, and to integrate that back into the therapeutic relationship.
Re-balancing I just like to end with a reference to a book that I have been reading. It is by Iain McGiChrist[2], a British psychiatrist. It was 20 years ago that he has been studying and researching into the two hemispheres of the brain. The initial research was about 40-50 years ago and it didn’t lead very far, because the evidence was over-popularised that the stereotypical definition was that the left brain was rational, logical and risk-taking and the right brain sort of did massage, was rich in incense and went for meditation retreats! (laughter) But with a great deal of more research – thanks to our technology - they were able to observe and measure the brain and have produced some very fascinating results. Basically the two hemispheres of the brain, he says, worked together in all the operations of the mind and feeling; they are partners. However, there is a world of difference between them - they are responsible for different kinds of attention. Remember the ways in which the cup of tea is delivered? It is the way it is done that is the important thing – the quality of attention. However, you have different responsibilities and specialisation. The left hemisphere of the brain specialises in familiar knowledge, that is stored and used and it is also responsible for creating representations of reality – images and models of reality to enable us to help the institution to create ten-year plans and make all the predictions that we think will control the future e.g. economic predictions. The other quality of the left brain is that it is highly uneasy when it is uncertain of something, when it does not have all the answers and is not in complete control. Therefore, when you are operating from an excessive left brain mentality, you will find it very difficult to say, “I am sorry, I was wrong” - which is, when you think about it, the very basis of human authority. You can’t say sorry if you have very little authority. The right hemisphere of the brain specialises in a very different kind of attention. It deals with new experience and new knowledge, which is continually flowing into your life and is constantly changing and presenting you with new ideas and new situations. So, the right hemisphere of the brain is perfectly comfortable with uncertainty. It can remain in complex situations and remain calm, centred and clear even though you don’t have all the answers and cannot control everything, and it is also capable of changing its mind. In McGilchrist, our culture in the modern world has been severely affected by an excessive shift to the left brain. I said in the beginning, the crisis that is affecting modern Medicine and that is affecting the other institutions as well, has come about through an excessive reliance upon technology upon rationalisation and upon depersonalisation of systems. The solution to this crisis must involve a re-balancing of the kinds of attention that we are capable of giving. Our those two hemispheres of the brain are two kinds of attention - which would you say is the master? Which is more in touch with reality as it is now? That is the important question for our times. Left brain mentality and left brain culture for all our institutions is convinced that it is the master and that it has all the answers. The right brain is a flaky sort of a troublesome little imp. Maybe we need to reconnect with the ancient wisdom of humanity. With that wisdom that formulated into the great wisdom traditions which are still around us; the wisdom is there for us to draw and the wisdom is within ourselves. As soon as any of us start a simple contemplative practice, from that instant you are re-balancing yourself. You may have 10, 20 or 30 years of training and conditioning in that lopsided mentality. You will have experienced the anxiety in the sense of dislocation, the sense of disconnection that results from them. You will reduce your effectiveness as a healer and professional because it denies you of your full potential of human operation. The minute you begin a contemplative practice, you reset that balance and you breathe a deep sigh of relief. You wouldn’t know exactly what is happening; you don’t have all the answers, but you know something is changing in you. You may not even be the first person to notice it. It may be your patients who notice it first, or you colleagues at work; or your husband or wife who tells you that you are easier to live with. But from the very moment we begin this contemplative practice of pure attention, we begin to see a new balance and a new quality of attention entering into our daily life. I am recalling two stories, one involving the Buddha, and the other involving Jesus, which I think help in understanding healing. In the first, in Buddhist wisdom, is a story about a young mother who comes from a very poor family and married a rich man and had a child, a son. Then this child became sick and died. The poor woman was literally distraught and began to reason - so great was her suffering. Somebody told her that Buddha was coming into town and brought her to the Buddha and asked for help. The Buddha said to her, “I can give you help but you have to do something for me.” She asked “What?” and he said, “Give me a handful of mustard seeds.” She said, “Okay, that’s easy,” and he said, “But you must get it from a house where no one has died.” So she went around the houses in the village, knocked on the door and asked, “Can I have some mustard seeds?” Out of pity for her, they said “Yes.” Then she asked, “Has anyone ever died here?” and they said, “Yes.” So she went from house to house but she couldn’t find the house or the