Institute of Noetic Sciences: Good evening everyone, I'm Angela Murphy, program director for Shift in Action, and I welcome you to this week's teleseminar. We are very excited tonight to have John Astin as our guest, and with our host Marilyn Schlitz. So I'll turn it over to you Marilyn.
Marilyn Schlitz: Great, thank you. And welcome John, just by way of introduction. You've been on this program before, so maybe you don't need any introduction, but you are a health psychologist, and a scientist at California Pacific Medical Center. Your work is just stellar in terms of helping us to understand the relationship between the mind and the body and understand how it is that the data and the research that has been done in this field is both useful and limited in terms of the opportunities for people to really begin to bring it into their practices, and the research that you've done sponsored by the National Institute of Health to really look at these kinds of barriers of integration. I'm absolutely delighted to work with you on a new project that looks at barriers of integration not only at the individual level but at the collective level in terms of institutional change that's happening in medicine, something that's desperately needed. And then your own work in terms of your meditation practice, and so let's talk about all that tonight, if that's okay with you.
John Astin: Okay.
JA: I'm game.
MS: Good. Welcome. So if we could just start with a little bit of background on how it is that you came into this field of mind-body medicine, and you know, your training in psychology. What made you choose to go that route?
JA: Well, actually it was pretty much driven by personal experience. I, around the age of 19, dropped out of college and got very interested with sort of undergoing a transformation of, you know, it was a pretty volcanic time in my life, having been raised pretty non-religiously, considered myself an atheist, at the time all of a sudden that all kind of fell away, and I got very interested in sort of inner exploration, and gravitated, just the way it happened, I don't know how it happened, but I gravitated towards sort of Eastern approaches to spiritual growth and transformation and got involved in various meditation practices and almost became a monk during that time, being away from college. And when it became clear that that wasn't my path, I thought, Well, maybe I'll go back to school, and because these experiences I was having doing these practices were so profoundly moving and transforming, I thought, Well, it might be interesting to see what's out there in the world of science and academia in terms of people studying these practices, and so I thought, Well, if I'm going to go back to school, what don't I study what I'm finding moving in my own life. And so that's, as an undergrad when I went back, I started looking into the whole area of, kind of naturally fell into looking at health psychology and mind-body relationships and lo and behold, people had actually been starting to study meditative practices and the impact of those. Of course they'd been being studied, you could say, outside the realm of formal science for thousands and thousands of years, people experimenting in the laboratory of their own lives with these practices; but science had gotten interested in them really in the seventies, and when I was finishing my undergrad work in the early eighties, it was still relatively new, people doing research on this, and that interest just really continued through my undergrad years and master's training and counseling, and then later on when I went back to get a Ph.D. and did some of the early research on mindfulness meditation in my doctoral program. So I think it's just, you know, always been tied to my own personal exploration of those practices and that always fueled my interest in it academically.
MS: And your parents are both really involved in this area; how did they influence, or not, you know, your development of these ideas?
JA: Probably the influence has gone more the other direction, I think [laughs]. You know, certainly my father has gotten more and more, over the years, interested; and, for people who don't know, my parents are both academics, now retired from UCLA, but were psychologists and then education researchers but in the last few years have gotten interested in, have a very large grant that is ongoing from the Templeton Foundation studying the role of spirituality in higher education and so, I think the relationship has gone both ways, but I think that my kind of diving head first into these areas over the last twenty, twenty-five years has certainly played a role in turning them towards that as an area of interest to them. And I think it's also just a natural movement in their lives as they grow older, that looking to those deeper questions and seeing how those questions are related to their domain that they've been studying all these years, being education, higher education.
MS: So let's kind of start with the big picture of this field of mind-body medicine, as you mentioned, the science of meditation; obviously mind-body interventions are broader than that. What would you say in terms of how you define the data and the strength of the evidence for these kinds of mind-body interventions as efficacious in terms of actually impacting on physical and psychological aspects of health and healing?
JA: Well, it's always a little tricky in the mind-body area to talk about it as if it's one thing because you've got, as you just said, very diverse practices that get lumped together--this has always been the challenge even within the whole kind of complementary integrative medical field. We start talking as if we're talking about a single thing when we're really talking about very different approaches and something like progressive muscle relaxation, which sort of falls within mind-body practice, to various forms of visualization and meditation, to tai chi to yoga and there's a question as to whether those practices have some common elements that might explain why they seem to give rise to health benefits, and I don't know what the answer to that question is, I mean, some people have argued that awareness, which we will talk about later, is maybe a key point that something about those disparate mind-body practices, what many of them share in common is that harnessing of one's attentional faculties. And some sort of systematic training of awareness in some way, or bringing awareness to the very capacity to be aware, which we all ordinarily don't do as human beings, so whether that might be a common feature that links them together. And I think you know we could take a lot of time to go over what the research says about these mind-body practices, but certainly there's a now large body of evidence across a lot of different practices and mind-body therapies that indicates that they offer many, many health benefits. And I think that what's interesting is that despite that, and you and I have talked about this, that that evidence base has been slow to be incorporated into medicine, and I think that the reasons for that are very complicated, but it's a curious thing because I think just in our own experience we know that, our own direct experience tells us that what is happening in our interior experience is impacting what is happening in the body. If we feel anxious, you know, our stomach starts rumbling, I like to use that as a simple example that what we call the mind and the body are maybe two different aspects of the same phenomenon, and maybe not separate at all.
