Book Review: Siddhartha’s Brain by James Kingsland

sid-brainSiddhartha’s Brain, written by science journalist James Kingsland, opens with what would be a somewhat shocking quote from Ajahn Amaro, a Buddhist monastic in the UK.

We are all mentally ill.

While this should not quite raise the eyebrows of mental health professionals, it is a rather bald (apologies to Ajahn Amaro!) statement to make in public. However, it does set the tone of Kingsland’s book which takes, by turns, an unflinching look at the state of the mindfulness industry today and the roots of its conception in Buddhist teachings. Kingsland presents his work imaginatively. Using the development of the Buddha, Siddhartha, from pampered and protected prince to a teacher of the Eightfold Path to liberation from suffering, he weaves what we know of Siddhartha’s quest and practice into what we know of the results of our current pursuit of liberation through mindfulness. And, it begins with acknowledging that we are all mentally ill.

In this insightful book interlacing the current findings of brain function, mental states, and mental health with the teachings of Buddhist psychology, Kingsland is a craftsman in making neuroscience accessible and presenting it through the lens of contemplative practices. Using the story of Siddhartha Gautama’s own journey to enlightenment, he draws a rich landscape of the merging of Eastern contemplative practice, Western psychology, and contemporary mindfulness.

As a device to introduce us to the roots of contemporary mindfulness and place the history and progress of the Western approach to knowing the mind in that historical context, Kingsland has done a much better job than most writers. Siddhartha’s Brain doesn’t fall into a polemic of modern science or a contemplative holier-than-thou pit; that is refreshing. The writing is crisp and clear, quiet and confident. It invites examination of concepts not by attempting to convince but by introducing perspectives that are easily testable by the reader. Of course, that is in essence the basic teaching of the Buddha: ehi passiko – come and see (for yourself).

Kingsland makes the important point – as have many Buddhist teachers – that one does not have to be Buddhist to meditate or benefit from the practice. In fact, one of the enjoyable aspects of Siddhartha’s Brain is a broader bandwidth than just a Buddhist social and political transmission of wisdom. Kingsland draws from evolution science, psychology, anthropology, and philosophy, weaving them together  with ease. Most poignant for me was his examination of the early beginnings of meditation through the stories of Herbert Benson and the Transcendental Meditation practitioners of Indian guru Maharishi Mahesh Yogi. Benson’s downfall in the community of psychology is a sad part of our collective history and Kingsland’s insight into Benson’s work – that the foundation of all meditation is the evocation of the relaxation response – is a validation of Benson’s valuable work.

I particularly recommend Chapters Three and Four for their lucid descriptions of the roots (The Cloud of Unknowing) and rationale (The Second Dart) for meditation and practice (and a more universal presentation than just a Buddhist one). It’s a bit more of a slog in Chapter Five (The Man Who Disappeared) only because the idea of a “self” that is not fixed in any one definition or role is still alien to our Western senses. Even in psychology today the discussion of identity is a confounding mess with terms like self-esteem, self-image, existential self, categorical self – all of which rests on a concept of a separate(d), individuated entity. Chapter Five will challenge your notions of these variegated and rarefied selves but also introduce you to the social neuroscience that actually supports the observation that there is no fixed unity called a “Self”. As Kingsland puts it:

Thus, from moment to moment, each of us is no more than a unique blend of spices, a homemade garam masala. (p. 101)

My favourite part of the book is the running theme of the Default Mode Network (DMN), a concept gaining much traction in the neuroscience of mindfulness to explain the fluid state of connection/disconnection that can lead to rumination as well as creativity. Kingsland’s description of how the DMN plays a role as our “Self app” that “(posts) repetitive messages of a personal nature on the screen” is a brilliant image of what happens when we wander down those “dark neighbourhoods” noted by the writer Anne Lamott as places she “never goes alone”.