family where someone has not died. So she came back to the Buddha, ready to understand and see what healing he was offering. Using that experience she was able to recover her balance and sanity and to experience her own suffering and loss in connection to the compassion that she now felt is universal - that who has not suffered that kind of loss? So she was healed. The other story is from the Gospel According to Luke. It is about Jesus walking through a crowd. The crowd is jostling all around him. There was a woman in the crowd who had been suffering from haemorrhage for twelve years, and under strict rules she shouldn’t be there because she was unclean. Actually it says in Luke’s Gospel that she had spent all her money on doctors and had not been cured. So this was her last effort. So she came and said to herself, “If I can touch just the helm of his gown, I would be cured. So she did and she was cured. The haemorrhage dried up. But Jesus stopped and said, “Power has gone out of me. Someone has just touched me.” They said to him, “You are in a middle of a crowd and everyone is touching you.” But he said, “No, someone touched me.” The woman who was now frightened now that she had been exposed, came forward and said, “It was me.” He then said to her, “Your faith has healed you. Go home.” In many of the healing stories of Jesus, that is what he said to people after they have been healed, “It isn’t magic, it’s faith that has healed you. Now go back to the life you were living. Start living it again. Reconnect.” In this particular case, it sounded very cool for Jesus to expose her and she was clearly frightened and embarrassed. But that was specifically part of the healing - isolation, desocialisation and exclusion from society needed to be healed. He needed to know that she was now socially and publicly reconnected to the world. There was the cure, but there was also the healing that took place. Healing is what recognizes the fact that we will always be cured. It will come a day when we will be cured, but healing allows us to feel reconnected healthily to our world and our relationships. In both of these stories, the healer, be it Buddha or Jesus, was using the power of attention. They were paying loving, careful, wise and compassionate attention to a particular person and spending time necessary with that person to help him or her to reconnect and be healed. In a community in London few years ago, there was a lady who has breast cancer. She had surgery and 6-9 months later, she went for a check up to see a doctor. And when she was called into the office, the doctor was sitting there looking at his computer, drawing out a file on the computer. Without looking at her, he said to her, “Have I seen you before?” She said, “No, but I’ve seen you!” (laughter) He immediately woke up and said, “Well, I am very busy and I see lots of people every day.” But I think it is the quality of attention, the ability to give one’s attention in the right way, at the right time and for the right amount of time that matters. Does it mean you have to spend hours? I was in a hospital recently. A cousin of mine was dying. I saw her in two hospitals, one of which I thought was a health factory. She got sicker in that place. The other one that she went to for her acute care and where she died eventually was a smaller hospital but very professional, very caring and the quality of attention she received there was entirely different. I remembered speaking to the doctor. He was a busy man seeing lots of patients but the attention he gave was more than adequate and personal. He was not in a rush, but he also knew he had to go somewhere else. He wasn’t going to be there for an hour with me, but it was the quality of attention that he and the other people in the hospital – there was a generic quality of attention and care in that hospital that was lacking for one reason or another, in the other one. These things are not just personal and individual. They relate to the institution that you work in that shapes you and conditions you. But it makes a world of difference by the two hemispheres of the brain. Both work together but it is a world of difference in the kinds of attention we can get.
Questions: Audience: I am curious about the period around 500 B.C. that had an extraordinary consciousness about self and others and what that meant to society. I am wondering if you can you share a little bit about what you have studied and recapitulate the characteristics or conditions to allow that to happen during that special period?
Fr Laurence: The historians and students of what we call the Axial Age are sometimes wondering if we are going through a similar one. It was a period of shift in consciousness. Certainly with our attitude and the way we have been changed by technology and scientific development, it is arguable if we are going through something similar. We are aware of our unity. In a way, even in the period 500 B.C. there was a common room of consciousness, interiority, discovery of the meaning of external ritual has been found in part in self, and a new sense of self developed. Even the idea of self-knowledge, you could say, began then. What was lacking in that period was of course, communication and infrastructure that allowed people to realise that this was happening at the same time. Now we know what’s happening around the world in different cultures. We have globalised consciousness. There are quite a few books on the topic which I find helpful, including the one called “Evolution of Human Consciousness”.
Audience: What does MARANATA mean? Do you need to have a religion in order to meditate? How do you rate people of different religious persuasions?
