Bhikkhu Pesala
Healing Through Mindfulness
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Contents
Curable and Incurable Diseases
Seeing Things as They Truly Are
The Buddha’s teaching is all about suffering and its removal. He was like a skilled physician who first diagnoses a disease, and then prescribes a remedy for that disease. An unskilled physician fails in his or her duty to carry out a thorough clinical examination of the patient and therefore makes an incorrect diagnosis, and prescribes an incorrect course of treatment. The patient is not cured, and may get more seriously ill or die sooner than if not treated at all. A correct diagnosis is therefore vital.
According to the Buddha’s teaching there are four nutriments, any of which may be the cause of a disease, or a disease may be caused by a combination of these four factors:
The first of these four, kamma, according to Buddhism is the cause of congenital diseases. As a result of injuring living beings in a past existence or past existences, one is subject to many diseases in the present existence. If you don’t believe in kamma, but in an Almighty God, then you may believe that such medical conditions are a result of God’s will. If you place your faith in science, you may believe that such diseases are caused by faulty genes or damaged DNA. Whatever you believe, the fact remains that there are some diseases that are inherited from birth, and which have no known cure. The only treatment for them is palliative medicine to mitigate their effects.
The second cause, food, includes diseases caused by lack of food, excess of food, or the wrong type of food, and diseases caused by ingesting toxins such as alcohol. Such diseases can usually be cured by a change of diet or a change in the patient’s life-style.
Climate and air pollution also cause many health problems. Modern urban environments and sedentary life-styles contribute to conditions such as asthma and diseases related to Vitamin D deficiency. Toxins also build up more due to a lack of exercise. Such diseases can usually be cured by moving out of town, taking long vacations, or engaging in more outdoor activities.
The fourth cause, that of mind, refers to both physical diseases and mental disorders that are the result of negative thoughts — and what are commonly referred to as stress-related disorders. Here, we should extend the meaning of disease to include dis-ease or unhappiness, lack of mental tranquillity and equanimity.
These four categories are often inter-related. Someone who is obese due to excess of food, or the wrong type of food, and lack of fresh air and exercise, may also suffer from depression. Conversely, someone who suffers from depression, may indulge in comfort eating, and be disinclined to socialise or engage in physical activity.
To get a better idea of what the Buddha meant by suffering we should examine the meaning of the Pāḷi word that is usually translated as suffering. The word “dukkha” means much more than suffering. In his discourse on mindfulness the Buddha elaborated on the meaning as follows:
“Jātipi dukkhā, jarāpi dukkhā, maraṇampi dukkhaṃ, sokaparidevadukkhadomanassupāyāsāpi dukkhā, appiyehi sampayogopi dukkho, piyehi vippayogopi dukkho, yampicchaṃ na labhati tampi dukkhaṃ, saṅkhittena pañcupādānakkhandhā dukkhā.”
“Birth is suffering, aging is suffering, death is suffering, grief, lamentation, physical pain, mental sorrow, and despair are suffering. Association with the unloved is suffering, separation from the loved is suffering, not getting what one wishes is suffering. In brief, the five aggregates of attachment are suffering.”
It is easy to understand that pain, disease, death, and other misfortunes are suffering. However, the final phrase referring to the five aggregates of attachment (the body, feelings, perceptions, mental formations, and consciousness) as suffering means that life itself is inherently unsatisfactory, oppressive, and the root cause of all suffering. It does not mean that life is devoid of happiness.
If separation from loved ones is suffering, then being united with them is happiness, isn’t it? If association with unloved, despicable, and disagreeable individuals is suffering, then getting away from them is happiness. If death is suffering, then avoiding it is happiness. Suppose someone who has been on death-row for years gets granted amnesty and released from prison, or someone who has cancer, gets treatment, and is declared by the doctors to be completely free from cancer, that would be a source of great relief and happiness to the person who was previously fearful and depressed at the thought of their imminent death, wouldn’t it? It is obvious that happiness is not suffering in the ordinary meaning of the word. That is why we need to investigate deeper into the real meaning of dukkha.