Kingsland continues in Chapter Ten (Wonderful and Marvelous):

The marvel is that we can learn to control at will the signals that determine which track we take at any particular moment. By honing our powers of attention and emotion regulation through mindfulness practice, we can, if we wish, restrict the time we spend in self-focused, narrative mode of thinking that can lead to anxiety and depression. We can choose to take the scenic route, favouring a more experiential mode of being in which we are not held captive by our thoughts but rather treat them as transient mental events. (p. 235)

Now, I do have two quibbles – not with the book itself but the information offered from two sources. First, (p. 249) when inquiring into the frequently made claim that meditation can trigger unstable mind states, researcher Britta Hölzel is quoted as saying (somewhat flat-footedly) that “I (Hölzel) have never seen any major problems like that in our classes.” This is a common statement I hear from researchers and teachers of various mindfulness-based programs, which while true evades the question itself. In fact, we have, at the Ottawa Mindfulness Clinic, had many applicants to our program who want to learn mindfulness and are fearful because previous experiences have resulted in intense mental distress, including dissociation, depersonalization, and profound anxiety. Whereas it is quite likely that in Hölzel’s experience there have not been such occurrences, it does not therefore mean this is not an area to be sensitive about as clinicians and to investigate further as researchers. Ottawa psychologist Nicola Wright and colleagues have written about adapting mindfulness for vulnerable populations and it does behoove us to acknowledge this as a necessary direction for future research and definitely for caution.

Second, Ajhan Amaro, who seems to have been a delightful guide and teacher for Kingsland, wrote an important response to our target article in Mindfulness (journal). He calls for a need to include ethics explicitly as a core component of mindfulness programs. I do respect the stance taken by MBSR developers that the cultivation of ethical action is inherent in its programming (see discussion on p. 269 of Siddhartha’s Brain). However, a statement of presumed fact is not a substantiated fact nor does it address whether the outcome is in the desired direction. Given that no therapeutic intervention is values-neutral, the examination of how mindfulness can become weaponized (see my earlier blog post) is important. After all, we are collectively responsible to examine if mindfulness training does give rise to skillful action and ultimately compassion for ourselves and all others.

Kingsland has done well in this book to translate complex concepts into accessible knowledge and convey ancient wisdom with a gentle, inviting voice. If you are at all fascinated by how and why our brains and being are the way they are, read this book. If you are curious about how meditation and mindfulness practices can help with the everyday struggles of just being human, read this book.

PTSD, Growth & Recovery: Bouncing Forward by Michaela Haas

Trauma and its sequelae are likely the greatest challenge we face as individuals who have experienced them and as healthcare professionals who try to help. For decades and generations, post-traumatic experiences have been misunderstood, mislabeled, and misrepresented. It wasn’t that long ago when I found myself in a shouting match with a military medical healthcare individual who kept screaming at me, “There is no SUCH thing as PTSD!” It wasn’t that long ago when I listened to some of my education program cohort telling me my reactions to what I felt was professorial bullying were probably “cultural” and “well, you know, not Canadian-like.”

Continue reading

I am not this body: Mindfulness for Pain Management

maple shadowPain is unavoidable. We inhabit a system that is engineered to become wonky, cranky, and otherwise uncooperative over time. We know this conceptually but not when and how it matters. Why me? What now? tend to be our responses when the body fails us – as it inevitably does. In case you think this is only a problem for aging folk or those afflicted with strange hard-to-diagnose illnesses, it’s not. Athletes injure themselves. Random acts happen to young and old alike that leave them having to reshape not only their bodies but their mental attitudes towards their entire life.

Joy is unavoidable too. We have a resilient system that is subtly wired to sense into experiences that nourish and sustain us. We don’t know this in the definition of sensing joy; we hope and believe it will be true some day – if we’re really good, work hard, and check off all the boxes that we think entitle us to joy. And it’s not just aging folk who do that. In fact, the older you get the more you begin to see that it’s not the boxes you’ve checked off that brought you joy in any lasting way. Continue reading

Craig Mackie RSW joins OMC

Craig We are pleased to welcome Craig Mackie RSW to the Ottawa Mindfulness Clinic. Craig has a BA in developmental psychology, MA in philosophy and a Masters of Social Work. He has worked in therapeutic recreation, mental health, and social services for over 10 years. He is a certified Transformative Mindfulness practitioner, 16 Guidelines international facilitator trainer, and has taken multiple trainings in clinical and mindfulness modalities. Currently he teaches in the Applied Mindfulness Meditation program at the University of Toronto and is the Director of Essential Change.

At the clinic, Craig will be offering mindfulness programs for youth and adults.

Program and contact information on the adult and youth programs can be downloaded here:

Youth – Transformative Mindfulness.