MS: Well, I do want to come back to that because I think that really speaks to some of your own practice and the notion of a unitive, non-dual consciousness. But before we go there, let's stay kind of in the research and say, Yes, obviously there are many different kinds of mind-body interventions, a wide range of these, and overall when we look at the field, it's very clear that the whole area of mind-body medicine has gained momentum and really is an intervention that's offered in most medical centers in the country now, that's quite an interesting phenomenon when you think about Jon Kabat-Zinn's influence or Herb Benson, and how much they've impacted in terms of the practice of health care. And yet, I mean, your work is revealing that it's not really as widespread as it might seem, and when people feel like well, the paradigm has shifted and that's like common sense now, that's not exactly what you've found in terms of the research you did with physicians and medical students. So maybe you could tell us a little more about what you did find and how willing people are to acknowledge the data, to use the data, to bring it into their practices, and if they're not willing, why not?
JA: Well, I think if you look in general at all the literature linking psychological, if you will, or psychosocial factors in health, and that's the literature that's been being built for several decades now, and the reality is that while most medical schools will say that, if you ask them, Do you teach a bio-psycho-social approach, you know, one that recognizes the importance of psychosocial factors in health, not merely biological and genetic and molecular biologic factors, they would, the medical schools would have to say that they do, because they know that that's politically correct [laughs], if you will, to say that, Sure we recognize the importance of these factors. But the reality is that if you actually look at the curriculum, the amount of attention that's given if you look at bio-psycho-social to say how much curriculum attention is given to the psycho-social, it's probably, you know, it's very, very small, maybe one percent, maybe a little more than that. But the bottom line is that they'll say, and I hate to say lip service, but there's a certain amount of lip service that's being paid to those domains of human experience and their impact on health; and I think it's challenging in medical training because your medical students are overwhelmed with the curriculum as it is, and in terms of trying to learn all that they can learn about how the physical body works and how cells function and the types of things that influence cellular function and give rise to pathology and disease. And so there's a lot to learn, and in my interviews with people in my survey research, one of the things that I've found was that they say, Yes, it's important to learn these other things about the psychological factors and social factors and their influence on health, but where is that going to go in the curriculum, how are we going to fit that in, we're already overwhelmed with trying to keep up with the knowledge base in the more biologic and genetic and molecular areas. So that's a real challenge I think, and there's some people who said to me that, and I think a lot of it does hinge on the curriculum, ultimately what are they learning in medical schools. And I think that what a number of people told me is that their very traditional medical training still involves a heavy emphasis in the first couple of years on basic science, and that most of the people that I spoke with in survey interviews said they felt that most of what they learned there was forgotten very quickly; they certainly don't remember much of any of it now [laughs]. And my sense is that it's probably important to get some exposure to basic science, but it's probably an overemphasis and an underemphasis on these other factors that are clearly, you know, if we just look at human behavior, how much human behavior is one of the leading causes of preventable disease in this country, and yet so little attention is given that. And of course the question is why is that, and I think that there's a lot of reasons for it; I think that there's certainly in the practice of medicine there's just the constraints of the structure of how medicine is set up, and that, say with managed care, that physicians have less and less time with patients, and of course what's going to get squeezed out, but what's considered to be less vital to know, and so talking with patients about what's happening in their lives and the stresses that they're under, and how those stresses might be influencing their physical health; if you have ten minutes with a patient that may not get covered when you have what you consider to be more vital things to deal with in that office visit. So there's sort of a structural constraint, and then I think there's really a paradigm barrier that probably has something to do with kind of our being enamored with a sort of a materialistic view and a reductionistic view of human health and well-being; and I think that the whole genetic revolution is probably beating that in many ways, and some notion that we hold that, you know, eventually we'll be able to figure out the genetic causes of everything [laughs], and in the process overlooked these other dimensions of human beings that simply can't be reduced to genetics, as hard as we may try.
MS: So part of it is just the structural aspects of time management, and inherent in that is a bias toward the physical, and then there's this other issue that you're talking about which is just fundamentally a worldview question about what counts, and clearly in our culture what we're talking about is the physical aspects of our experience are really the only things we - we being the dominant culture - consider to be important; and yet that's not what gives meaning or purpose or volition in our lives. So you see these paradigmatic and structural as well as the educational, so they didn't learn it, so they don't know it, so they're not comfortable...
