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Psychiatry
I'm interested in what Buddhists think about psychiatry. good, bad, or otherwise.
I was part of a conservative branch of Christianity back in the day, where psychiatry was considered to be highly suspect at best. After many years of changing and a few turns of events, I have now been been working in the mental health arena for about 10 years. The intersection of religion/philosophy and mental health is of great interest to me.
I was part of a conservative branch of Christianity back in the day, where psychiatry was considered to be highly suspect at best. After many years of changing and a few turns of events, I have now been been working in the mental health arena for about 10 years. The intersection of religion/philosophy and mental health is of great interest to me.
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Buddhism appears to be a form of cognitive behavioural therapy too. It's obviously much more than just that though.
Does the psychiatrist seek financial gain, or status or fame among his colleagues and peers, as apposed to aiding the suffering and ill? Does he frequently fall back and rely on prescription medication as a first resort for many ailments, as apposed to seeking alternative methods or avenues of treatment? If so, then I would say that his actions are not in accordance with the Dharma.
Meds are over-prescribed because insurance companies push for that. It's the way the system is structured. Insurance companies want diagnosed conditions to be resolved as quickly as possible, and therapy takes much too long, though can be highly effective. All meds do is mask the symptoms (as is true for medical practice, as well).
My personal thought is that sometimes people need a psychiatrist to get through life temporarily. I could have functioned without medication and I wouldn't of had anxiety if it weren't for having to go to work. My case was temporary although the psychiatrist said it was for life. I think there are examples like this where a psychiatrist is necessary however, I believe they are overused and meds are over prescribed.
After getting a job I liked I no longer have anxiety. One thing that attracted me to Buddhism is the teaching to let go of the self and that that everything perceived is just a concept in your mind. After fully embracing Buddha's teaching I came to realize that I can survive without a job and not to worry about what others thought, or if I lose my house. I found the source of my anxiety and problems was my concepts in my mind I thought I had to adhere to.
I think with the right attitude most people can get through life without medication. However, I think there is a minority of people out there who should be on medication. I just think our society is about money and those doctors need you to take their pill in order for you to keep coming back every 30 days or whenever. Some psychiatrist like the one I had are in fact just evil drug dealers brainwashed that they are doing something good. In retrospect I suspect he was on heavy medication based on his weird actions.
It is important I think to try to deal with life without these drugs as man has done for 1000 of years. Look for the real source of problems don't just mask it with a pill. If you have a brain disorder and all else fails then in rare cases I think some need medication. Above all don't put doctors on a pedestal as authority figures and get other opinions. I am greatful that I was also seeing a very wise psychologist who disagreed with the psychiatrist and told me he thought the guy was full of it.
In other words, medication is powerful, life changing, mind altering and should be used with more caution and as a last resort. A psychiatrist only has that one tool in his tool box so, proceed with great caution and awareness.
Psychologists on the other hand treat disorders which aren't illnesses (stress, depression, phobias etc.) and which doesn't need medication.
My view? They help people, they make people happier - they even cure some. And it does in fact work. What's not to like?
I was part of a conservative evangelical church that looked down on psychiatry/psychology/counseling and am now in the mental health field as well.
Buddhism is not going to emphasize that one "should" or "should not" take medications because it is morally "right" or "wrong". The emphasis is on skillfulness of behavior. So, if I need to take medication in order to get my symptoms under control enough to even benefit from psychotherapy than it is a skillful use of medication. However, taking PRN's of Klonopin simply to avoid anxiety might not be skillful, especially if my anxiety is trying to teach me something. Taking the PRNs is not a moral issue and I'm not "bad" if I take them however. It simply may effect my karma (other issue entirely, but karma is NOT the same as sin), or could "slow down" my process of enlightenment.
Hope this helps.
I have a friend who has been incorporating some principles of Buddhism into his practice, and I know another doctor who believes that until the spirituality of the person is addressed, the treatment is not complete.