Returning to that case of a condemned prisoner on death-row who gets granted amnesty. Suppose that he or she was wrongfully convicted of murder at the age of thirty, and spent twenty years on death-row until new evidence proved that the conviction was unsafe. After getting released from prison, and receiving some compensation for wrongful imprisonment, that person is not free from the fear of death. Although they are now free to do as they wish, they cannot live forever, and so will have to face the inevitable eventually.
If association with loved ones is the reason for one’s happiness, then one is never free from the anxiety that arises whenever one is separated from them, or thinking about it. If a beloved child is late home from school, and the parents are unable to find out where their child is, they become frantic with worry. The grief and distress experienced by the relatives of an airline or shipping disaster when it simply disappears never to be seen again is immeasurable. It is perhaps a greater source of suffering than knowing that their loved ones have died. There is no closure, no acceptance of the new situation, and this can make it very difficult for the bereaved to move on with their lives. There may be financial hardships too, with insurance claims or transfer of property deeds being delayed until death is confirmed.
Non-acceptance of the way things are is the cause of sorrow, lamentation, grief, and despair. If one understands this thoroughly, then one can be free from this self-inflicted suffering.
There is a story from the Buddhist texts about a farmer’s wife. Every day her husband and son would go to work in the fields and she would prepare their meals, which she would send with a courier later in the day. One day, as they were working, the son was bitten by a snake and died on the spot. The father sent a message back to his wife, “Prepare only one meal today.” She understood what must have happened, so she sent only one meal, and came to the field at the end of the day, bringing flowers and incense. Together, the parents cremated their son, and performed the customary rituals. Since she was spiritually mature, she did not lament or grieve over her son’s death, fully understanding the nature of existence. That’s the way it is with living beings — once born, death is inevitable.
The practice of mindfulness is central to the Buddha’s teaching. It is a key factor of the Noble Eightfold Path, and the basis of meditation as explained in the Mahāsatipaṭṭhāna Sutta.¹ In the introduction to this important discourse the Buddha declares:
“This, monks, is the only way for the purification of beings, for the transcendence of grief and lamentation, for the extinguishing of pain and sorrow, for attaining the right method, for the realisation of nibbāna, namely, the four foundations of mindfulness.”
It means that without cultivating and perfecting the practice of mindfulness, no one can put an end to suffering. As long as unmindfulness and confusion remain, insight is not mature, and it is therefore impossible to know things as they truly are. Only genuine insight into the nature of existence could put an end to suffering.
I should therefore explain carefully what the Buddha meant by mindfulness. As a factor of the Noble Eightfold path, mindfulness is “Right Mindfulness,” and in the Satipaṭṭhāna Sutta it is referred to in conjunction with two other terms. The phrase, “Ardent, clearly comprehending, and mindful,” is repeated when referring to the practice of bare attention. It is not just superficial awareness of an object, but paying keen and full attention to it for the purpose of understanding its true nature. A short anecdote may help to make the meaning of bare attention crystal clear to those who have not practised meditation seriously before.
An American nun I knew while living at the Chithurst Forest Monastery in West Sussex was from California. In the days before becoming a nun, she encountered a bear while hiking. The bear chased and caught her, and held her head in its mouth. Try to imagine being in that situation. Would you be thinking about this and that, or would you be paying bare attention?
Bare attention means giving 100% of your effort and mindfulness to whatever is happening in the present moment — knowing it as it really is. It is not imagining how you would like it to be, or assuming how you were taught that things are. Bare attention makes a thorough and careful examination of the object currently being observed.
There are other forms of mindfulness, but they are not right mindfulness because they do not have the aim of knowing the true nature of phenomena. Consider, for example, the mindfulness practised by an acrobat as she performs an exercise on the beam. No one can deny that she is being extremely mindful of every bodily movement. However, her intention is merely to perform her well-practised routine flawlessly, to dismount safely from the beam, and to win the praise of the judges and the crowd who are watching the performance. Her performance is difficult and praiseworthy, however, it is not right mindfulness.
