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How might the beliefs and practices of Buddhists affect their mental health or influence the treatments that Buddhists seek when they experience mental health problems? In this chapter I speculate on the positive and negative effects of Buddhist beliefs and practices on mental health.
Positive Effects
Buddhism is a religion, but it is more than that. It is a philosophy for living couched in an Eastern worldview. The core teachings in Buddhism directly address the fact that people emotionally suffer and argue that there is a way to relieve that suffering. The Eightfold Path describes the way as perceived by the Buddha, and every step is aimed at initiating, maintaining, or improving mental health. Here are the eight steps in the path and their expected mental health consequences.
1. Right Understanding. Buddhism claims that suffering is part of the human condition, nothing is permanent, and lasting happiness cannot be achieved through relationships, occupation, or material possessions. This belief is essential to having a right view of the world. Therefore, one might expect that practicing Buddhists would be more able to accept loss and change, rather than have unrealistic expectations of continual happiness and fight against the inevitable disruptions and disappointments associated with living, which often result in depression, anxiety and distress.
2. Right Intention. Buddhism motivates adherents to renounce attachments and stop clinging to pleasures, people, fame, power, or anything that might lead to greed or disregard for the well-being of others. Thus, Buddhists are encouraged to hold onto things lightly (like gently holding a frightened bird in the palm of the hand, without crushing it). Again, such a view should result in less anger, less anxiety, and less emotional pain when losses occur or expectations are not met.
3. Right Action. Buddhism prescribes certain behaviours (compassion, kindness towards others) and proscribes others (cheating, stealing, dishonesty, sexual misconduct). Such “prosocial” behaviours (and avoidance of antisocial ones) should promote good social relationships and increase the availability of social supports when needed during times of stress. Right action should also result in a lower likelihood of being put in prison, fired from work, or divorce from a spouse or partner as a result of wrong actions, all reducing stress and vulnerability to mental health problems.
4. Right Speech. Speaking softly, gently, affectionately, and avoiding lying or gossiping should inevitably lead to better relationships with others, including those with family members and with colleagues at work and during play. Again, this should increase the likelihood of having people around to support and encourage one when needed to combat depression and anxiety.
5. Right Livelihood. This involves pursuing an occupation that does not involve trickery or cheating others, and instead one that deals fairly and up front with colleagues in business. The Buddhist’s conviction is to avoid anything that might increase the suffering of others. Being content with less, non constantly wanting more, and not being willing to harm others for selfish gains (due to unrestrained greed) should enhance relationships at home and at work, and ultimately reduce stress and promote mental health.
6. Right Effort. This Buddhist principle emphasises that through personal effort an individual can make constructive changes in thought and behaviour and pursue a life that minimises their own suffering ad that of others. It includes stopping whatever thoughts or behaviours that are preventing right action. This, in fact, is the essential purpose of cognitive behavioural therapy (CBT). Central to the success of CBT is motivation at the cognitive level to alter core beliefs and challenge dysfunctional cognitions, and change behaviours that are self-defeating. If this Buddhist belief increases efforts to think and behave in positive ways, then it should enhance mental health.
7. Right Mindfulness. Keeping thoughts in the present, being open to whatever arises, and avoiding wandering thoughts of the past or the future are emphasised here. The application of this principle may help to avoid concerns and ruminations about the past and prevent worries about the future that contribute to mental distress. Indeed, mindfulness meditation has today become incorporated into many standard psychotherapeutic approaches (particularly CBT) for the treatment of emotional problems (and many other mental disorders).
8. Right Concentration. This involves focusing on a single object and excluding everything else in order to quiet the mind and bring it under control, leading to deep states of peace and well-being. Such concentration is likely to move consciousness away from disturbing thoughts to present-centred quietness. Again, the purpose of this pathway (as in every step of the Eightfold Path) is to promote a healthy state of mind and relieve anxiety and distress.