JA: They don't know the evidence base, most of them. That's the reality, they've never been exposed to it. I mean, I read when I was interviewing physicians and medical students and residents, I would read them some of the seminal articles that have been published in some of the major medical journals linking psychological factors to health, and I would say, Did you ever come across articles like this in your training, and almost never. So it's a big case of them not being exposed to the evidence base that's actually out there. And I think that one aspect that represents a barrier and a challenge to them sort of shifting the paradigm of healthcare and medicine is that we are talking about things that are less tangible, domains of human experience that are less amenable to measuring and quantifying. And so it makes it more difficult for people to wrap their hands around in the same way they might wrap their hands around measuring your cholesterol, or even behaviors, like knowing that you smoke, and being able to assess, when that's a simple thing to assess, Do you smoke? But telling me, How are you experiencing your life, in a more interior way is harder to get a handle on, more difficult to assess, and so it's messier, if you will, less concrete, and less amenable to control as well, and so I think for all of those reasons it makes it, makes physicians let's say more inclined to deal with the concrete, with the tangible, what they feel they can actually measure and assess and then be able to influence in some way.
MS: Kind of reminds me of the parable of the fisherman who goes out with his net and the space in the net is like two inches big, and so he comes back from his fishing expedition and concludes that all fish are larger than two inches, because that's what his instrument would allow him to measure.
MS: It seems like there's a similar thing, there's a bias towards kind of what's in front of us rather than sort of the deeper inquiry and you know, that's a big fundamental challenge in terms of how we should reform and revise the healthcare system. What are strategies do you think for beginning to overcome those individual barriers and then let's talk about it at a larger institutional level.
JA: Well, I think that my sort of intuitive sense, and confirmed by my talking to people in my research, is that probably direct experience is going to go further than simply generating more evidence, more empirical evidence. I always like to tell the story of a former colleague of ours when I was at the University of Maryland who was an immunologist, and we did a lot of research on acupuncture and he was always very interested but very skeptical, and yet there were these very compelling randomized control trials and meta-analyses and systematic reviews suggesting there's something going on with this acupuncture at least in the case of some conditions, certainly management of pain. And yet he remained very skeptical and he's this brilliant scientist; he developed back pain at a certain point and he tried everything and nothing worked and finally my boss Brian Berman who's also an acupuncturist said, Look, I know you're skeptical but why don't you just try acupuncture. And so he did some treatments on this immunologist and his back pain went away. And you know that was more convincing than a thousand randomized control trials to show that something, it's very hard to refute direct experience [laughs].
MS: And yet we know that direct experience can be unreliable. So how you weigh the impulse then to say, on the part of the kind of established medical science practitioner who knows how to measure something in a fMRI, you know oftentimes psychologists are quite dismissive of subjective reporting because it's unreliable. How do you find the balance between this notion of direct experience and then the kind of reliability that comes from the objective epistemology of science?
JA: Well, I like what Ken Wilbur says about there's narrow empiricism and there's broad empiricism; and narrow empiricism tends to include only those things, he would say that you can see with, that have simple location, that can be seen with the eyes or with some extension of the eyes essentially. But there's this whole other realm of reality that we all experience, right now we are having an experience that's not empirical in the sense of you can't see my experience, but I'm having this experience nevertheless; and you can call it subjective, but it's still empirical in the sense that it's data. So he encourages us to broaden our notion of what we say is empirical to include the interiors as part of what falls within our realm of what can be observed and studied, you just have to use different tools, you can't measure them with the same tools. So there's other types of measurement and inquiry that are used for gaining knowledge about our interiors.
MS: So direct experience is part of it and...
JA: I think it's huge, actually.
MS: So the idea would be what, in terms of medical school?
JA: Let's use the example of meditation, okay? So let's say you're a physician or just a human being and I could talk to you till I'm blue in the face about what a fantastic thing meditation is and here's all the evidence showing all the health benefits and okay, how about if we just do some meditation together [laughs] and you have direct experience of what happens when you engage in that practice, in the laboratory of your own direct experience. And I think that can become a very potent, if you will, tool for helping people to go beyond their preconceptions and their judgments and their conceptual barriers to considering the potential value of something when they've actually experienced the value directly in their own life. So I think that's probably the most important thing.
MS: I think that's kind of the essence of the noetic sciences, is that notion of the direct experience and then trying to find a reliable, rigorous way of understanding that, and I think about Tibetan Buddhism and how in that system there is a epistemology for studying consciousness, but it's based on a subjective methodology that involves verification and replication and corroboration and some of the things that we think about as essential to the scientific process. How does that translate? I think again about Toynbee, and Toynbee said that historians of the twentieth century are going to look back at that period and say the biggest thing that happened was Tibetan Buddhism coming to the West because it's this convergence of methodologies or really ontologies of what's important. What's real? And for this Tibetan model it's that interiority becomes very real and there's ways of understanding and mapping and developing it; and in the Western world it's really much more about the objectification of that, and we certainly see that today, looking at the front page of Time magazine to National Geographic, Richie Davidson's work for example has so captured the collective imagination because in a way he is bringing this objective lens to the subjective experiences of these meditators and what do you think are the strengths and weaknesses of that kind of tension?