Fr Laurence: The word MARANATA that I used is Aramaic.[3] It is a Hebraic word which means “Come, Lord.” It also contains the open vowels and syllables of universal language you find in many religious, spiritual traditions which have used a mantra or meditation word. There is actually a word in Tibetan that is similar in sound which means compassion. As for the question, “Do you need to have a religion?”- No, you don’t. It is perfectly possible to meditate without any particular religious belief system. I make a distinction between faith and religion. This is important for a multi-religious and a multi-cultural world such as the one you are living in. We use the word "faith" when we think about marriage, or friendship or a relationship, or a promise that you’re keeping. You are faithful to something or someone. Faith in that sense is about commitment, e.g. “I promise I will be faithful to you for the rest of my life.” Nobody celebrates infidelity. We celebrate the great human gift of our capacity to commitment for relationship over time through ups and downs. Faith begins with commitment and falls in with relationship over time and will therefore leads to transcendence, because you are transcending yourself, your ego in that way. Your full development and potential is only discovered through self-transcendence – let’s call it "love", a simple word. We very rarely know who we are and when we are capable of loving. Loving means give yourself in, the capacity to turn the attention off yourself. That’s what I mean by faith. Then we have a belief system; everybody has some kind of a belief system. Even if you don’t believe in anything that is what you believe in. (laughter) Belief may incorporate religious ideas, symbols, concepts, doctrines, dogmas, relationship to a particular tradition or maybe something purely humanistic or purely secular. That belief system will incorporate your values. That is very important when you have difficult decisions to make. You may say, “What I should do in this situation?” You draw on your belief system and your values in order to help you to deal with those difficult questions of life. The relationship between faith and belief is a real relationship, whether or not you can separate them entirely, but meditation in itself is pure faith. You can meditate holding any kind of belief system. Meditation will teach you in a very direct, personal way what faith means. First of all, you have the fidelity to practice the particular contemplative practice you are using and also you have the fidelity to do your daily or regular practice. Nobody is forcing it on you. You only do it when you want to do it, but it is something that people do want to do because they know they will be better and they will experience healing and enhancement of their lives through that. Now, will your belief system be affected by that experience of meditation? I think you probably will be, but you will be affected differently for each person.
Audience: Seeing the benefits of meditation, what should we be putting in place in an organisation that actually encourages that? Our wider culture shapes a lot of our views, for example, Singapore is a “fine” city and we complain a lot. That will affect staff attitudes when we are working. We have to adapt to the high demands of society as well. What would your advice be for staff who wants to balance the demands of society and culture, which is one of complaining, with something which is more thoughtful and attentive?
Fr Laurence: Well, you start where you are. In Ireland I heard of a group of nurses who started a meditation group in a hospital at 7:30 am in the morning. When they started, a woman from the administration of the hospital turned up at the first group. And they all thought, “Oh, no!” She was the most unpopular woman in the hospital and she was just a very difficult person and apparently made life difficult for everyone. So she was not somebody they would like to join them but she did and she came every day. They didn’t talk about anything and went straight to work. They noticed, after about 3-4 weeks, somebody suddenly said, “They are getting on much better with that person now.” They couldn’t quite understand what has happened but they could see that the relationship has changed. How are you going to explain that? It all depends upon your belief system, but the fact that they meditated together changed their relationship and way of working. There was respect and tolerance for each other. I think you just have to start and I don’t think you can prescribe meditation or any contemporary practice and tell people you got to do it. But, if the institution is wise and caring, it may well say, you can meditate during your working hours (laughter) because we know you will work better and you will be happier and the whole institution will be changed. People will have to believe in it. There is leadership taking the next step to introduce people to it. You find that people will come if you offer a course - an introduction to meditation, and then it is a simple next step to say that we will have a regular session at lunchtime or early morning or whenever it may be. That implants the seed of consciousness that affects the whole group, not only the people who comes to that meeting, but the environment as well.
Audience: Thank you for sharing with us. My takeaway today is that the important thing in a healthcare setting is the relationship we have with the patient. You started by bringing us through meditation and that is very much individual practice, and a few minutes ago you mentioned about how we can step that up for the organisation. Is there a possibility that we could ever have a contemplative healthcare system? Can you give us some insights into that and what is happening in Ireland - what made them want to do this?