There is every reason, then, to expect that Buddhists who follow these principles should experience greater peace, happiness, and better mental health overall. Almost every emotional disorder, then, should be less prevalent and psychological well-being greater among Buddhists who follow the Eightfold Path. In fact, these principles should be applicable in the treatment of individuals with mental disorder more generally in Buddhists and non-Buddhists. Such an approach, for example, might be particularly useful for individuals with addictive disorders (a form of pathological “attachment”) (see Groves & Farmer, 1994).
Worsening Mental Health
As with other world religions, Buddhism is unlikely to have only positive effects and the potential for negative effects on mental health is also there. For example, the experience of deep meditative states without professional guidance can lead to (or uncover) dissociative (Waelde, 2004) or psychotic symptoms (Kuijpers et al., 2007; Vives st al., 2011), including the precipitation of manic episodes (Yorston, 2001). Thus, practicing various forms of Buddhist meditation – particularly the deeper stages of Jhana (stages 5 through 8) – may have untoward consequences for the novice, particularly if vulnerable to mental illness.
The emphasis in Buddhism on asceticism could promote self-harm (as the Buddha almost experienced at the beginning of his search), and detachment from friends/family may also lead to social isolation, particularly among those who misunderstand the Buddha’s teachings. Williams et al (2012, p 2) not that “Buddhism is thus a high individualistic path of liberation. One is bound by one’s own mind, and it is by working on one’s own mind that one becomes liberated, attaining the highest possible spiritual goal.” With regard to relationships, attachment to others in Buddhism is discouraged (as in attachments of any kind). Again, this may increases the risk of social isolation and withdrawal from the world, especially among those with mental disorders (schizophrenia, social anxiety) or personality traits (anti-social) who take this teaching too far.
Regarding suicide, the Pali Canon is equivocal with regard to the permissibility of ending one’s life, where such an action is both “censored and condoned” (Wiltshire 1983; Keown 1996). Addressing this point, De La Vallee Poussin (1922, p. 25) wrote that: “We have therefore good reason to believe (1) that suicide is not an ascetic act leading to spiritual progress and to nirvana, and (2) that no saint or arhat – a spiritually perfect being – will kill himself. But, we are confronted with a number of stories which prove beyond dispute that we are mistaken in these two important conclusions.”
While every step of the Eightfold Path would hopefully lead to mental health and the relief of suffering, it may not always do so. It is difficult for imperfect humans to think and act in a “right” manner. The self-discipline required may simply be too much for many frail humans whose powerful passions and attachments have come to rule their lives. As indicated in the systematic research above, many Buddhists do not believe or practice in the way that the Buddha intended or that is prescribed in Buddhist texts. Not following the Eightfold Path, Buddhists believe, may result in bad karma and delay their progression towards enlightenment, causing some to feel hopelessness, guilt or shame for their inability to live up to such high standards. This is a challenge that the followers of all the major world religions must struggle with.
Conclusions
Buddhist beliefs and practices arose out of Hinduism over 2500 years ago with the life and teachings of Siddhartha Gautama (the Buddha). After years of struggle and during a deep meditative state, the Buddha arrived at the Four Noble Truths that address the cause of suffering and the way to relieve it through the Eightfold Path. Based on conventional wisdom and simple logic, following the Buddha’s teachings and adhering to the Eightfold Path should lead to the relief of suffering and improve mental health. However, many Buddhists in the world today do not strictly follow the Buddha’s teachings, but rather integrate Buddhist teachings with those of other religions and local beliefs, traditions, or customs. Many Buddhists may not have read about or studied classic Buddhist texts, and following the Eightfold Path may be difficult for many ordinary people struggling to survive in resource-limited areas of the world (other than those pursuing the life of a monk or a nun). Nevertheless, if followed and adhered to, Buddhist beliefs and practices should result in better mental health and greater well-being. The question that now remains is whether objective systematic research shows that Buddhists experience more peace, happiness and well-being than members of other religions (or no religion), and if greater adherence to Buddhist teachings is associated with greater well-being. The next two chapters will examine that research.