JA: I think there's great value in, human minds are curious and we seem to be curious by nature and trying to understand what we see around us and make sense of it in some way. And so in terms of understanding the interior one way we try to make sense of that is by looking at what interior states of consciousness, how they register in very observable domains, i.e. the brain and how changes in the brain may give us some clue as to what's actually shifting in people's interiors. The problem with that is that it may be a function of, our current neuroscience tools are still pretty crude, but they actually don't tell us a whole lot about what's happening in this state of consciousness. You know, if I ask you to imagine--forget about kind of very rarified states of consciousness that one might realize through some contemplative practice--but if I do something simple, like ask you to imagine an apple in your mind's eye, most people could do that, create some visual image of an apple, and if I looked at your brain under an MRI machine before you did that and then while you were doing it, something would change; because you were creating that visual image it would register, that interior experience of visualization would register in the brain in some way. But the fact that something shifted in the brain, what would that actually tell you about how you experienced the seeing of that visual image? The only way I'm really going to know about that experience is if I talked to you about it, if I ask you, How did that look? What did that feel like? What was that experience like? Did you enjoy that experience? There's so many dimensions of that one little visualization example. And then you compare the richness of you telling me about that experience, how it made you feel, what was difficult about it, what you enjoyed about it, what you learned from it, I mean the list could go on and on; versus what shifted and what part of your brain was using glucose when you had a visual image of that apple [laughs]. Do you see what I mean? And with our being enamored with the material realm, and that sort of constitutes real science, we end up I think missing this whole other dimension of the real richness, where the human experience is actually happening, you could say. It's also happening in the brain, but we're not experiencing this moment as neurons firing in our brains, all of us who are listening to this conversation, we're experiencing this as, we'll give different names to these experiences, bodily sensations and thoughts and insights and feelings and states of mind and the whole rich, what we would call our inner landscape of what's actually being experienced.
MS: But there has been a trend now, in a certain sense neuroscience is co-opting consciousness as something that is an epiphenomenon of the brain, and all things can now be reduced to that, and what I'm hearing you say is that that would be very misleading to make that kind of conclusion.
JA: Even if it is all just the brain, [coughs], excuse me, there's a part of me that says, So what? Where does that leave us? What if it is just the brain?
MS: What do you do with that?
JA: Yeah, so that's okay; it's just brain, and here we are in this moment having this experience. In a way it doesn't change anything, which is kind of interesting. Some people feel like, that just sucks the marrow out of life, and the richness out of life and the mystery out of life and I don't know if it really does, which is kind of interesting because when we say it's just brain, we don't actually know what that even really means. Because even at the level of the material universe, if you start to talk about what the material universe is made of, well now you're getting into very mysterious territory of quantum phenomena that are essentially potential and how they come into form. I don't understand quantum physics but even the material level is not such a concrete, nice, neat thing that we understand [laughs]; it's quite ineffable.
MS: That's so true; Hans Peter Dürr was with us for a workshop and he was talking about how, as a quantum physicist he was the director of the Max Planck Institute in Germany, and he said that physicists are forever trying to find the elementary particles of matter, and they would go deeper and deeper and smaller and smaller and ultimately, within the framework of this quantum model it isn't about an elementary particle. It's about the relationship of the parts, so it becomes a very different sort of model that's from the Newtonian kind of view of billiard balls to something that is fundamentally about relationship even at the core level of matter. I appreciate what you said though very much about this kind of dilemma in a certain sense of consciousness; and Dave Chalmers talks about the hard problem and the easy problem, the easy problem is really documenting that the brain has certain qualities and characteristics, but the hard problem is really understanding subjectivity and that self-reflection and intention and volition.
JA: Well, what's interesting about, as it relates to my own interest in consciousness and awareness and the training that I do and the writing that I do about awareness, is that in a certain way everything that we've talked about, and does it ultimately reside in the brain, and what's the relationship between mind and body and what is the mind and the body, I meanthere's all this wonderful stuff to speculate about and wonder about and try to discover, and that's part of what fuels scientific inquiry, but in a certain way what's so fascinating is the most difficult to grasp by science, namely consciousness, we could say that that's the one thing that's not at all speculative, the fact that there's consciousness here, the fact that awareness is happening in this moment. In a sense it's the only thing, in my own direct experience, it's the only thing that's really certain, is that we're aware. And everything else is interesting speculation, but beyond that I don't go much further than to say that it's ultimately speculation.
MS: It's that "I think, therefore I am."
JA: It might be, "I am, therefore I think."
MS: [laughs] Very nice.
JA: Because I am, the fact that there is this sense of knowing that you know you exist, there's this knowing of that that's not dependent on thinking, this fact that you exist.
MS: [laughs] So moving beyond philosophy, one of the issues that comes up when we think about mind-body medicine and the whole system of healthcare today is really the alleviation of human suffering, and so we can get into debates about different philosophical positions and so on, but ultimately it translates to some bottom line issues about people's experiences of pain and discomfort and the kinds of things that, in Buddhism it's their major focus. So I wonder in terms of your research now, if...