Adults- Transformative Mindfulness.

 

Self-Compassion Practices for Emotional Distress: It’s not just about being kind

leavesSelf-Compassion practices and programs are gaining momentum in psychological treatments and look like they might well become the next wave of transforming our painful feelings. Mindful Self-Compassion (1), developed by Drs. Christopher Germer and Kristen Neff, is an approach that can be both an adjunct to conventional therapies as well as a stand-alone treatment model. The interesting and very useful aspects of this approach are its applicability to our multilayered experiences of suffering. First, let’s look at what they define as Self-Compassion.

Neff (2) describes it as a three-fold system that are antidotes to the experiences that cause us suffering. (A sidebar note: Suffering is typically described as Pain multiplied by our Resistance to the reality of that pain (3)). Here’s a table that summarizes Neff’s definition of self-compassion. Continue reading

Mindfulness, Ethics and End-of-Life Care: The impact of Canada’s Supreme Court decision

Today, February 6, 2015, the Supreme Court of Canada allowed the appeal against the “blanket prohibition on assisted suicide.” An earlier appeal by Sue Rodriguez (Rodriguez v. British Columbia) in 1993 to have the Criminal Code ruling against assisted suicide declared unconstitutional was denied. The upholding of the current appeal (Carter v. Canada) is destined to be controversial for many reason, not the least of which is the ethical weight it will place on health care practitioners. The ruling is clear that while the Criminal Code is still valid for assisted suicide, it is over-reaching in its application in regards to persons who suffer from intractable medical conditions that compromise their ability to live well. It states that the Criminal Code infringes on the individual’s “right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.

“…and are of no force or effect to the extent that they prohibit physician‑assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”

There will be many issues to clarify as this ruling enters the health care system. Parliament could enact a legislation should it “choose to do so” though whether it will be in favour is in some contention given the current government’s opposition to assisted suicide. Not only are there definitional issues, there will also be issues of a chain of decision-makers who can effectively guide and support individuals who wish to avail themselves of this right. Ultimately, one would hope this does not become a decision that is relegated to the hands of a few but one that will be made in community with compassionate support and wisdom of our past experiences. In order to meet these demands, we will be called upon to examine our own values and conscience with regard to a primary precept we hold, especially as mindfulness practitioners: What are the nuances of the ethic of respecting life in this context?

Can Mindfulness Practices Have an Ethical Role in Physician-Assisted End-of-Life Care? stump w flowersThe complex issues facing us will be challenging. More and more in the writings on mindfulness, an important point is being made that the practice of mindfulness must contain an ethical core. That means not doing harm, avoiding acts that encourage or precipitate harm, and respecting life in all its intricacies. Will we therefore wonder, as mindfulness teachers, if supporting requests for mindfulness training in cases of assisted suicide is ethically within our scope of practice? There are no easy answers however, as with all koans it invites us to examine how these questions play out in our life.

A common question asked of secular mindfulness teachers is – given the purported absence of ethics in a mindfulness program – whether one can therefore rob a bank mindfully or shoot and kill someone mindfully. This argument maintains that what we learn in a mindfulness program is how to pay attention to what is unfolding in the moment and letting it be. Thus, we can bring our attention to the gun, the bank, the person we are about to kill and let that be without engaging in any critical thinking that may have us wonder if this is the right thing to do. Similar arguments may end up being levelled against an involvement of mindfulness teachers in end-of-life care that involves assisted suicide. (I should note that end-of-life work by many conscientious and compassionate colleagues is a powerful part of health care.)

It’s important to ask these questions. It’s also important to use the right understanding of what mindfulness practice actually is. If paying attention is the sole characteristic of a “mindfulness” practice, then the practice is missing a crucial component. Attention by itself generates raw and unusable data. Heat, cold, tingling, blue, red, grey, snow, sun and so on are data points but have no intrinsic ability to change our life path. Remembering consequences of past experiences and recalling our intention for paying attention makes the data meaningful. Mindfulness practice is the opportunity to cultivate wisdom from information to which previously we were reactive but which we now can hold with equanimity to facilitate a better choice. So, there is no mindfulness involved in knowing one is in that bank with a gun pointed at the clients and employees. Mindfulness is in remembering that this action is about to bring harm and recalling a core value.

