Thursday, August 12, 2010
The Wild Bunch, Nice, 2010
I had an interesting conversation with Teemu Kangas in the comments thread of my musings on spiritual practice and mental health. He also linked to a study on extreme mental states in meditation practitioners, and to a blog by meditators with serious mental health issues. So I got to thinking about this a bit more.
This is a risk management problem.
Intensive meditation practices do have risks. From the bit of reading that I've done, these risks do not appear to be too extreme – incidence of psychosis among meditators appears to be lower than among the general population, and while many if not most people practicing intensive meditation do experience "nonordinary states of consciousness,"1 most handle these states perfectly well. But the risks are there; people have suffered very serious breakdowns as a result of intensive meditation.
Everything we do involves risks. Some of the things we do involve bigger risks than others. When I hop on my bike to ride to the office, I knowingly assume the risk of falling or crashing into another cyclist, pedestrian, or even a car. I feel comfortable taking this risk, because I have a pretty good idea of what's involved – over the years, I've crashed plenty of times and suffered (and, on two occasions, inflicted) a variety of trivial to minor injuries, and I've seen the statistics about cyclists needing hospitalization or dying as a result of cycling injuries. I'm also aware of the benefits – better physical condition, better sense of mental and physical well-being, the pleasure of the ride, the convenience of being able to cover medium distances in the city quickly without the inconvenience and cost of a car, a taxi, or public transportation. I feel that I know what I'm doing, and the next time I crash, I hope I'll consider that just the downside of this particular choice.
It's also possible to mitigate these risks. I can considerably cut down my risk of death or permanent brain damage by the simple expedient of wearing a helmet while cycling. I can do my best to cycle responsibly, follow the rules of the road, look where I'm going, and not go too fast. However, I still recognize that despite doing all this, I am likely to crash yet again, one of these days. You can't completely eliminate the risk of crashing from cycling, unless you stick to an exercise bike in the bowels of a gym somewhere.
I think the biggest problem with risk management in meditation practices is a lack of awareness about the risks. Most of us newbies really have a pretty poor idea of what we're dealing with. How likely is it that we'll crash at some point, and how serious are the results of that crash likely to be?
Meditation is a bit more complicated than cycling from a risk management point of view, because I think the magnitude of the risks involved are more individual. An actuary could calculate your cycling risks pretty accurately from a fairly small amount of data – your age, sex, location, the amount you cycle per year, and a prior history of crashes, traffic violations, and the like. With meditation, I think this is likely to be more individual – one guy may never experience anything seriously unsettling, whereas another one might have a really rough time about it.
I'm sure that a good teacher with lots of experience with different students will be able to make educated guesses after getting to know a student, but I think it's gotta be a good deal trickier to do from hard data, beyond relatively obvious predictions such as that someone who has previously had a psychotic episode is more likely to have another one than someone who hasn't.
I would like to know what I'm getting into. Risk tolerance is individual, too. I don't mind crashing too much, if I believe that the likeliest outcome of the crash isn't more serious than some minor bruises and perhaps losing a bit of skin, but if I thought that cycling is so dangerous that a crash would probably mean broken bones, brain damage, or death, I wouldn't bother.2
I've been reading up on this a bit lately, or, rather, reviewing stuff I've already read, with these questions in mind. I have decided to go on with my meditation project – even including intensive practices, once I feel I'm ready for them. The picture I've formed is a bit like this:
The risk of serious psychological damage is real, but relatively small. Meditation-induced psychosis severe enough to require medical intervention or significantly screw up the meditator's life does happen, but it's pretty rare, and it's even rarer among people who don't have a history of psychotic episodes.
The risk of encountering something highly unpleasant is big. Many, if not most people practicing intensive meditation appear to have to deal with some pretty difficult stuff. We have extreme emotional states running the full gamut from ecstasy to abject terror, and we have psychosomatic effects like extreme pain, muscle cramps, gastrointestinal symptoms like diarrhea, nausea, or vomiting, and so on. I don't particularly like the idea of running into this stuff, but since most people don't suffer permanent damage from it, I'm willing to take the risk.
What, then, can be done about mitigating these risks?
First, there's stuff I can do. I am going to err on the side of caution, and not apply for a sesshin before I'm relatively certain that I have the concentrational ability and mental stability to benefit from it while dealing with the possible side effects. I've only been on one weekend retreat so far. I'm going to stick with that level until I feel, at the end of such a retreat, that I would really like to keep going rather than go home. At that point, I'll seriously consider participating in a four-day sesshin. If and when I get that far, I'll worry about what to do next.
Second, there's stuff that teachers and sanghas can do. First and foremost, they can make sure that people applying for retreats know what they're getting into, simply by making all relevant information about their retreats and practices available, and offering it to all applicants for them. They can ask applicants about a history of psychotic episodes, and then talk to these applicants more, to make sure they understand the risks they're running – and to make an informed guess about whether they're likely to benefit from the retreat in the first place. They can build working relationships with the local mental health specialists, in order to consult them about problematic situations.
I don't think intensive meditation is particularly dangerous, compared to stuff most of us do all the time. However, most of us have a pretty poor idea of what the risks are, what we're likely to encounter, and what we can do to mitigate those risks. I don't think the right approach to risk management is to water down the practice – it's pretty clear that many people can benefit from the pressure-cooker environment of an intensive meditation retreat. However, perhaps we could do more make sure people know what they're getting into.
And, perhaps, if we notice a culture developing that sees intensive meditation as the only kind of "real" meditation, we could do something about that too – because I believe that slower paths up Mount Sumeru will work better for some (me too, perhaps?), and it would be entirely unnecessary if they were to think of themselves as second-class Zennies.
Addendum: Kyle and Mumon continue this discussion on their blogs. Go check them out.
1I would expect samadhi and kensho to be classified as "nonordinary states of consciousness" too. That would make these states if not exactly the point, at least fully intended consequences of intensive meditation.
2This, incidentally, is the main reason I don't have a motorcycle. I really enjoyed riding one once, but not so much I'm willing to assume the downside risk of a typical crash.