JA: Well actually it relates very much to what I was just saying about that's there's this certainty of being aware, and then there's this speculation about, let's just say what that awareness is, not to mention all the other things we wonder about, who we are and what the meaning of life is, and what's brain and what's mind; I say it's the stories we tell about our experience. And what's interesting, as it relates to the alleviation of human suffering is that in a way suffering, as I have come to understand it, is always tied in with some story about our experience, some interpretation of our experience. And that's ultimately part of what contemplative practices do is to help to reveal the ways in which we are constantly telling stories about our experience. And sometimes they're nice stories that make us feel good, but a lot of times they're stories that create suffering. And what's interesting is that, I make this distinction, I use this a lot in my work, a lot of my work right now is focused on addiction, and we draw this distinction. It comes out of some of the contemplative traditions, it's between the little mind and the big mind. The little mind is the mind that tells stories about what's happening, it's commenting on our experience, it's evaluating our experience, it's judging our experience, and in its most primitive form it's either liking what's happening or not liking it in some way; and it's probably true of our experience right now, like there's some part of us that's got some little running dialogue about this conversation, and do we like this conversation, do we like the direction it's going, we have maybe some judgments about it, we think, Wow, this is really exciting, or God, this is the most boring thing I've ever heard, and When are we going to get to something more interesting, and so the little mind is just kind of going Yak, yak, yak about our experience, sort of monitoring it and talking about it. And then there's this other dimension of awareness, what I call the big mind, which doesn't have any opinions about the experience; and in a sense it's, in the mindfulness field one of the ways they, even Jon Kabat-Zinn traditionally defined mindfulness, it's non-judgmental awareness. And really what that's pointing to in my own perception of this is it's pointing to this dimension of awareness or consciousness that is simply not evaluating this moment, but is aware of the moment, and it's also aware of evaluation that we might, that the little mind, if you will, might be generating about this moment.
MS: So how do you bring that in to the addiction, or another project I know you have an interest in is this conscious parenting and working with pregnant moms around mindfulness.
JA: Well, with addiction the theory that we're testing is, we've been looking mostly at relapse prevention. A lot of treatments for addiction are pretty successful but despite however successful they are, people end up relapsing, and a lot of research suggests that, we all probably know this from personal experience too, we don't need research to tell us that we tend to revert to a habit like an addiction as a way of managing the stress, right? So if it's food or if it's alcohol or if it's cigarettes, one of the things that's powerful about ingesting the various substances is that they change our consciousness. That's why we do them, is we don't like the state of consciousness we're in and we want it to be different; and that could either be the stress that we want to medicate, let's say, if we're depressed so we'll drink to manage our depression; or it might be boredom, and we don't feel like the moment is quite enough, quite exciting enough so we want to pump up the moment in some way so we'll use some substance to enhance the moment. In any case they both come out of this sense that something about the present moment is not enough. And so what we're teaching people to do in our training, in our studies with meditation, is when some state of mind arises that would ordinarily lead somebody to use or return to using a substance to manage that state or change that state, we're presenting a radical idea and I think it's very radical for most of us, and that is what if this state of mind that you're in doesn't have to be changed actually? That just runs up against people's sort of conditioned habit and tendency which is to try and feel better, it's a deep human yearning. But what we say is, the paradox is that the way to feel better is to not try to change the state that you're in, because what ends up happening is if you can enter into a different relationship with, or as I like to say, discover a place within you, an awareness, this big mind that I was speaking about is already in a different relationship with experience, it's not struggling with your state, even if the state is agitated or upset or distressed; that there's something that's not struggling with that experience, that's at peace with it even if the state is not peaceful. And of course if we take any state, even a distressing state and we discover what it's like to not fight against that state, well then the experience of being agitated stops becoming a source of suffering in a sense, because we're not struggling with it anymore, we're not resisting it, we're not fighting against it. And so the theory we're testing in our research is that once somebody starts to discover that they can relate to their distress in a different way, they don't actually have to manage it or change their state, but they can actually allow it or accept it, then they're going to be less likely in theory to turn to some you know, conditioned habit or substance use to manage their distress. Does that make sense?
MS: And also it's a way to kind of begin to reframe the pathology of all of our activity to allow us, in the Living Deeply work and the transformation study that we did what we found was very similar to what you just said, that transformation isn't really about any fundamental change in who you are, it's actually coming to a more authentic appreciation for exactly who you are, but in the process just a shift in perspective about the Who is the me that's having that experience. So from your own perspective, I know that the non-dual philosophy is very important for you, so what are your own perspectives on meditation and how to do it and how it's valuable to us in our lives?