How might this play out in the potential future of end-of-life and assisted suicide? We have to ask which carries the greater potential to harm: teaching someone to “live well” with a grievous, intractable, unendurable illness or teaching them how to be truly mindful by opening to all the consequences of their wish to be free of pain and suffering. I believe, in this context, the former risks reducing our work to trite phrases like “be grateful for the life you have,” “be in the moment,” or any of the aphorisms we find in mindfulness memes these days. The later however may allow for a clarity of mind in our clients and therefore a range of decisions they can make in conjunction with family, faith communities, physicians, psychologists and all other health care support available to them.

We are entering interesting times.

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Edited at 16:43 for typing errors & paragraph spacing.

10 books that are good for your health: Mindfulness, Self-Compassion & Happiness

As we enter the New Year, let’s make 2015 a year of exploring the many gifts from skilled researchers and clinicians which can support our resolution to live better. The participants of the Mindfulness-Based Symptom Management, Burnout Resilience and Pain Management programs at the Ottawa Mindfulness Clinic have one wish in common: a desire to find a way to live their lives differently. In fact, this wish is not only that of the participants but also of everyone who works at the OMC. We share together the realization that despite our best intentions, we falter in caring for ourselves and others in a way that is kind, nourishing and supportive. We have strong values and tend to be committed to making ethically informed choices and yet we find ourselves wondering where all the wisdom went as we choose against those exact purposes.

If you’ve taken a mindfulness course, good start! You know over eight classes there can be shifts in your thoughts, actions and speech. You also know it’s not a quick fix and that the Ninth Class is the toughest! So to help with the rest of your practice life, here’s a collection of books that we recommend to support, boost and sustain your practice!

Mindfulness Starts Here: An eight-week guide to skillful living by Lynette Monteiro & Frank Musten. Now you didn’t think I would miss a chance to prop up our own book? If you’ve taken the 8-week program at the OMC, this is a great way to extend your practice. It also helps to come to the monthly Alumni groups! Nuff said. Let’s get on to the books you really need to get for yourself!

Leaves Falling Gently: Living fully with serious life-limiting illness through mindfulness, compassion & connectedness by Susan Bauer-Wu.  This is likely my all-time favourite. Bauer-Wu is an expert in the field of pain, oncology and mindfulness. The book is infused with compassion and an open-hearted approach to the vagaries of chronic pain. The exercises are easy and helpful, realistic and encouraging. The sections on the impact of chronic illness on memory, attention, emotions, etc. is invaluable. This book also is unstinting in its honesty about life-threatening illness and offers opportunities to change our rigid stance to the reality of living and dying.

The Practicing Happiness Workbook by Ruth Baer. This is a terrific book that brings together Dr. Baer’s skills as a clinician, methodical approach as a researcher and clear understanding as a mindfulness practitioner. I loved the set-up of the workbook because it … well, it works. Start with a nice pithy overview and then jump in at your own pace. The second section explores four very important traps that can derail our practice:  rumination, avoidance, emotion-driven behaviours and self-criticism. The section following on mindfulness skills is clearly written and I truly appreciate the inclusion of values and goals. The chapters are punctuated with stories about people with whom we can identify and the worksheets are very user-friendly. It makes me happy just to read it!

Hardwiring Happiness: The new brain science of contentment, calm, and confidence by Rick Hanson. Neuropsychologist Rick Hanson is well-known for his ability to pull together neuroscience and psychological mind states in a way that is immanently understandable by most of us non-neuroscientists. There are so many catch phrases used in the mindfulness circles that originate with his teachings and in his books! Velcro for bad/Teflon for good, HEAL yourself, metaphors for resilience and vulnerability, the list is endless. What is important though is his ability to explain why we act the way do and how this is hard-wired. The section “Paper Tiger Paranoia” is my favourite and has helped me out of many a flight reaction! Mostly, in this book, we get to practice the ways in which to make changes to those survival instincts and hard-wire responses to experiences that sustain and help us. If you find this book helpful (or if you’re curious), also try his new program called Foundations of Well-Being which is a year-long on-line program and worth taking.