Consider, by way of contrast, the case of a cat-burglar who climbs a drain-pipe to enter a house through an upper-storey window. He is mindful not to make any false move that might lead to death or serious injury. He is also careful not to make a sound that might wake the sleeping householders or the neighbours. His actions are difficult and dangerous, but not at all praiseworthy. The kind of mindfulness that he employs is also not right mindfulness.
A meditator who is ardently practising mindfulness, clearly comprehending each and every mental or physical phenomenon that occurs throughout the entire day, without a break, is not doing it for the sake of praise or material gain. A well-taught meditator is just practising mindfulness for the purpose of understanding the true nature of mental and physical phenomena. His or her goal is to purify the mind, to transcend grief and lamentation, to extinguish pain and sorrow, to attain the right method, and to realise nibbāna, which is the end of suffering. Nevertheless, it is also difficult to do, and extremely praiseworthy to realise the true nature of phenomena. Having gained some insight into the causes of suffering and the right method leading to its cessation, the diligent meditator enjoys bliss quite unlike any happiness experienced before. One can give similes comparing it to the cool shade of a tree on a hot summer’s day, or the relief felt by a refugee fleeing a war zone on arriving safely in a peaceful country. However, you will only understand how peaceful these experiences are if you spend many weeks or months striving to develop mindfulness and insight. The greater the effort, the deeper the insight will be, and the more profound the changes brought about in one’s attitude to life.
It is similar to the healing of a scald. If you scald yourself with hot water or fat, the skin is very sensitive to every touch, for days or weeks, until the skin heals. An ordinary person who lacks training in mindfulness is often very sensitive to every criticism or hardship that he or she has to face on a daily basis. Not everyone is irascible and complains openly about the slightest difficulty, but many feel it nevertheless, and endure it until later, then complain about their day to their long-suffering loved ones when they get home. An unmindful person suffers needlessly, and spreads their suffering to others too.
“Having seen a form one loses mindfulness. Getting involved in the attraction of it, one feels the onset of desire that tries to imbibe it. A multitude of passions such as covetousness and rage, springing from form, torments one who takes a firm hold of it, with the result that his mind becomes burdened with vexation. Therefore, nibbāna remains remote from one who would rather carry the burden of suffering than practise meditation.”
If someone is well-trained in mindfulness, every slight displeasure or disappointment is noted and observed whenever or however it occurs, and if the cause is seen with insight the suffering ceases there and then. A mindful person doesn’t pick up and carry the burden of suffering.
“Passion remains undeveloped in him who recollects with mindfulness the form that he has seen. Thus freed from lust, he refuses to imbibe it. Passion remains undeveloped in him who recollects with mindfulness the form that he has seen. Thus freed from lust, he refuses to imbibe it.”
It is the same with sounds, odours, tastes, touches, and ideas too. The mind of an ordinary person who has no training in mindfulness is tossed up and down throughout the entire day by whatever sense objects he or she contacts. Nor is it very different for one who is trained in mindfulness if they neglect to practice meditation regularly and diligently. The mind is extremely fickle and difficult to control. To gain mastery over passionate thoughts and feelings that arise due to contact with pleasant and unpleasant objects is a remarkable achievement. saints are rare, but we can all aspire to gain greater equanimity and mental purity to cure the terrible mental diseases of desire and discontent that afflict mankind.
Throughout history, monks, nuns, and recluses have retreated to lonely places to avoid worldly contact for the purpose of spiritual development. The Bodhisatta spent six years in the forest in his quest for Enlightenment. Modern day monks and nuns have less social contact than lay people. However, as long as we have eyes, ears, a nose, a tongue, a body, and a mind we have to experience contact with the six sense objects: sights, sounds, odours, tastes, touches, and ideas. No one can avoid sense contact in this sensual realm.