JA: Well I think that in my own life, I mentioned at the outset of our talking together that I got interested in this stuff when I was about 19, and I spent about the next 20 years trying very hard to find inner peace through meditation; and I didn't quite know how hard I was trying, but I was very disciplined and doing lots of meditation practices and going on retreats and funny enough, I only saw this through a particular experience where I was striving really to get to a particular state which I thought was a higher state or a more enlightened state or a more God-realized state or a more whole state, pick your favorite term, and what I didn't realize until that process sort of unwound itself in a way was that that's a guaranteed way to keep a state of, an experience of peace away is by trying to find it, trying to seek after it, because of course the seeking for it is it's own kind of agitation, the looking for it, looking for it, where is it, where is it. So in the case of meditation what's happened for me in my approach to doing it in my own life and teaching it to other people is helping people to discover that rather than something that one sort of develops, really awareness is already present, obviously as I was saying earlier it's the most certain thing about our experiences, that we're aware, so actually you don't have to do a practice to be aware; you already are aware. And so I introduce meditation and the qualities that one is cultivating as part of meditation practice, let's say something like acceptance of our experience and not something, we hear "Become less judging of your experience," we hear that as a prescription and we hear from all the various religious traditions and spiritual traditions we hear various prescriptions. Become more forgiving, become more loving, become more compassionate, become less judging, right? And really what I think happened in the evolution of spiritual tradition and practice is that people heard what were essentially descriptions of what we fundamentally are as prescriptions for what to become. Then we engage in various practices to try to become more loving, become more forgiving, but actually if you look into, and I teach this in our studies in fact, if you look into the nature of ordinary awareness, what's aware and awake in this moment right now, and you actually begin to explore, in a sense you almost let awareness explore itself, if you even ask the question, if you turn awareness back on itself, let awareness be aware of awareness, and then you ask the question, What are the qualities of ordinary awareness? What's very interesting is that you begin to see that all those spiritual prescriptions are in fact describing the very qualities of ordinary awareness, that it's open by nature, it's not placing conditions on what it's open to, it's not judging, it has no biases, it has no opinions, it's not grasping, it's not pushing experience away. So it's very, very interesting to see that could it be that it's not so much, again developing these qualities as it is discovering that these qualities are already present, as the most natural thing about us, is our own ordinary awareness.
MS: That's beautiful, thank you. I think we should probably open the phone lines, because I'm sure people would like to be chatting with you. So Angela, you want to take it away?
IONS: I can do that, yes. This has been a great discussion, thank you. So we are now going to open all of the lines for Q & A, and we ask that you please mute your own phones by pressing *6 when I count to three, if you have a question for John or Marilyn, you can press *6 again to un-mute your phone; please say your name, where you're calling from, ask your question, and then please remember to re-mute your phone again after your question. That way we won't hear all the background noise. So get ready to mute your phones, one, two, three... All right, it sounds like everyone is re-muted.
MS: Okay, good. So who out there would like to raise the first question or broach the first conversation with John Astin?
Q: I have a question.
MS: Okay, great.
Q: This is Dale in Portland.
MS: So we have two people, let's start with Dale in Portland, and then there's a woman's voice in there that just spoke up, we'll take you second, okay? So Dale, go ahead.
Q: Okay. Hi Marilyn, I was with you at Ashland, and I'd like to ask, have you envisioned the role of ritual in a treatment process; shamans use ritual, AA has kind of a ritual that they say this framework seems to hold in it the human potential. Would treatment centers develop rituals that would enhance the treatment process, and what might that be in your imagination?
MS: So, John, you want to pick that up?
JA: Well, I think that we could say that, in a sense everything that we're doing is our ritual, right? That's what we do, that's our ritual, that's the way we are in relationship to other people, that's the way we behave with other people, the way we treat other people; in a sense I would almost say, what is not a ritual? I know that what you're speaking about is maybe more ancient traditions and rituals and do they hold value in the way we do healthcare and the way we treat patients. I would say probably that may be the case, I don't think it's been something that's been studied very much, but I guess that I would ask you what is sort of underneath the question for you, what's your own sense, have you had some experience with rituals of one kind or another as you understand them that have somehow been, have done something for you, have transformed you in some way that makes you be interested in that?
Q: Well, for instance just AA has a simple process, and they have definite limits and the process seems to guide people in a helpful way. So I was thinking if there were a way to do intakes or ways of preparing people for, say, physical treatments, that might be a quiet session, it might be saying certain things or watching a video that would enhance just their sense of presence and well-being. I don't know, I'm wondering if there are some ways we could create an experience, as people enter into treatment, that would enhance the treatment process.
JA: That's a great question. I think it's pretty unexplored in terms of, if you say even using some kind of centering technique or quieting technique or meditative kind of technique before, you can imagine as a simple example, if you're a physician and every time the patient walks in you say, You know, before we start dialoguing about what's going on with you, why don't we just sit in silence for a couple of ( ). You can imagine how that might alter the whole tone, shape, that dialogue will then come out of their dialoguing together. I think you're right, those kinds of things are very simple things you can do to kind of set a certain tone as part of the whole healing ritual, absolutely.