I know that there are several friendly hands within western psychiatry that are reaching out toward some of the spiritual traditions, and I'm wondering if there is a hand reaching back.
It is an area of medicine that takes a pathological approach to understand negative mental behaviours and disorders. A good psychiatrist should take a non-pharmacological approach if possible; however, this can take longer/be more expensive than just prescribing a pill.....
I think that being a Buddhist is a good path to follow to be mentally healthy. However, there are instances where meditation or seeking refuge in the Sangha is not sufficient. I know that Buddhism is full of contradictions and dilemmas but I don't see one here. Unless psychiatrist operate quite differently in the US to the UK then there appears to be no conflict.
Some of us have messed up our B. chemistry, or lost a good balance through environment or just heredity.
Psychiatry will eventually be able to see what's wrong and have "chemical" therapies to tweak things and fix neuronal imbalances. It will be complex, not just a "take-a-pill" thing.
When I was in Canada I got depressed, I took some 5HTP tryptophan, and the blues I was feeling for weeks went away after a week!
When I'm tired I'm a different person than when I'm fully awake.
All of that is brain chemistry. Mood changes mean the difference between enjoying a rainy day or staying in bed. Staying in bed will eventually make things worse.
I'm sure the advances in MRI and yet-to-be-developed brain imagery will make it so people can have optimal mood and energy every day. Not that people will be getting high! Just that people will be getting normal.
A person with depression or anxiety (which just feeds upon itself) is just like a person who is sick with an infection if they don't get antibiotics they get worse and worse. A & D, and other "common" mental problems will be early detected and treatable.
Yes, changing thinking changes the brain AND changes in the brain can be brought about by "chemistry" as my wine example proves. I dunno.
Psychiatry: It's gotta get better!
For instance, a patient is a very "short" guy in height and is a lawyer by profession, he is wealthy and knowledgeable but too short to be true. He is so desperate for love, and have many adorable girlfriends and wanted to get hitched. However, these girls never love him and often laughed and sniped over his height. Their gestures and treatment have resulted in him in developing evil bad dream, wild imagination and hallucination. He is despaired and depressed, and having frequent strong suicidal thoughts. His life is in total chaos. The stigma of short in height has gotten in him, terribly.
A psychiatry may divert his attention to the joys and bliss of many short lovely successful men around him, and he may recover superficially from the psycho medication which very much owing to the patient's profession of having a logical mind. This patient lives a good life then but desperate, still in single.
In this scenario, it has achieved the desired result of solace and remedy for this patient. And if you were to notice, the memory of his shortness still exists though not as explicitly presented externally or even the patient himself did not even aware of it. Take computer chip as an example, it stores data and tons of data can be stored inside it, even if the data is deleted from computer, it is still recoverable. In the great old days, no one knew that it is possible to recover data even it has been deleted away. Likewise to human brain. Simply, the knowledge and technique that psychiatry applied is not a long term solution of total cleansing of bad data.
Buddhism on the other hand is similar to disk defragmenter in computer, it does not clear the bad data and instead, it reprocessing all of them into wholesome data so that the system regained back its original adorable functionality.
For instance, the above patients after learning buddhism, he understands his "shortest" was due to his loathe and abhors against others intensely in his past life. He would deeply remorse from within and the remorsefulness was conscientiously palpable. Having this insight, it changes his perspective, a true impetus of moving forward and living an enriching and blissful life thereon.
On a peripheral human cognition, he understands true wisdom is a nature of all beings that beyond life & death, and life of future continues blissfully as there is no actual death on human sphere. It is a matter of continuation till he recovers fully as a Buddha, either in his short human lifespan or enlightenment assured in his subsequent lifespan. On the insightful cognition, he vows to achieve fruition of Buddha so as to liberate himself and all beings to the same pristine condition of bliss and harmony that truly belongs to them.
Do you not find that this Buddhism's psychology is so much endearing, amazing and nobly magnificient and incredible.
