By Barry Kapke, ACST, CI
Originally published in Massage & Bodywork magazine, April/May 2001.
While developing a somatic healing practice, I found meditation and Buddhist teachings gave me incredible support in developing a logical approach to health and healing. The result? Insight Bodywork™, a young branch on the well-established tree of Dharma Medicine.
Dharma Medicine is the liberation teachings laid out by the Buddha some 2,500 years ago. In its most complete sense, it is the path the Buddha mapped out for the spiritual seeker to reach total freedom. To end suffering, to heal what is deranged, the Buddha offered clear instructions based in experience. This teaching is called the Buddhadharma. Additionally, Dharma Medicine includes Tibetan Medicine, with its amalgam of conventional, yogic and Dharmic approaches to healing pain and suffering. Other examples of Dharma Medicine include mindfulness practices, like Buddhist yoga and qigong, Zen Archery, the Tea Ceremony or the Mindfulness Walking of Thich Nhat Hanh; the mindfulness-based mediation and peacework of Engaged Buddhism; and integrative somato-spiritual practices like Insight Bodywork. Dharma Medicine seeks to heal the wounded mind-body and to awaken the illumined heart-mind (bodhicitta). It is characterized by the cultivation of mindfulness and clear comprehension (sati-sampajañña), and is informed by, and in harmony with, the spiritual laws (Dharma) of how things truly are.
Dharma Medicine, like all healing systems, is concerned with ameliorating suffering and confusion, and restoring wholeness and harmony. As with other holistic systems, the focus is the relationship between the mind and body, as well as the relationship between the embodied being and the universe at large. Health is defined in terms of balance and harmony, and disease as the disruption of that peaceful relationship.
Illness is approached in two ways. On the relative plane, disease is perceived as a disharmony within the microcosm or between the microcosm and the macrocosm. Dharma Medicine first tries to maintain health and prevent such imbalances from arising but, when arisen, necessary steps, such as herbs, changes in lifestyle, or bodywork, are undertaken to restore equilibrium. On the other hand, in the plane of absolute reality, it is understood that the distant cause of disease is the delusion of duality and of the existence of a fixed permanent “self.” The root imbalance is of the mind, not of the body. The remedy is to purify and awaken the mind. “Do no harm, do only good, purify the mind — this is the teaching of all Buddhas.”1 The Buddha elucidated a detailed course of treatment, called the Noble Eightfold Path,2 developing concentration (samadhi), morality (sila) and wisdom (pañña) to cure the fundamental taint of the mind — ignorance (avijja).
The Buddha, in his time, was often referred to as the Supreme Physician and his teachings were often offered as if medicine. The Four Noble Truths,3 the final insight4 leading to his Enlightenment, was described in the same way an Ayurvedic physician might formulate the diagnosis and cure of a disease: diagnosis, cause, prognosis, treatment. The Dharma is the medicine. Like any medicine, it is of no value to the patient if it is not taken as prescribed by the doctor. The Sangha, in this context, can be compared to nurses— helper companions that minister to the sick and aid in the healing process through their compassionate care. Should you be fortunate to have relationship with a monastic community (Sangha), this is a tremendous support. If not, then it is important to associate yourself with spiritually-minded friends and co-practitioners as your Sangha.
Tibetan Medicine, one of the oldest medical traditions and one where spirituality is thoroughly integrated in its view and its practice, is a unique mixture of Ayurvedic Medicine, Buddhist teachings and practice, Chinese and Persian medical influences, and Tibet’s indigenous pre-Buddhist shamanic traditions. Tibetan Medicine addresses illness on three levels.5 The more conventional or somatic approach seeks to restore harmony to constitutional humors (doshas) gone out of balance — wind (vatta), bile (pitta), and phlegm (kapha). Conventional treatments might include herbal medicines, naturopathic treatments (baths, massage, changes to diet or environment), or acupuncture. Tantric (or yogic) Medicine utilizes psychophysical practices, such as breathing (pranayama), postures (asanas), protection chants (paritta), chakra balancing, mantras, visualizations and rituals to transform the subtle energies of the body. Healing through spiritual and psychological development, Dharmic Medicine uses meditation, ethical cultivation, prayer and religious practices to awaken to the true nature of mind and to step off the karmic wheel.
From a Buddhist point of view, suffering is a disease of the mind; therefore, treating the mind is preeminent. According to Dr. Yeshi Dhonden,6 personal physician to the Dalai Lama for more than 20 years, “Mind is the architect of all our suffering and happiness. Mind is the master; body and speech are its attendants.” It is not uncommon for the physician to prescribe meditation or some spiritual practice, in addition to a regimen of herbal remedies, to treat a patient complaining of a physical illness. The Buddha himself prescribed meditation for serious illnesses.7 When the disease was incurable, perhaps the fruition of past-life karma, the Buddha would recommend meditation on impermanence (anicca). Those who could be cured in this life were instructed to meditate, in successive steps, on the Seven Factors of Enlightenment.8
Specifically, according to Dr. Dhonden, it is “the imbalances in the body which arise in dependence upon the five aggregates”9 that Dharma Medicine seeks to heal. The five aggregates (khandhas) are the psycho-physical phenomena which appear to constitute what we experience as a sense of self. The khandhas are corporeality (rupa), sensation (vedana), perception (sañña), mental formations (sankhara), and consciousness (viññana).