MS: And you can also think about the placebo, and the expectancy effect and how you can really prime people to have either a state of discomfort or a state of comfort. And so much of it is our anticipation of that so if you can find ways to either minimize or enhance, depending on what the goal is, a certain kind of experience, I could imagine that that would be very beneficial. Thank you Dale. And there was a woman who was on the phone who started to ask a question, and I didn't get your name, but go ahead and jump in.
Q: My name's Lorraine, out of El Dorado Hills, California.
MS: Hi there.
Q: Hi. I'm a registered nurse, and I've worked in acute care settings, trauma ER's, ICU, and I don't any longer; and I wonder have you ever thought much about the barrier in medicine of the false ego, the lack of mindfulness and spiritualness in how people are treated, the patients and doctors toward nurses, nurses toward nurses, et cetera. As I've gotten older I've realized that thoughts are real things, and one day I think we'll discover that the negativity of the thoughts in these centers--ICU, et cetera--are actually harmful to patients.
JA: Is that part of what led you to get out of being in medicine?
Q: Yes, I felt like my own health was being impacted, because there's too much negativity and falseness going on just in the treatment of these very ill people, and a lot of negativity, and it's very, very negative, there's nothing healing about it.
JA: What was your sense, since you were in those environments as a practitioner, did you have a feeling of what was giving rise to that kind of negativity, what was at the root of that?
Q: Yeah, I do. I think it's in the schooling, it's in the competitiveness, it's insecurity that people have. There's so much to know, and I think it creates an insecurity, and I think that people have developed this false ego of trying to protect themselves from one another, from what they don't know, from what they think they don't know, that creates a very negative atmosphere.
JA: I think you're right in many ways about that, and I think one of my observations, I've seen it working directly with medical residents, that it's actually not okay to not know.
JA: And what we do, all of us as human beings, is, I think in a lot of ways our dysfunctional behavior comes out of this discomfort we have with uncertainty, and with not knowing, and so we make things up; literally we make them up and we make them up in the form of belief systems and ideologies, and one way it can manifest is negativity as a way of regaining a feeling of power and control in a situation that we know actually is fundamentally out of control, and not very knowable.
Q: That's it, thinking power and control in situations where you aren't going to get it, you know? They've all have been heading down a slippery slope for many years and they come in to you, and they're getting ready to die, and there's a lot of stress.
JA: Right, and it's very interesting, I think it's both a question for medicine, but you know maybe it's a question that's much bigger than just medicine and has to do with how do human beings deal with not knowing, with being uncertain about, what's interesting, I talked about my work with mindfulness and it's a very, very interesting thing to think about that we don't, we can't actually predict what's coming in the next moment let alone the next week or the next few months or the next few years. And so in the face of not really being able to know what's going to unfold in the next moment, are we okay with not knowing that? Or are we struggling against that, and fighting against the reality that it's actually not fully controllable at all.
JA: It's interesting. I've looked at that a lot in my own life and I've seen it in people that I work with, and it's interesting too, I was describing these two minds, if you will, there's that mind that's trying to understand which is a very natural thing, is also trying to get a foothold of certainty and security and yet there's this other part of us that's actually very comfortable with not knowing, it's fine with not knowing.
Q: Right, yeah.
JA: And can we gain more familiarity with that part of us that acknowledges the not knowing and in a way really almost rejoices in the fact that it's not knowable, it's mysterious, and most people aren't familiar with that but they can learn to become more familiar with it.
Q: I agree. Just hearing it helps.
JA: Yeah, well thank you for your question. That's a great observation.
Q: Thank you.
Q: I have a question.
MS: Thank you. Go ahead. And who is this?
Q: My name is Jeff, I'm in New Jersey.
JA: Hi Jeff.
MS: Great, Jeff.
Q: Hi. I was fascinated with your discussion of you know, self awareness, the big self. And I guess my question is when you start becoming self-realized, and this relates to the way this was billed on the website, not a lot of questions, technical questions on healthcare and mind-body interaction, but on structured versus unstructured meditation.
Q: You know, I've done a lot of reading in a lot of different areas, and Eckhart Tolle and just acceptance of the present moment and just even, you know he defined consciousness as the absence of thought without loss of consciousness, so there's perceiving; in other words, you're becoming aware of the big self, you're a perceiver for the self that's functioning through you, living your life, and I think that's what you were getting at before. And I was wondering if you could relate those different meditation techniques, whether structured or unstructured, to how to more greatly embody that unconditioned, nonjudgmental awareness also referred to by Jon Kabat-Zinn, into everyday reality so you become more and more an embodied sage rather than something you have to consciously bring in, and you know, something that kind of takes over your life so you become the enlightened sage instead of a person that's still...
MS: John, before you answer that call, a question. Could I ask that everyone please remember to re-mute your phone if you've already asked a question; press *6, we're hearing a lot of background noise, thank you.