Psychiatry ought to be aware of living in the disguise of a psychicwarriorism - a recommended book of good read - http://psychicwarrior.com/
:eek:
Buddha noticed how thoughts effect mood and behavior 4,000 years before Aaron Beck did. So I guess that's a "yes" on one level?
You might be interested in Buddhist writers that have also practiced psychotherapy:
* Jack Kornfield (The Wise Heart: Principles of Buddhist Psychology)
* Tara Brach (Radical Acceptance)
* Mark Epstein (Thoughts Without a Thinker, Psychotherapy Without a Self)
I hope this helps. It's kind of hard to answer your question as Buddhism has always had an interest in "psychology" since before the word was coined.
So psychology or psychiatry might stabilize that person enough to get in a sangha whom to share ideas and learn of the dharma.
I had a decent experience with one psychiatrist I am thinking of. Interwound with a much less stressful life. It was more stressful in that I didn't work which created self worth issues and difficulty socially. As in "so what do you do....(i say) Oh I'm schizophrenic
My new doctor we really problem solved based on what I wanted and what he thought would help. For example I increased my dose and for a long period had no pschotic symptoms, my world seemed normal. This was after I tried a drug for 6 months that made me so sleepy I couldn't do anything. I gave up on that drug but I use it now because I am getting very energetic and hearing voices progressively as I cannot sleep sometimes. Paranoia also. When I am psychotic and paranoid the world looks like the matrix, no like a bee hive and all the bees are in sync and I am toxic. And a lot of delusions so overwhelming all feeding my anxiety and more delusions. Buddhism helps me sit with all this confusion and let it be. From a strict perspective mindfulness is the only medicine I need. But if I have the flu I would take thera-flu to alleviate symptoms. I could just be mindful of all the symptoms, but I don't know about you I would rather be well. For one thing I can get out more and take a nice walk when I am not sick.
Klonopin helps me to not totally reject my 'bee hive' experience and not go out of the house. I know its addictive so I rarely use it. Only when I am having extremely painful tension. Or extremely paranoid of outsiders and want to have coffee with my dad eg.
I have recently taken a mood stabilizer which has made less depression. Less stickiness of the thought 'this sucks I hate myself'. Maybe because a brain change has given more energy into me. More perseverance and a feeling activity will be rewarded. However the mood stabilizer has made me more psychotic. And quitting drinking probably has too. Alcohol is a depressant and I think of a sling shot.
Anyhow
Psychologist - Talk to you about your issues, treat disorders as defined by the DSM (Diagnostic and Statistical Manual of Mental Disorders). Some are more eastern philosophy and some are more in your face about it. I think both have their merits and I gained a lot of insight and knowledge from both. Insight I could have gained on my own yet, I believe they saw through my denial helped me faster.
Psychiatrist - Give medication to treat mental issues based on a some questions on they ask on each visit.
As a patient of both I can only relay my experience. The psychologists I have seen advocated not taking medication and talked me through issues. The psychiatrists basically asked a standard form of questions and gave out medication as they felt necessary.
From my experience (and everyone I know who has gone) if you go to a psychiatrist you will be prescribed medication. I asked if they wanted to review with my psychologists records and the answer was no. Just answer some questions and get your meds was what I experienced.
In Austin where I live it takes three to four months to meet with a psychiatrist on a first visit unless you know someone. There is so much demand that only one doctor out of at least 20 took patients. I had to wait months for the privilege of a first visit and this was through my insurance company. I have very good insurance.
I am happy I now feel great without having to deal with any of these professionals. Good friends and family are very important.
Meditation is not a full path. Its only one part. You can easily turn meditation into Mara.
I don't buy the argument that psychiatry is a drug dealer. They are literally but I perceive some of it as loaded emos projected on psychiatrists. They are not your friends and they have a lot more detachment that psychologists. YOU have to know your needs and the psychiatrist takes a guess at meds that might interact with that. The good ones acknowledge that the side effects can be worse than the drug.