These sense contacts stimulate feelings, which may be pleasant, unpleasant, or neutral. Pleasant feelings will arouse desire, while unpleasant feelings will arouse ill-will or anger. To pursue spiritual development and mental purity, it is advised to strictly limit sensual stimulation. A meditator should eat less, sleep less, talk less, and practice mindfulness diligently. Eating should be only for the sake of nutrition, talk only for the sake of gaining knowledge and wisdom. Listening to music and watching entertainments must be given up, while sleep should be limited to no more than six hours out of twenty-four. At first, these restrictions may seem burdensome, but after a few days the meditator will find that the mind becomes less disobedient. If the meditation teacher’s instructions are followed carefully, the mind will become bright, energetic, and keenly aware of each phenomenon. When the mind no longer wanders, but remains focused on the present moment, the true nature of the mental and physical process will become crystal clear. The meditator will then be following the Buddha’s instructions to Mālukyaputta:
“As phenomena are seen, heard, thought of, or known, just let them be as they are seen, heard, thought of, or known at that moment. When you see, you just see it; when you hear, you just hear it; when you think, you just think it; and when you know, you just know it.”
When the mind is tamed in this way, desire and ill-will are temporarily banished. The mind, which was like a raging forest fire before, consuming all fuel with which it came into contact, is cool and calm. Even beautiful sense objects arouse no desire, while unpleasant objects cause no ill-will or fear. When the link between feeling and craving is broken, suffering ceases. The mental disease is cured. In many cases, physical diseases are also cured if the meditator gains deep insights.
Diseases can be mental or physical. There are some fortunate individuals who rarely suffer from any physical disease, but those who are free from mental disease are extremely rare. By “mental disease” I don’t mean psychiatric disorders, which are virulent and often incurable. I am referring to the mood swings that ordinary people experience on a daily basis. If left untreated, these minor mental diseases can become severe and lead to depression, eating disorders, and even to self-harm or suicide.
Most people resort to harmful methods to treat these minor mental diseases — they take drugs or alcohol, watch entertainments, or over-indulge in various sensual pleasures. They seldom confront the root cause of their unhappiness, so it remains untreated and only gets worse due to the effects of the harmful treatments that are used to avoid the issues. If the harmful treatments are used to excess, further problems arise — they get into debt, their health degenerates, and their relationships fall apart. If they use more of the same remedies this may become a downward spiral to severe mental and physical health issues.
The medicine that they need to take for their mental unhappiness is readily available and completely free. The teachings of the Buddha have been carefully preserved for millennia by Buddhist monks and nuns, who are financially supported by the community.
The way that faith healing works is different to the practice of developing mindfulness directly. The mind is purified by reflecting on the noble qualities of the Buddha, Dhamma, and Saṅgha. Several of the protection discourses (paritta sutta) work in this way.
The eighth verse of the Dhajagga Sutta says:
“I say to you, monks: if, when you have gone into the forest, to the root of a tree, to an empty place, fear, panic, and horripilation should arise, then on that occasion remember me and recollect:
“The Blessed One is fully enlightened, endowed with knowledge and conduct, fortunate, knower of the worlds, the incomparable trainer of trainable persons, the teacher of gods and men, enlightened, and Blessed.
“Itipi so Bhagavā arahaṃ, sammāsambuddho, vijjācaraṇasampanno, sugato, lokavidū, anuttaro purisadammasārathi, satthā devamanussānaṃ, buddho, bhagavā”ti.
Again, the twelfth verse says:
“Well taught is the Dhamma by the Blessed One, realisable by oneself, of immediate effect, inviting investigation; leading onwards, to be personally realised by the wise.
“Svākkhāto bhagavatā dhammo sandiṭṭhiko akāliko ehipassiko opaneyyiko paccattaṃ veditabbo viññūhī”ti.
Then the fifteenth verse says:
“The Blessed One's Disciples have practised well, they have practised honestly they have practised wisely, they have practised dutifully — that is the four pairs, the eight individuals — they are the Blessed One's Disciples. They are worthy of offerings, oblations, gifts, salutations, an incomparable field of merit for the world.
“Suppaṭipanno bhagavato sāvakasaṅgho, ujuppaṭipanno bhagavato sāvakasaṅgho, ñāyappaṭipanno bhagavato sāvakasaṅgho, sāmīcippaṭipanno bhagavato sāvakasaṅgho, yadidaṃ cattāri purisayugāni aṭṭha purisapuggalā, esa bhagavato sāvakasaṅgho, āhuneyyo, pāhuneyyo, dakkhineyyo, añjalikaraṇīyo, anuttaraṃ puññakkhettaṃ lokassā”ti.