Q: Yes, and before I get on and you answer that, or before I get off rather, I have a response to the gentleman that talked about ritual. There's been a lot of experiments over the years since the 70's using psychedelic drugs in psychiatric settings with people about to die and bringing them into that more unconditioned awareness, using music and other rituals to try in this setting, and it helped these individuals tremendously, so I think there's a lot of research going on in that area, but it's more in connection with, you know, with entheogenic substances more than through meditation.
JA: And in relationship to your question about how to sort of let this kind of unconditioned, nonjudging awareness sort of take more hold of a life, and be what's moving the life rather than something else, I think that, for me it's, and why my own relationship to meditation and the way I introduce it to people to shift it, is that I think that the practices sort of emphasize technique and making effort and trying to cultivate, sustain, and maintain a certain kind of awareness can, I mean they're very powerful practices but what they tend to reinforce in my experience is they reinforce the meditator, they reinforce the one, and somebody was mentioning earlier about kind of the ego mind, and that's what they tend to reinforce, is the notion of I, as a sort of separate individual, have this power to create, sustain, and embody this awareness, and really I think it misses a really fundamental thing, which is that, and the traditions speak about this, and that is that if you look into awareness and the nature of awareness, we're not fundamentally anything but that awareness, we're not separate from it. There's not someone who is aware, there's just awareness, and that really these kind of more direct path sort of approaches to meditation, it's much more about seeing that it's this kind of integration or this embodiment that we're talking about. First of all, it can only happen in this moment, because this moment is the only moment we're ever alive, and it's happening now, that this awareness is present. And in a certain way it's the simplicity of this sometimes kind of takes people aback, but the simplicity is that maybe there isn't much to do about that other than see that the reality, this awareness that has an unconditional relationship to experience, it's not judging it, it's open to it, and that maybe the work, if there's any work to do, is simply to allow oneself to keep surrendering in a sense, back into that awareness. It's already present, and that we're really not fundamentally separate from it. Does that make sense?
Q: It makes sense. But you know that there's a definite difference in the sense when you feel yourself sort of as the eye of God, the eyes of the world, the eye that's perceiving the force in itself, and you're consciously conscious of it, as you said, awareness becomes aware of itself, whereas when you're, you know, discombobulated with a problem and you go into a suffering mode and you have to bring yourself, you have to consciously say to yourself, at least I do, Well, this is God too, it's happening in this moment, it's all part of the flow that I'm part of, and there's a little bit of an exercise that has to be done to kind of reunite you with that flow, and even though you're never technically apart from it, I understand what you're saying, you're never apart from it because you can't be.
Q: You know, nothing could function without that ever-present awareness. But my sense is that the sage, like Ramana Maharshi or Sargagada Maharaj and people who have attained those things in this moment can never kind of lose their center.
JA: Right. Although we don't really know that, do we? We don't really know that, in a way it's speculation as to what someone else may have achieved. And what we really know is that there's awareness here, and there's a way in which it's, what if it were so much more simple than we, I am continually astounded by the way we make the simplicity of awareness into something more complex. I don't deny what you're saying, about the experience that happens when there's a contraction, and one goes into a kind of suffering, one gets caught up in the stories of the mind and of course it happens, but what's interesting is that if you look from the perspective of awareness, remember how I was saying that awareness has no opinions, or judgments; so let's say that suddenly one is wrapped up in some judgment, it's like, from the perspective of what's just registering that, what's just awake to that, aware of that, that judgment isn't actually turned into a problem that you have to do something about. I say this to people when I'm teaching meditation that it's very interesting that we, in a lot meditation traditions thought is sort of turned into a problem, the thinking mind is the problem, right?
Q: (...) said if the thinking mind doesn't dominate your consciousness, you're not going to get swept away by it, it's no problem. But I guess that leaves the final issue which was the subject of the discussion tonight, and it's what Eckhart Tolle talks about, do we just (...) sit back and (...) don't do anything about our spiritual development or do we take a structured amount of time every day and you know, devote ourselves to (...) unconditional awareness...
JA: Sorry there was some distortion there.
MS: Yeah, we're getting a lot of...
JA: It was a little difficult to hear you, but...
MS: The cell phones and speaker phones are probably still on.
JA: I think I got the gist of what you were saying and I think that maybe there's no formula for that, that's a very individual, if you feel drawn to making some kind of effort to be more in touch with this, then that's what you'll do. And at moments it may dawn that no effort is required to be, any more than any effort is required to be aware, that there's a sense that it's quite effortless. And there may be times when some effort may be engaged in to see that, and to know that and to rediscover that moment by moment.
MS: And to be reminded, I guess, huh? Well, John, thank you so much, I think we're out of time, and this was very stimulating, and I think very inspiring for people and I very much appreciate that.
JA: My pleasure.
MS: Thank you for taking your time, and for all the brilliant work you're doing in the world and all the ways in which you really are helping to alleviate the kind of suffering that we've been talking about, so thank you. And Angela, do you want to take it away?
IONS: Yes, I will. Thank you both, it was a really wonderful discussion!