Lt. Col. M.B. Pethe and Dr. R.M. Chokhani

Abstract

Vipassana meditation is a scientific technique of self-exploration: a system of self-transformation by self-observation, a healing by observation of and participation in the universal laws of nature. Its theoretical basis, health potential and practical applications are discussed and reviewed in this paper.
Key Words: Vipassana Meditation, Positive Mental Health, Self-Actualization, Transpersonal Consciousness.
Introduction

Health, as defined by the World Health Organization, is a state of complete physical, mental and social well-being and not merely an absence of disease or infirmity. This is considered to be an idealistic goal, setting out the standard of positive health, with due emphasis on the promotion and protection of health. "Health for All by 2000 A.D.", is the main social target set the by the 30th World Health Assembly14. Health, therefore, is a dynamic concept and can be described as a multidimensional process involving the well-being of an individual in the context of his or her environment.

This presentation shall deal primarily with the mental dimension of health since it is the "mind" which is the central directing force of one's entire life and activity, and also because every health disorder is affected directly or indirectly by psychological factors. It is truly said that mind matters most.
In Indian parlance, health is a positive concept: "swasthya" means being oneself. Indian introspectionists over millennia have produced a rich harvest of profound psychological insights, which needs to be reinterpreted in the contemporary context and the currently familiar idiom; for example, nibb±na or "nirvana" by Gotama Buddha as the burning out of passions or mental impurities; "mokŒha" by Lord Krishna as freedom from conditioning and constraints of all kinds; "sahaja" by Guru Nanak as one's nature: literally born along with oneself 7. Various austerity and self-control measures and meditative approaches have been detailed in their treatises, to enable one to attain the desired goal of self-realization or self-liberation, called in modern parlance a higher psychic state or transpersonal consciousness.
Abraham Maslow6, generally regarded as the modern founder of transpersonal psychology, postulated the concept of "self-actualization", which emphasizes the importance of maximal growth and development of human potential. It has also been equated with such terms as self-realization, optimal functioning, psychological health and individual autonomy. All these imply the highest stage of personality development or the optimal personality functioning and positive mental health. Shostrom8 describes self-actualization as an ongoing process of growth towards experiencing one's potential in terms of creative expression, interpersonal effectiveness and fulfilment in living. Vipassana is a way and means to such self-actualization or self-realization.
Vipassana Meditation11
Also known as Insight Awareness or Mindfulness Meditation, Vipassana is a very ancient meditation technique of India, laudatory references to which are found even in the Rigveda. Long lost to humanity, it was rediscovered twenty-five centuries ago by Gotama Buddha. Although Vipassana contains the core of what was later called Buddhism, it is not an organized religion, requires no conversion and is open to students of any faith, nationality, colour or background.

To learn Vipassana, one is required to take a ten-day residential course under a qualified authorized teacher. Meditation teacher Shri S.N. Goenka and about two hundred assistant teachers trained by him, hailing from various parts of the world and practically all walks of life, are discharging this onerous responsibility voluntarily and selflessly.
There are in all thirty-one permanent Vipassana Centres across the globe in countries like India (14), Nepal (2), Sri Lanka (1), Myanmar (1), Thailand (1), Japan (1), the United States (4),Australia (4), New Zealand (1), France (1) and the United Kingdom (1). The main Centre is the Vipassana International Academy, located at Dhamma Giri, on the outskirts of the town of Igatpuri in the Nasik district, about 135 kilometres from Bombay.
Vipassana is a P±li term and it means insight, to see things as they really are. It is a scientific technique to explore the laws of nature (called Dhamma), within the framework of one's own mind and body. During the training period of ten days, the participants follow a basic code of morality, which includes celibacy and abstention from all intoxicants. For the first three and a half days, one is trained to focus one's attention on breathing (Anapana) and thereafter, one learns to examine the reality pertaining to oneself, systematically and dispassionately. One realizes, by direct experience, the scientific laws that operate on one's thoughts, feelings, judgements and sensations. One also learns to live in conformity with these laws, a life full of peace and harmony, a really healthy and happy life.