The first khandha — form — is physical, while the remaining four are mental in nature. The interacting aggregation of the four elements — earth, water, fire, and air — manifests as corporeal form (rupa-khandha), or the body. Vedana is how we experience things, either physically or mentally, as pleasant (sukha-vedana), unpleasant (dukkha-vedana), or neutral (upekkha-vedana). Experientially, there is a raw feeling, calling attention to the experience, which we then recognize through the perceptual process, sañña. The sensation is perceived as “hot,” “person,” “friendly,” “wet,” “anger,” or whatever. Sankhara, or compounded things, are mental constructs, opinions, attitudes, thoughts, predispositions and impulses formed from our interpretations (sañña) of experience (vedana). Consciousness (viññana) is that which makes phenomena present for us. It is sixfold, consisting of eye consciousness (seeing sights), ear consciousness (hearing sounds), nose consciousness (smelling smells), taste consciousness (tasting tastes), touch consciousness (feeling sensations), and mind consciousness (thinking thoughts, perceiving experience, arousing emotion). The first three khandhas are instinctual processes, while the latter two are volitional.
Ven. Phra Payutto, one of the great contemporary scholar-monks in Thailand, points out, “Human life consists of a current of numerous intricate corporeal and mental phenomena that exist in accordance with interdependent causes and conditions. When people are unaware of this truth, they cling to the feelings, thoughts, desires, habits, views, beliefs, opinions and impressions that arise at each moment and take this to be the self, even though this so-called self is continually changing.”10 This mistaken view, of course, leads to difficulty.
The Buddha repeatedly recommended mindfully putting one’s attention on the body as the path to liberation. In the Mahasatipatthana Sutta, the Buddha speaks of the Four Foundations of Mindfulness as being “the one way to the purification of beings, for the overcoming of sorrow and distress, for the disappearance of pain and sadness, for the gaining of the right path, for the realization of Nibbana.”11 Satipatthana is the “method of cleansing the mind of all mental illnesses, eliminating all knots and impediments to its smooth functioning. Satipatthana creates an expansive mind, one ready to move forward in life, to face up to and deal with everything in the world with determination and joy.”12
Insight Bodywork uses the body as a field for cultivating awareness and understanding in ways not unlike meditation. Like many bodyworks, Insight Bodywork is effective in restoring and maintaining physiologic and energetic equilibrium, promoting greater ease and ability in the body, and balancing and supporting the emotions. However, Insight Bodywork, in some unique ways, opens the body to what Rolfer and writer Will Johnson beautifully describes as its “sensational presence.” Johnson says, “When we actually let ourselves experience the body, we realize that it is not at all solid. Instead, body can be directly felt as a whirling mass of minute sensations, ebbing and flowing, surging and subsiding, pulsing with the energy of life.”13 In some profound ways, it is a “coming home” to an embodied aliveness long forgotten.
Initially, Insight Bodywork sessions are concerned with opening the body to relaxing its patterns of holding and tension, allowing the breath to move, finding alignment and flow, gaining access to the full range of feelings and sensations, and grounding awareness in the present. Over the course of many sessions, this cultivated mindfulness can be brought to bear on deepening the exploration of embodiment, sensation, perception, mental formations and consciousness within the Insight Bodywork session. For meditators, these sessions can be a powerful adjunct and support to vipassana practice.
In receiving an Insight Bodywork session, as in vipassana meditation, the mind is focused on its object of investigation. This can simply be feeling the body being pressed upon, rubbed, moved, stretched, brushed, rocked and held. The object of investigation can be the body and its movements, the breath, the constituent elements (earth, water, fire, air), feelings (pleasant, unpleasant or neutral), the arising of perception and the naming of experience, states of mind, the presence or non-presence of the five hindrances,14 impermanence (anicca), not-self (anatta), or the arising and passing of the khandhas.
In the same way, meditation is not daydreaming, or at the other end, thinking. Insight Bodywork session is not intended for sleeping or for “spacing out.” There is a continually renewed vigilance that gently, but persistently, brings the distracted mind that has lapsed into past or future moments back to its object of investigation. The inquiring mind simply observes impartially what is happening in each moment, without reacting, criticizing or judging. Experience is not embellished with concepts of him, her, me or mine. There is the objective noting of what is occurring as it arises and passes away, and the understanding of things and actions for what they are. In this field of practice, insight can arise and wisdom develop.
Zen Master Thich Nhat Hanh was asked how he saw Western civilization. “Lost in thought,” he replied. Thought is always out of time, either clinging to some memory or projecting into some non-existent future. When we are lost in thought, we are disembodied and incapable of feeling, because feeling is always in the present moment. Mindfulness is always here and now. Dharma Medicine is an important way to awaken to the reality of things not as we want them to be, but as they truly are. Buddha means “One who is awake.” Let us learn how to awaken.