Living Well with Pain & Illness: The mindful way to free yourself from suffering by Vidyamala Burch. This book is written by and is based on the Breathworks program developed by someone who truly understands the challenge of physical pain. Vidyamala Burch’s history is unlike anyone I’ve read about and her strength is apparent throughout the book. Chapter 2 explains what is pain and is one of the clearest and most useful descriptions available. The use of research-based information is well-placed and does not overwhelm the information in each chapter. I totally fell in love with the third chapter. It’s my favourite allegory of how we create our suffering out of pain. And Burch patiently tells the story in gentle sequences making it come alive. The exercises and case stories are accessible and very user-friendly. I prefer the book to the e-book simply because the text set up is more compelling.

Empathy: Why it matters and how to get it by Roman Krznaric. This is an important book to keep the practice of mindfulness from becoming a self-centered practice. While we start our practice because we suffer the effects of personal difficulties, it is important to see that we are created, and can be undone, in a social context of family, community and global events. Mindfulness brings our awareness to our suffering and we practice so that we don’t repeat the same cycles of interactions with ourselves and others. However the deeper intention of mindfulness is to create a compassionate world and that change can’t happen without seeing that others too want to be free of the same suffering we endure. Empathy is the capacity to walk in their shoes, to make choices that are informed by understanding that what others need is not what we think they need. The exercises and examples in the book are wonderful and challenge us to find a different way to know the world. Grow your connection with those you love and beyond!

Mindful Compassion by Paul Gilbert & Choden. Paul Gilbert is well-known and respected for his work on compassion and cultivating the compassionate mind. In this book, he teams with Choden, a Buddhist monk who helped develop the graduate program in mindfulness and compassion at Aberdeen University. I particularly like the way they organize the book so that the arising of compassion is a natural outcome of how we organize the world as we know it. Gilbert’s perspective of compassion as a social mentality which helps us negotiate through relationships and interactions is an important understanding. In other words, being compassionate is far from being soft and squidgy or a door mat. The exercises are nicely explained and inviting. The definitions of compassion clear up misconceptions. The development of a compassionate self (Chapter 10) is probably the most important part of the book. However, it rests on all that precedes it; I especially liked that the exercises in this chapter are also empathy cultivating ones. An important addition to your mindfulness practice!

The Mindful Way Workbook: An 8-week program to free yourself from depression and emotional distress by John Teasdale, Mark Williams & Zindel Segal. This book is a user-format version of the previously published A Mindful Way through Depression. The first section lays out the foundations and the next section takes us through the eight weeks. I liked how the issue of traps and obstacles is re-framed as “another way of knowing” which opens up the thought patterns and is subtly a practice in cognitive flexibility. It is focused on addressing depression through mindfulness however, the various exercises also might be useful for anxiety and general stress. I had trouble with the layout of the book (too many boxes for a book that wants us to get out of our mental boxes) and the excessive number of balloon quotes are distracting (not cool for a mindfulness book). I have used it as a guidebook with individual patients and found it organizes the sessions well. Be patient when you use this but do try it!

The Mindful Path to Self-Compassion: Freeing yourself from destructive thoughts and emotions by Christopher Germer AND Self-Compassion: The proven power of being kind to yourself by Kristin Neff. These two books come as a perfectly balanced pair. Germer approaches self-compassion with a clinical understanding of the emotional impact of our often harsh inner critic. Neff comes from the perspective of a research-based understanding of what self-compassion means and how it works. With both the experiential practice and the knowledge base to ground it, I find the practice of self-compassion inviting and easy to integrate into my life. As both Neff and Germer remind us in their workshops: don’t chose a practice that sets off an argument in your mind about it. Folded into both books is also the much-needed practice of forgiving ourselves for not being that superhuman being we think we need to be.

The Mindful Way to Study: Dancing with your books by Jake Gibbs & Roddy Gibbs. For all you students out there and those of us who are perennial students, this is a terrific guide to setting down and getting the work done. And more. I like the way this book addresses the various obstacles we encounter (traps) by setting the perspective of “gumption”. Just do what needs to be done! Well, it’s not that easy and Gibbs & Gibbs walk us through a number of gumption traps. The first one was ego (but I figure I already know how that works so I skipped it… no, not really). Check out the section on procrastination though; it’s not just about boredom or priorities! Gibbs & Gibbs’ focus on Right Effort (the last section) is helpful and has a nice balance of meditative practice with insight to our actions.