Mechanism and Psychological Effects

The teachings of the Buddha embody "Abhidhamma", a very systematic and intricately laid out psychology, which presents a set of concepts for understanding mental activity and methods for healing mental disorder. It differs markedly from the contemporary psychotherapeutic outlook. In this model of mental activity, every mental state is composed of a set of properties of mental factors, which gives it its distinctive characteristics. There are 52 basic perceptual, cognitive and affective categories of these properties. The basic dichotomy in this analysis of mental factors is between pure, wholesome or healthy and impure, unwholesome or unhealthy mental properties; healthy mental states are antagonistic to unhealthy ones, inhibiting them. Vipassana meditation aims to eradicate these unhealthy properties from the mind; the operational definition of mental health is their complete absence, as in the case of an arahanta (saint)4.
"Everything that arises in the mind is accompanied by a concomitant physical sensation", said the Buddha. This interrelationship is the key to the practice of Vipassana meditation. Vipassana trains the concentrated attention to follow the mechanics of mental processing with the base of physical sensations, in a detached fashion. This perspective of an observer allows the controlled release of mental contents such as craving and aversion, past and future, in a seemingly endless stream of memories, wishes, thoughts, conversations, scenes, desires, dreads and lusts. Thousands and thousands of emotionally-driven pictures of every kind rise to the surface of the mind and pass away without provoking a reaction, while simultaneously anchoring one in concrete, contemporary reality1.
The mind is deconditioned with meditation altering the process of conditioning per se, so that it is no longer a prime determinant of future acts4. A refinement of awareness occurs and one responds consciously to life situations thereby becoming free from limitations, which were forged by mere reactions to them. One's life becomes characterized by increased awareness, reality-orientation, non-delusion, self-control and peace1. Such a person is able to make quick decisions, correct and sound judgement and concerted effort-mental capabilities which definitely contribute to success in contemporary life10.
Vipassana is not merely an exercise to be performed in the special environment of a meditation retreat. When a ten-day course is over, meditators take the tool home with them. The path of Vipassana is a continuous, disciplined pursuit of this experiential gnosis throughout life; it is a human capacity and a personal choice. Through Vipassana, one can transcend body-mind or even East-West dualism and shake hands with ethical rootedness, cultivated mindfulness and wisdom in all its enduring forms2.

Vipassana, Health and Healers: A Review

Considerable data is available, documenting the various biopsychosocial benefits that accrue from the practice of Vipassana meditation. It indicates the vast therapeutic potential that Vipassana has. For instance, many case report studies have been recorded on the positive effects of Vipassana in different psychosomatic disorders such as chronic pain, headaches, bronchial asthma, hypertension, peptic ulcer, psoriasis, etc., and so also in different disorders including alcoholism and drug addiction. Beneficial aspects of Vipassana have also been studied in special population groups such as students, prisoners and police personnel, besides individuals suffering from chronic pain and various mental disorders 11,12,13.
However healing-not disease cure, but the essential healing of human suffering-is the purpose of Vipassana. Suffering springs from ignorance of one's true nature. Insight, truth- experiential truth-alone frees one2. "Know thyself", all wise persons have advised. Vipassana is a practical way to examine the reality of one's own mind and body, to uncover and solve whatever problems lie hidden there, to develop unused potential and to channel it for one's own good and the good of others5.
All people need healing, most particularly healers. "Physician heal thyself", is a well-known phrase. Freud and Jung insisted that analysts be analysed. The very vulnerability and compassion that sets the healer on a lifelong journey to heal, coupled to the constant exposure to human suffering, requires a treatment of its own. Vipassana is acceptable and relevant to healers of diverse disciplines because it is free of dogma, experientially based and focussed on human suffering and relief. With its practice, healers are able to deepen their autonomy and self-knowledge, at the same time augmenting their ability to be a professional anchor to others in the tumult of their lives. Vipassana is verily the path of all-healing, including self-healing and other-healing2.
A Model for Clinical Application
The clinical utility of Vipassana is more likely to be in terms of providing a general psychological pattern of positive mental states rather than a response to any particular problem. Generally, the conventional psychotherapies are generated as treatments for the latter. Many therapists11,12,13, who are themselves meditators, teach "Anapana"-a preparatory step in the training of Vipassana, to their clients. The clients may be suffering from various neurotic, psychosomatic and personality disorders including addictions, and Anapana is taught as a supplementary form of treatment, with a good clinical response.
Before commencing the formal training in Anapana, the therapist explains to the patient its potential benefits, particularly relaxation. This helps reduce the patient's apprehension and enables him or her to co-operate and participate actively in the treatment. In addition, it is necessary to ensure that the physical environment is one that will facilitate relaxation; the room should be quiet and free from interruptions and the patient's couch should be reasonably comfortable.
The patient is asked to lie comfortably on the couch, close his eyes and observe, that is, cultivate awareness, of his respiration at the entrance of his nostrils-whether in-breath or out-breath, deep or shallow, fast or slow; natural breath, bare breath and only breath. When his mind wanders, the patient is asked to passively disregard the intrusion and repeatedly focus his attention on his breath, without getting upset or disturbed about the drift of his mind.
Two things happen. One-his mind gets concentrated on the flow of respiration. Two-he becomes aware of the relationship between his mental states and the flow of the respiration; that whenever there is agitation in the mind-anger, hatred, fear, passion, etc.-the natural flow of respiration gets affected and disturbed. He thus learns to simply observe and remain alert, vigilant and equanimous.
The patient is advised to continue practising the technique on his own, twice daily-in the morning and in the evening, each session lasting for about thirty minutes. The therapist reviews the progress of his patient from time to time, simultaneously counselling and motivating him to undertake a regular ten-day Vipassana meditation course. The patient is thus encouraged to continue to strive for his personal autonomy9, that is, to take personal responsibility of his own health and well-being.
Conclusion
Vipassana's ability to tranquillize the human mind, changing its turbulence to calmness with increased vitality, makes it a positive mental health measure and an excellent human potential development method. The meditator becomes free to live for higher values, richer goals: loving-kindness, compassion, sympathetic joy and peacefulness. Vipassana thus leads people from narcissism to mature, social love, to a life of altruism3 and this personal transformation becomes the catalyst for social change and development.
More scientific research needs to be pursued on the role of Vipassana, both as a self-regulation strategy for specific psychotherapeutic and psychophysiological aims and as a discipline and way of life for deep self-exploration and transformation. The various psychophysiological changes with Vipassana ought to be studied with the aid of modern sophisticated instruments. Also, long-
term prospective studies on meditators, besides multicentred controlled clinical trials of this technique, need to be conducted to clarify which individual types and health disorders respond to and benefit from the practice of Vipassana. Such endeavours
will make "Health for All" a more realistic proposition. ¦