But I don't agree with rigid negativity towards them. Even McDonald's happy meals can keep a kid smiling and parents relive their own childhood. Drugs that effect dream consciousness are no less important than statins which cardiovascular health.
We are in samsara baby. And at least I met the cat in the hat. At one time Santa was alive until I killed him. Thats why they say to kill the Buddha. So you can see that the dharma is here and not in any one thing. Can't have words for it. But it is said there is no understanding without compassion.
A Judge or Psychiatrist are the ones who can Baker act you. Otherwise you voluntarily go to the institution like summer camp.
There are also places other than hospitals called Behavioural Correction centers. There you will see people on drugs and psychiatric patients, mostly with mental problems not deemed that they have committed an offense to be put in jail, but just that they need to Be Corrected. Kind of like Baker Acted. I used to think it meant Bake Her Acting. Until the shit hit the fan and I woke up and smelled the coffee I would still be in the bin thinking it meant 'bake her acting'.
Theres a spectrum of mental states. Getting ina particular state is not the mahayanna path. It is not about aligning your chakras or eating chocolate. But both of those can be part of life. Part of your practice.
Neither has much value, in my opinion. I've known plenty of Buddhists who, while asserting that Buddhism can heal all wounds, have sublimated some serious psychological difficulties and thus denied themselves the richness of Buddhism. Likewise, I have known plenty of people deeply in love with psychology who have overlooked or denied the limitations of the approach ... and thus missed the richness of psychology.
But speaking in generalizations, while kool, is not so much the point. The point is the uncertainties and sorrows that individuals can experience. These are not just power-point discussions. These are living aches and pains.
The Zen teacher Rinzai once said, "Grasp and use but never name." To my ear, that means using the circumstances at hand to understand and actualize both the ailment and the cure. If Buddhism fills the bill, use Buddhism. If psychology fills the bill, use psychology. It's the suffering that counts, not the names. What name has ever brought anyone an honest peace?
There is no reason to be more skeptical towards psychiatrists than other doctors either. A specialty in treating the brain and it's illnesses is no different from a specialty in treating eyes or ears or feet or heart.
I don't know how doctors are educated elsewhere, but here they are all generalists from the university (3+2 years to become cand.med), then work for three years to become physicists while probably writing a lesser doctor-degree in their preferred area (the ph.d., which could be in psychiatry).
They then work as physicists at hospitals or as privates while teaching at the universities and eventually they write a "disputats" to become doc.med - a "doctor".
We're talking at least 12-15 years of education at the absolute highest level yet possible to humans - they know what they're doing when prescribing pills and treating the, well, insane. Buddhism doesn't beat that...
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They may know what they're doing when prescribing pills, but increasingly, at least here in the U.S., they are under the insurance-payment gun to prescribe pills whose efficacy they know may be less effective than other, longer and more costly approaches. Some will admit it. Some won't.
now, there's another proof that we are in "kali" yuga.
monks should have the function of psychologists. psychiatrists are crazy. the will not find mind in brain. this is... almost too stupid to explain.
Private insurance has always been a bomb under the average Joe's interest in receiving an effective health care treatment - psychiatrists still know what they are doing though. The reason meditation and Buddhism is not widespread in psychiatry is not that psychiatrists won't use it - they simply know better, or at least know what's safe and effective to use. Until meditation and Buddhism has been proved (by unbiased scientists) undeniably effective and advisable by the "medical society", I think we should all be grateful such practices aren't used. It's never smart to use untested methods in any serious case, and thankfully few do that. You wouldn't test da Vinchi's "flying machine" knowing that airplanes do the job.
@Vincenzi
The uneducated mind holds many odd truths. Never though, did the uneducated rule and make prosper...
i won't go into details but i touched base in almost every negative situation in life. although buddhism resonated greatly with me, practice was impossible. a certain medication was almost a miracle for me and and i know many other people who were helped with medication as well. personality disorders are another matter. i won't discuss them as treatment for them is almost as varied as the disorders themselves. anyway, that's my two cents.
may all beings live with wisdom.
may all beings be awakened.
may all beings live an enlightened life.