Fr Laurence: Well, I think what happened in Ireland and I suspect what is also happening here in Singapore is that a small group of people begin to reflect on their conditions of work, their healing and judgment of their professional life, and they feel they begin to see that something is lacking and something is needed. So that awareness begins in individual or in a small group of people who then share that awareness and reflection. The next step is, what can we do about it? If there is a need, if our healthcare system does need to become more caring, more relaxed, more intensive and more peaceful, what can we do? Then, some kind of a contemplative practice is needed to teach people how to care for themselves, how to be present for themselves, how to pay attention to their own depth, to recover the interiority without which all relationships suffer. I think it is cumulative after that. I think it is a ripple effect. More and more people will catch on, see the point and collaborate and different gifts will be drawn in to making it happen. You will find the leaders maybe in unexpected places. That is a very personal thing to see this. It is very difficult to institutionalise, but it will become institutionised if there are enough people who are part of the institution and have a personal engagement with it. That takes time but with careful and skillful management there is no reason why it shouldn’t be made available to more people. Many institutions, banks, multinational corporations are doing the same thing maybe with less altruistic motives. They want to reduce the level of stress. There was a Chairman of a big bank in London a couple of years ago. He took three months off work. The condition of his body was going to break down because of stress. So they were very conscious of him. Obviously he has gifts and they want to keep him in the bank and when he came back they re-employed him. With reservations, no doubt they want to make greater profits. What is your motivation in healthcare? It is not for profit I hope; it is for health – that you would like to heal people, more people, more carefully, more gently. So your motivation is more altruistic perhaps and therefore, if it is more altruistic it will be more effective. The secret of this is other-centredness. That is the secret of leadership and is also the secret of healing. It just catches on and passes from one person to another. It is an insight rather than an idea or just a technique. It is a perception that passes from one person to another.
Audience: Thank you so much for being with us. Ever since I saw that video of you interviewing our late Minister Mentor Lee Kuan Yew, I hope that someone in the leadership will bring you here and my prayers have been answered. (clapping) I think the issue of contemplation, in my very simplistic way of looking at it, is really training of the mind. I counted that you mentioned “compassion” 27 times. (laughter) So, in a way when we talk about empathy, compassion, care for patients, how do we develop these qualities? It is what you mentioned, the right side of the brain versus the left side. I think the emphasis in healthcare delivery, and we have grown up in a system, is No: 1 to achieve excellence in healthcare. What does that mean: “excellence in healthcare?” The other emphasis is “affordable healthcare” which has got to do with finances, as far as the patient is concerned, as well as our healthcare budget. So those issues are very pertinent, even if we are going into Contemplative Healthcare. It is not one replacing the other. It is the balance. We have been so concentrated on giving excellent healthcare and affordable healthcare that we have almost given minimal recognition that the other aspects of healthcare are just as important. I think that the example you gave of the nurse offering tea – we cannot compromise as far as the quality of the tea that we offer. It is the manner in which we offer that tea. For me, I am at the end of my clinical career as a healthcare worker and I wish I have been exposed very much earlier to Contemplative Healthcare as you have taught us, because that is very important from the very beginning. I think it is right we should be teaching contemplation to children so that it becomes almost like part of their nature. So when we are delivering healthcare, that aspect of it comes naturally. You don’t even have to do it – it comes naturally because that’s the way you are, so that you can concentrate on the excellence of delivery. So, that’s my regret – it has come too late in my life. I am glad that there are so many young people within the audience here. I am very thankful for the leadership to make contemplative healthcare a part of the curative mission of health and healthcare workers. Thank you. (clapping)
Fr Laurence: I think you are the pioneers. This is a new paradigm that is shaping and it will take time, not just an institutional event. It is something deep in society, culturally and spiritually. So I think all of you here are pioneers. You have good leadership and it is a real movement in consciousness that is taking place. I think the only danger would be if it were reduced to only techniques. I was talking to someone somewhere who was teaching a course on compassion. Well, maybe, but the first step in learning compassion is to recognise where it is lacking in yourself or in others or in the system. The second step is to open up your heart, your deeper self to your true nature. The Dalai Lama says, “Your true nature is your compassion.” All we have to do is to be ourselves. That will be enough to change the system eventually. You said you have come to the end of your career, but I would say this is the beginning of a new phase in your career. (laughter) You didn’t retire from what you have seen and shared. That can be invested in the new pioneering work.