References
1. Fleischman P.R., "The Therapeutic Action of Vipassana" and "Why I Sit," Buddhist Publication Society, Kandy, Sri Lanka, 1986.
2. Fleischman P.R., "Vipassana Meditation: Healing the Healer" and "The Experience of Impermanence," Vipassana Research Institute, Igatpuri, India, 1991, 3-15
3. Goenka, S.N., "Altruism: Quintessence of Religion, in: Issues of Biomedical Ethics" - Proceedings of the Festival of Life International Congress, December 1988, Bombay; Editors: Vas C.J. & de Souza E.J., McMillan India Ltd., Delhi, 1990, 95-102.
4. Goleman D., "Meditation and Consciousness: An Asian Approach to Mental Health," American Journal of Psychotherapy, 1977, 30: 41-54.
5. Hart W., "The Art of Living": Vipassana Meditation as taught by S.N. Goenka, Harper and Row, New York, 1987.
6. Maslow A.H., "Motivation and Personality," Harper and Row, New York, 1954
7. Neki J.S., "Psychotherapy in India," Indian Journal Psychiatry, 1977, 19(2): 1-10
8. Shostrom E.L., "Comments on Test Review: The Personal Orientation Inventory," Journal of Counselling Psychology, 1973, 20: 479-481
9. Surya N.C., "Personal Autonomy and Instrumental Accuracy, in: Psychotherapeutic Processes," Editors: Kapur M., Murthy V.N., Sathyavathi K., & Kapur R.L., N.I.M.H.A.N.S., Bangalore, India, 1979, 1-19
10. Thray Sithu Sayagyi U Ba Khin, "The Real Values of True Buddhist Meditation," Buddha Sasana Council Press, Yegu, Rangoon, Burma, 1962
11. Vipassana Research Institute: A Reader: "International Seminar on Vipassana Meditation," December 1986, Igatpuri, India, 1986
12. Vipassana Research Institute: A Reader: "Seminar on Vipassana Meditation, Relief from Addictions, Better Health," November 1989, Igatpuri, India, 1990.
13. Vipassana Research Institute: A Reader: "International Seminar on Vipassana Meditation and Health," November 1990, Igatpuri, India, 1990.
14. World Health Organization, "Health for All," Sr. No. 1, Geneva, 1978