This kind of healing succeeds by replacing negative emotions like fear and timidity with the positive emotions of confidence and courage. The dis-ease is mental and the cure is also mental.
The Ratana Sutta is very similar in that it uses declarations regarding the virtues of the Buddha, Dhamma, and Saṅgha as the basis for overcoming negative emotions. The third verse declares that the Buddha is more precious than any gem:
“Whatever treasure there is here or in the other world, or whatever precious jewel is in the heavenly worlds, yet there is none comparable with the Tathāgata. This precious jewel is in the Buddha. By this truth may there be peace!”
The fourth verse refers to the special quality of the Dhamma, which is nibbāna or the cessation of suffering:
“The tranquil sage of the Sakyas, realised that cessation which is passionless, immortal and excellent. There is nothing equal to that state. This precious jewel is in the Dhamma. By this truth may there be peace!”
The seventh verse refers to the special qualities of the Noble Ones (the Saṅgha) who have realised nibbāna. In this context, the Saṅgha is not the ordained monks and nuns, but the Noble Saṅgha who have reached the first, second, third, or fourth and final stages of the path and personally realised the cessation of suffering:
“Those who are freed from desires are well established in the teaching of Gotama with firm mind. They have attained to that which should be attained, having plunged into immortal nibbāna. They enjoy the peace obtained without price. This precious jewel is in the Saṅgha. By this truth may there be peace!”
The tenth verse refers to the special qualities of the Stream-winner — any individual who has attained the first stage of the path, realising nibbāna for the first time. This may be a monk or a nun, a man or a woman, or a deity:
“Three conditions are forsaken by him at the instant of acquisition of insight, namely: (i) self-delusion, (ii) uncertainty, and (iii) the indulgence in rites and ceremonies should there be any. He is also absolutely freed from the four states of misery and is incapable of committing the six crimes. This precious jewel is in the Saṅgha. By this truth may there be peace!”
The fourteenth verse refers to the special qualities of the Arahants who have attained the fourth stage of the path and reached the final goal.
“With the old (kamma) extinct, nothing new (kamma) to be reproduced, the mind detached from future birth — they have destroyed the seeds of existence. Their desires do not spring up again and those wise ones go out even as this lamp. This precious jewel is in the Saṅgha. By this truth may there be peace!”
As this verse was being spoken by the Buddha, an oil lamp that was burning beside him ran out of fuel and stopped burning. When an Arahant passes away, he or she does not go to heaven or “enter parinibbāna,” as nibbāna is not a location that anyone can be reborn into. When the fuel of kamma is utterly destroyed, the Arahant is not born again anywhere. Some false doctrines refer to a Pure Land where only Arahants, Buddhas, and Bodhisattas reside, and poetic language may refer to the Arahants “entering parinibbāna,” but these ideas are misleading. If there were any such rebirth, then aging, disease, and death would not have been destroyed.
All of these declarations regarding the special virtues of the Buddha, Dhamma, and Saṅgha dispel the mental dis-eases of fear, anxiety, sorrow, and so forth, replacing them with confidence, serenity, and joy. Mental purity derived from reflecting on the virtues of the Triple Gem can cure psychosomatic ailments such as headaches, skin eruptions, and other physical imbalances caused by negative emotions.
The Bojjhaṅga Paritta was prescribed by the Buddha specifically for curing illness. He recited it for Mahā Moggallāna and Mahā Kassapa. On another occasion, the Buddha asked Mahā Cunda to recite it for his own benefit when he himself was sick. As with the other protection discourses, the reflection on wholesome qualities cultivates them and cures disease.
The seven factors of enlightenment are:–
One might wonder why these Arahants and the Buddha himself needed any help to focus their minds on the factors of enlightenment, which they had all fully developed? I don’t have any answer to that other than to say that it may have been done to show the method for others of lesser ability. There is no doubt that being reminded of wholesome qualities that we possess gives us renewed energy.