Audience: Some issues in healthcare are important, like dying and how we choose to die. Some of these conversations are glossed over or evaded not necessary by patients, but by family, caregivers and healthcare providers. We are often left to chance, or the assumptions of culture and religious norms. So how can we be contemplative about these kinds of difficult conversations? How can we overcome the discomfort to listen to the difficulties in the face of emotions, past experience, culture and folklore? How do we prompt these discussions and by whom? What are the potential conflicts held by the dying and living kin and healthcare professionals and how can we find resolution?
Fr Laurence: Well, this’s a multilayered question. I once gave a talk in Italy. Somebody walked into the hall by chance and she stayed for the whole session. Then she spoke at the end and said she had lost two children in a car crash. As she went into the hospital, the chaplin, a young priest, inexperienced but wanting to help, spoke to her and said the worst thing that could have been said, “Don’t worry, they are in a better place.” He has not learned the contemplative art of “being with.” What can you say to a mother who has just lost her two children? There is nothing you can say; there is no idea; there is no belief. But what you can do is be with them and the courage to be will involve the courage to be silent with them. That is what we are very weak at – it is being silent with people. Sometimes that’s all you can do. Then that experience of being silent with generates a trust and a relationship in which you can then contribute advice or clarification or help the person to express their feeling. It takes time of course but it begins with the ability to practice the silence of the tongue and silence of the mind. Normally we find it embarrassing to be with people who are going through a tremendous anxiety, or fear, or loss or impending death. We feel helpless. Many healthcare givers also feel that there is nothing they can do, or helpless … therefore, I shall go to the next room where I can do something. What contemplative meditation can teach you is that greater ease about being with someone in silence, and allowing the stillness between you to build a new deeper relationship with trust. That’s the primary element. The secondary element I think is the support that you get from your colleagues and the sense of community at work. Here is a big community you can share these difficult cases or difficult situations or mistakes that you make. You can share with them in an open and trusting way. Again that is the fruit of doing contemplative practice together. Meditating together reshapes differences in your relationships with them.
Audience: From a patient’s perspective, how can we, who receive care, help those who care for us be contemplative to meet our needs? How can we as patients be contemplative partners in managing our health and not merely consumers exercising our rights?
Fr Laurence: There is a video of a lady integrated with one of our meditations in England. She died of myeloma about 3-4 years after diagnosis. During that time she became a very radiant and deeply spiritual person and a great teacher. I saw her shortly before she died. I did a little interview with her on my iPAD which I did actually for a doctor in Ireland whom I was going to see the next day. One of the questions I asked her was: “What would you like to say to your doctors and healthcare providers?” She said, “I would like them to know I let them off the hook.” (laughter) By that she meant she didn’t expect them to work miracles; they didn’t have to succeed. They were helping her and in partnership with her in her health. That came out of her heart. She spoke with great simplicity, wisdom and clarity. When I said it to the doctors, they were very moved. One of them said, not all patients are like that. (laughter) Another video you might like to look at is a very powerful conversation that I was able to have with very dear friends of mine who are sitting there with us - Ng Kok Song and his wife Patricia, before Patricia died.[4] It is a beautiful video up on our website. Patricia, in her 18-19 months of diagnosis of cancer also became a very beautiful, radiant teacher. It is very clear that you can teach others, or family or community or friends or caregivers. You can teach them by the way you die. If you die well and you die healed. That is what contemplative healthcare reminds us: “You can die healed." So, if you can die in that way, you are generating a tremendous positive event. Your death, however painful it may be, will bless all those around you, people who care for you and your family, even though they are leaving you behind. Patricia has this gift and she speaks in this video about many aspects of her life, her loved ones, her family and faith and about meditation. It would be a great thing to get the video to watch and pass it to caregivers for them to reflect on this meaning of Contemplative Healthcare.
[1] Saṅgha is a word in Pali (Sanskrit: संघ saṃgha; Chinese: 僧伽; Tibetan: དགེ་འདུན་ dge 'dun) meaning association, assembly, company or community. [2] The Master and His Emissary: The Divided Brain and the Making of the Western World. Yale University Press, 2009. [3] Aramaic is a family of languages belonging to the Semitic family which also includes Canaanite languages such as Hebrew and Phoenician. During its three thousand years of written history, Aramaic was used as a language of administration of empires and of divine worship and became the lingua franca of the Neo-Assyrian Empire. [4] Video: “From Panic to Peace” - https://www.youtube.com/watch?v=BZiwyEHlp_w
|
Meditation |
Follow Dr Mack on
Please direct your enquiries to dr.pmack@gmail.com