Occasionally I receive patients referred to me by their family physician, because after a meditation retreat they develop different kinds of psychiatric symptoms, such as panic attacks, generalized anxiety, depression or psychotic symptoms like hallucinations. They usually attend such retreats to come to terms with personal life issues, and on the retreat they receive bad advice when psychological material arises that causes emotional pain. For example, when strong emotional and cognitive activations arise in the form of thoughts and memories, they may be told not to pay attention to the content of these thoughts and stories, and simply redirect their attention to the breath. The explanation given is that the stories we create are just unreal fantasies and productions of the mind without real meaning, and that they need to be let go of. The more people then try to follow this advice, the worse they get, until they get overwhelmed by a full-blown psychiatric syndrome.
A psychiatric assessment of such persons often reveals significant childhood problems in their relationships to their parents, which end up deeply affecting their whole lives. As adults they then develop different kinds and degrees of symptoms and discontent, for which they seek help in whatever way they see fit.
The advice meditation teachers give seems often formulaic, and therefore plainly wrong in many cases. Meditation teachers of all sorts are often rigidly wedded to their method, unable to meet their students where they are. When this happens, meditation can become toxic or ineffectual, causing harm and alienating people from this training.
It is important to distinguish mindfulness from meditation. Mindfulness is a state of being, while meditation is a technique. Mindfulness is a way of being in the world that is characterized by presence and non-identification with subjective experience. Rather than being preoccupied and constantly caught up in internal and external dramas, we can be ‘free and easy in the market place’ as they say in Zen. Meditation on the other hand is a technique, by which mindfulness can be developed and achieved. But it is not the only technique.
To understand this a bit better, a peak into our brain is necessary. Roughly speaking, as Daniel Siegel describes, the brain has nine sets of neurocircuitries, called domains of integration, all responsible for organismic health. To be well functioning, each domain has to be integrated, meaning harmoniously connected within itself, like each section in an orchestra. In addition, all these domains have to also be integrated among each other. If one domain does not function properly, we develop symptoms of one sort of another. One of these domains is called narrative integration. This means that to lead a healthy life we need to be able to construct coherent narratives of our lives. What that in turn means is that we will develop psychological and even physical symptoms and be sick, if we are not able to make detailed sense of our lives, where we come from, how our history has affected us, and how we got to become who we are now.
Even if embedded in the vast non-verbal world of behavior, intuition and the body, this process of making sense is profoundly verbal and related to our human capacity to tell stories. Meditation does not address this narrative integration in any direct way, because it only focuses on the process of thought arisings, not on their content. When narrative integration becomes an issue, which is very often the case when people report emotional and thought activations, we need to be able to explore the stories of our lives and make sense of them. This requires talking and relating in some form of psychotherapeutic intervention as a way of bringing mindfulness to the story contents we create. This is in itself an additional technique apart from meditation to develop mindfulness.
Some in the meditation community love to say that stories are just concocted phenomena of the mind of no real interest, and that meditation is the art of learning to see verbal formations, cognitive processes and thoughts coming and going without entering their content and getting caught up in them. That is true from a meditative perspective, and learning how to do that is central to the meditative path and the exploration of deep existential truths. However, this addresses other domains of integration, not the narrative one. If one ignores narrative integration that is so central to health, one can meditate until the cows come home, and one’s gains will always be limited by the deficiency in narrative integration. In other words, forget about deep spirituality and existential insight into the depths of your existence, if you haven’t done your homework of also bringing order into the way you understand the stories of your life. For that meditation will not help directly.
My patients who come to see me in a crisis following a retreat experience exactly this lack of proper guidance. When meditation teachers give the right advice at the wrong time, the organism rebels. Meditation students often need help in recognizing the need for psychotherapy and an in-depth exploration of their narrative world. When they don’t get it, they become symptomatic. When it comes to the thoughts and stories our mind creates, we have to respect both aspects of these cognitive brain productions. We need to learn through meditation to just see them as transient phenomena that come and go and that we don’t need to identify with. Once released from the hold their content has on us, the mind’s deeper nature can be revealed to us. But we also need to bring the same discerning observation to their content, realize how deeply lacking in coherence and mindful understanding our stories often are. We than have to immerse ourselves in the examination of the story line that has made us who we are and our relationships the way they are, and realize the different options we have at our disposal to change and modify these stories to our benefit. Once we understand them through psychotherapy as the spectrum of possible stories we can live by, another aspect of the mind’s deeper nature will be revealed to us.
Thoughts and stories are Janus-faced. They have a double nature of process and content that is inextricably intertwined. We cannot ignore one aspect without destroying the other. They both require our attention with the tools appropriate for each. When people meditate when they should be in psychotherapy and vice versa, no meaningful progress occurs. Lack of proper guidance and knowledge in this regard will lead to dangerous consequences.
Copyright © 2016 by Dr. Stéphane Treyvaud. All rights reserved.