The Aṅgulimāla Sutta is somewhat different to the other protection verses and specifically intended for women experiencing a difficult child-birth. Its power derives from a declaration of truth.
“Sister, since I was born with the Noble birth, I have not knowingly and deliberately taken the life of any living being, by this truth may you be well and may your child be well.”
Aṅgulimāla gained his name from a garland of fingers that he wore around his neck, cut from the body of his murder victims. He was from a low-caste family and won a scholarship to study with a renowned teacher in Taxila (in modern Pakistan). He excelled in his studies so his teacher would praise him in front of his fellow students, who were less able, but of high-caste. They became jealous and resentful and so plotted together to bring about the low-caste youth’s downfall. They spread rumours that the teacher’s wife was having an affair with the handsome and physically strong youth. At last, the teacher came to believe the rumours and pondered how to wreak vengeance on the youth. He was wise enough to realise that if he killed him, or had him killed, that the truth might come out and his own life might be in danger. At the very least, his reputation would be destroyed. He came up with a cunning and cruel plot. At the end of the training course, the students would have to pay a fee to their teacher, perhaps proving their prowess to demonstrate the value of their education. The teacher demanded a fee from the youth that he must kill 1,000 people. The youth felt obliged to fulfil his teacher’s demand to repay his debt, as he had no financial means to repay him. Thus the career of Aṅgulimāla began, murdering any travellers he came across in the forest that was his hiding place. Due to his great cunning and physical strength, none could outrun him or defend themselves against him. The king sent men to capture him, but they too were killed by Aṅgulimāla. At last, the king sent an army of men to capture this fearsome murderer dead or alive. Aṅgulimāla’s mother, hearing of the king’s plan to capture her son, set out to warn him of the danger.
Seeing that Aṅgulimāla would kill even his own mother to claim his 1,000th victim, and thus accumulate heavy kamma that would prevent his attainment of Arahantship, the Buddha went there to intervene before Aṅgulimāla’s mother could reach the spot. Seeing the Buddha approaching, Aṅgulimāla set off to kill him. However, although Aṅgulimāla was a powerful athlete, he could not catch up with the Buddha, who was walking along calmly but using his psychic powers to keep out of reach. Finally, exhausted from his efforts, Aṅgulimāla called out to the Buddha to stop. The Buddha stopped, turned to Aṅgulimāla and said, “I have stopped, you have not stopped.” Aṅgulimāla, being intelligent, thought to himself, “These recluses speak only what is true. What does he mean by this?” Thus, instead of accusing him of lying, as most people would do, he asked, “What do you mean by this: ‘I have stopped, you have not stopped’?” The Buddha explained that he had stopped making fresh kamma that would lead to rebirth whereas Aṅgulimāla was still running at full speed in the cycle of birth and death, making fresh kamma that would lead to great suffering in the future. Aṅgulimāla understood, and asked the Buddha to be his refuge. The Buddha ordained him as a monk on the spot, and within a short time, being well-instructed by the Buddha himself, Aṅgulimāla gained Arahantship and thus put an end to kamma and rebirth.
When walking for alms one day, Aṅgulimāla heard the screams of agony of a women who was having a long and difficult period of labour. Filled with compassion for her, he approached the Buddha and asked if there was anything that he could do to help the woman. The Buddha told him to recite this verse:
“Sister, since I was born, I have not knowingly and deliberately taken the life of any living being, by this truth may you be well and may your child be well.”
Aṅgulimāla replied that this was untrue, because he had killed many human beings since his birth. The Buddha then told him to recite:
“Sister, since I was born with the noble birth, I have not knowingly and deliberately taken the life of any living being, by this truth may you be well and may your child be well.”
The noble birth refers to the realisation of the Dhamma and the attainment of the nibbāna. Anyone who has attained even just the first stage of the path is incapable of intentionally depriving a living being of life. As it says in the Ratana Sutta above:
“He is also absolutely freed from the four states of misery and is incapable of committing the six crimes. This precious jewel is in the Saṅgha.”