Monks aren't trained to diagnose mental illness. Buddhist psychology may work for some people, but not for some of the types of cases that have been mentioned here.
I've only had experience with one psychiatrist and by all accounts he is a pretty remarkable one that has helped many people from prisoners to high performing athletes. I am sure the majority are less effective than him though.
I recently read am interesting academic paper on neophyte psychologists and the authors raised an important question on looking into the motivations of individuals for their practice. It was found that many were looking for solutions to their own problems or on deeper exploration the superficial ones were quite different to the internal/intrinsic ones. Such issues did impact on the efficacy of their practice often to the detriment of their clients. Fortunately, this appears to change over time
What's this got to do with Buddhism? Well, I'm not sure if their is a direct link but being a Buddhist for me means quite different things to me than many other Buddhists I know. My journey to this point of my life is unique, as are all our journeys!The same is true for any path we take in life whether we want to be a psychiatrist, a psychologist or a bus driver. We must, therefore, take care to judge everyone as humans, rather than by the professional path that we has chosen.
It is true that we take away some human rights when we court order a person into treatment. there's a lot of gray area, and we try to maintain as many rights as we can while also maintaining safety for the patient and for society. it's not easy, and I spend much of my time explaining this to my patients who are upset with being forced into the hospital.
The docs, social workers, psychologist, and nurses that I work with have a lot of compassion for our patients. I believe they want to see them get real help. and simultaneously we are struggling with tight budgets and demanding insurance companies and restrictive medication formularies.
thanks for all the replies. I think I'm getting a handle on how people within buddhism view mental health.
Maybe the psychiatrist's honorable job is to simply try to give people with extremely shaken minds a chance to settle down enough to be able to calm the mind for themselves.
I do not see psychiatry as inherently useless, but I am skeptical, just as with everything else. I believe that people on the front line working with patients have overwhelmingly virtuous intentions, but the system itself I am highly skeptical. I have the the inclination to believe that we are overmedicating our communities, and with children particularly (ex. Ritalin, adderall, SSRI's etc.)
We need to address and research the bigger picture of society and the constant stimulus and psychological effects of consumer culture/media, and if and how this contributes to depression and "ADHD/ADD", which most mental health experts acknowledge as a disorder, but is peculiarly diagnosed in larger and larger numbers.
The intersection of Buddhist thought and psychology/psychiatry should seem very obviously parallel - but the obfuscation of this similarity is exacerbated by the layers of misunderstanding and mistrust in drugs and/or incompetent or misguided practitioners and/or researchers of these sciences. The aim of these sciences is to use the mind to heal the mind in simplest terms. Neither a prescribing psychiatrist nor psychologist advocate of cognitive therapy are going to "heal" anyone. We see therapists or psychiatrists to release trauma and effect healing of "ourselves" by our own actions, discipline and practice. If that involves a drug due to an overwhelming physiological - hence psychological condition - so be it - such drugs are simply bridges to other techniques that might not be accessible otherwise. The politics of big pharma, rife with corruption,greed and the callous endangerment of the entire human population makes interesting conversation - but the aim of both these mental health sciences is the same - liberation from delusion - albeit by different means. The areas in which these bodies of thought intersect are intriguing and useful - but like all things they have their limitations. Obviously, the mental health sciences seek to build up, fortify and stabilize the ego - while Bhuddism strives to dissolve the ego. This is a matter of semantics. It is possible to have a healthy ego and be detached from it simultaneously without suffering schizophrenia.
I'm not sure that "dissolving" or "deconstructing" the ego is the way to go. I agree that one can have a healthy ego while praticing compassion and detachment.
A Zen teacher I knew once said, "You need a certain mental health in order to do this practice."
And my own Zen teacher once said, "Without ego, nothing gets done."
Just some associative stuff.