Killing living beings intentionally is a kamma that can lead to the four states of misery. A Noble One who has attained the path is incapable of falling into states of misery, and so also incapable of killing living-beings even to save his or her own life. The six crimes refers to heavy kamma such as killing one’s own mother or father, which a Noble One also cannot possibly do. Prior to attaining the Noble Path, even a devout disciple of the Buddha who religiously observes the five precepts may be capable of violating them in extreme circumstances, perhaps to protect his or her own life or that of loved ones. However, on attaining the path, an individual undergoes an irreversible transformation to the status of a Noble One. It is like a rebirth as a different individual with an entirely different nature and character. I have, I believe, met a few such individuals. They are quite different to the average pious Buddhist. Their character is impeccable, and even if mistreated they do no harm to others, never gossiping or telling lies and half-truths designed to denigrate others and harm their interests. Such rare individuals are indeed like precious jewels. Even when dropped in the dirt, they do not lose their lustre.
Aṅgulimāla was satisfied with this version, as he had attained not only Stream-winning, the first stage of the path, but the final stage of Arahantship. He knew that he was now incapable of intentionally destroying the life of an insect, let alone a human being.
He returned to where the woman was in labour, and sitting outside the room he recited the verse taught by the Buddha. The woman instantly gave birth without further difficulty. This declaration of truth has great power and is still recited by monks today to help women give birth without difficulty or danger.
Aṅgulimāla did not live long after becoming a monk. Although his powerful unwholesome kamma of killing many living beings could no longer lead to rebirth in the realms of misery, the painful results had to bear fruit in that very life. When he went for alms he would often return with his head bloodied by people throwing stones at him. The Buddha urged him to endure the suffering patiently.
All of the above healing methods amount to one thing, to accept and acknowledge things as they really are. When one is sick, the physical symptoms are bad enough, but far worse is the mental suffering that we pile on top of the physical suffering. Some patients are not patient at all, and constantly complain about their condition, hoping and praying for some miraculous cure. Al phenomena happen for a reason. It is not just kamma, nor blind chance, nor punishment by a malevolent God. Sickness may be partly or largely due to some evil kamma that we did in a past life, or in this very life, it might be the food that we ate, the weather, our unskillful thought patterns, or a combination of these causes.
When I was in Burma, I suffered frequent stomach ailments, perhaps due to eating oily food to which I was unaccustomed, aggravated by the hot climate, or perhaps it was just my past bad kamma bearing fruit — who knows? I often complained to my meditation teacher, and he did what he could to provide us foreigners with suitable food, free from too much oil and spice. However, I still complained. At one point he told me, “That is the problem with having a stomach.”
It is true, isn’t it? If I had no stomach, or did not need to eat, or only ate the bare minimum to survive, then I would not have to suffer from stomach disorders.
So we should understand about cause and effect (kamma-vipāka), about dependent origination (paṭiccasamuppāda), and the complex interaction of causal relations (paṭṭhāna). There are many causes for disease and dis-ease, and many remedies. Medicine should be taken, diet should be controlled, exercises should be done, and above all mindfulness and wisdom should be cultivated. If we are extremely diligent we can put an end to all suffering by realising things as they truly are — that is, all mental and physical phenomena are impermanent, unsatisfactory, and not-self (not subject to my wish or control). That insight will lead to the cessation of suffering, which is nibbāna.
In the Book of Tens ² Venerable Ānanda informs the Buddha that a monk named Girimānanda is extremely sick, and asks him to visit him out of compassion. The Buddha teaches the ten perceptions and tells Ānanda to convey them to the sick monk. These ten perceptions are: the perception of impermanence (aniccasaññā), not-self (anatta~), repulsiveness (asubha~), misery (ādīnava~), relinquishing (pahāna~), dispassion (virāga~), cessation (nirodha~), not delighting in the world (sabbaloke anabhirata~), having no desire for any mental formations (sabbasaṅkhāresu anicchā~), and mindfulness of respiration (ānāpānassati). As Girimānanda listened to the teaching his disease was allayed. This is another example of healing through mindfulness.
1. M.i.55, D.ii.289.
2. Girimānanda Sutta, A.v.108.