Meditation as Medicine
Thanissaro Bhikkhu

You all know the old image of the Buddha as a doctor and the Dhamma as medicine. When you come to practice the Dhamma, it's as if you're learning to be your own doctor, looking after the illnesses of your own mind. Everyone comes up here wounded in one way or another, suffering either from things outside or from things inside. At the time of the Buddha people were suffering from greed, anger, and delusion just as we are. With modern culture, modern society, it seems as if we have more diseases of the mind, more complex ways of getting involved in creating delusion, but they all basically come down to the same three roots.
So the treatment here is to learn how to uproot the disease. You want to look at your time here as a time for healing. The skills you want to take back with you are those of being not only your own patient but also your own doctor, learning how to look after the mind, seeing exactly where it needs treatment. And part of the treatment is the kind of healing that requires nourishment and rest.
This is a lot of what breath meditation provides. It gives the mind a place to settle down and be at ease with itself, to develop a sense of wellbeing inside-staying with the breath as you listen to the Dhamma talk. Don't really listen to what I'm saying. Give ninety-nine percent of your attention to the breath; leave one percent for the talk, in case something good comes by that's actually relevant to what you're doing. Otherwise, don't let the talk distract you from the meditation. Allow the mind to settle in.
You want to develop a quality where awareness and the breath become one, where you're right in the middle of the breathing process, not like you're in one part of the body outside the breath, watching another part of the body breathe. You're in the breathing-in, in the breathing-out. Allow those two things to stay together: your awareness and the actual sensation of the breathing. In addition to staying with the sensation of the breath, you'll also have to think about the breathing to keep the mind from wandering off. If the sensation of the breath isn't enough to keep you with it, then you can use a meditation word along with the breath. You can use the word "buddho," which means awake. Think "bud-" in and "dho" out, "buddho," "buddho"-or any word that helps keep you with the breathing. And if you want, think of the meditation word filling the whole body. The whole body goes "bud-," the whole body goes "dho," so there's no corner of the body where any other thought can come in.
You begin to realize that the breath is filling the whole body as well. The whole body gets involved in the breathing process if you allow it to. Every nerve gets involved in this energy flow. So think of them all working together. The breathing is soothing the body, soothing the mind right now, so the mind feels that it can melt in with the breath. The awareness melts into the breath. They become one.
However, the meditation is not just a bubble bath for the mind. There's the healing, comforting, soothing aspect, but remember, medicine comes in all sorts of forms. Some of it can be pretty strong. In other words, once the mind settles down you have to watch after it, make sure it doesn't go wandering off, doesn't get lazy and complacent. If the mind goes wandering off, ask yourself: "What trouble are you looking for now? Now that you're beginning to feel a little healed, what new germs are you looking for? What do you hope to get out of that particular thought?" And sometimes just this little warning is enough to bring the mind to its senses and bring it back. At other times you have to work at it a little more, focusing in more detail on exactly why you don't want to be thinking right now about anything else. Then bring the mind right back to the breath.
So you can't just wallow in the nice side of the breathing. There has to be constant vigilance over the mind because the problem with the mind is that as soon as it gets comfortable, it starts getting lazy and complacent. That's not the treatment at all. That's not the medicine the Dhamma provides. Once your sense of awareness settles in and gets comfortable, you have to be very watchful to make sure it doesn't slide off someplace else and start creating trouble for you.
So as the doctor for your mind, you want to combine these two qualities. On the one hand there's the sense of ease that comes with the breathing. On the other, you have to maintain mindfulness. You have to maintain alertness. Foster an attitude of heedfulness. Keep focused on the breath. Remember: The sense of ease and comfort is a product of your focus on the breath. If you lose your focus and start focusing on the wrong things, then once the cause is gone, the result is going to have to start fading away as well. You're left with nothing. It's like building up scaffolding and seeing a cloud next to the scaffolding. It looks nice and cottony and comfortable, so you go and jump on the cloud-and you go right through.
So allow yourself to rest with whatever sense of wellbeing there is, but remember that there's work to be done. After all, this is medicine; it's not always pleasant. It's not total relaxation. There has to be a certain amount of vigilance to keep the mind with the breath and not let it blur out. One way of doing this, once you've got a sense of ease with the breath, is to start thinking about the breathing process in different parts of the body. Just go through the body parts one by one by one, seeing how the breath feels at each particular part. You might want to start at the navel and then work up the front of the body, down the back of the body, and out the legs. Then start again at the back of the neck and then go down the shoulders and out the arms.
Take the body section by section and notice how each section feels as you breathe in, how it feels as you breathe out. If there's any tension or tightness, let it dissolve in the flow of the breath energy, so that you breathe in without building up any tension and breathe out without holding onto any tension that may already be there. Allow the tension to dissolve and then move on to the next section of the body, and then the next. Keep doing this until you've covered the whole body and can sense that all the parts of the body are breathing together in unison. Then try to maintain a broad awareness of that.
When the Buddha talks about the sixteen steps of breath meditation, number one and number two are just noticing the breath, to see how long or short it is. With number three you start training yourself. You're willing yourself to be aware of the whole body. And you'll find that there's a tendency, as you get lazy, for that awareness to shrink. Don't allow that to happen. This is the work you've got to do. Stay with the whole body, the whole body, the whole body as you breathe in, the whole body as you breathe out. And then work to maintain that sense of wholeness.
In the beginning you'll find that the work may seem to be too strenuous because you're not doing it very efficiently. Just notice what needs to be done, what doesn't need to be done in order to maintain that whole-body awareness until you find that you can maintain it with ease. You'll find that there may be slips. You're working with trial and error here. You're working on a skill. Try to think back to whatever manual skills you've developed-carpentry, sports, cooking skills, whatever-and the attitude you had to foster to help master the skill. If there's a mistake, you don't let yourself get upset by the mistake. Just start all over again. When things turn out well, don't let yourself be complacent. Try to think of other ways to improve what you've done. Or if it can't be improved, learn how not to mess with it, how to keep it going as it is.
There's a certain balance, a certain maturity that you have to bring to any skill. That's the kind of attitude you want to bring to the meditation. If you let yourself get too easily discouraged by bad sessions in the meditation or start getting complacent or cocksure about your good sessions, you're setting yourself up for a fall, and no skill is going to come from that. You want to keep at it, keep at it, keep at it. Whatever mistakes there are, you learn from them. Whenever things go well, you try to learn from them. If you come out of a good meditation session, don't leave it immediately. Reflect on what you did this time, what went right this time. And the more often you do that, the more precise your observation's going to be, the more you start seeing cause and effect as they operate in the mind.
We're working on a long-term project here. You come to realize that even though things happening from the outside may be wounding the mind, the real diseases come from within: our lack of skill in managing our thoughts, our lack of skill in relating to feelings, perceptions, thought-constructs, and consciousness. And so what we're doing is learning new skills to relate to what's going on in the mind, along with a new sensitivity that comes with these skills. The skill is not just staying with the breath but also finding ways to relate to whatever comes into the mind in the course of the day, wherever you are. The sensitivity you build up while you're working on the meditation should be applied to whatever happens throughout the day.
It's like taking a beginning art class. You come out of the art class and begin to notice colors and arrangements, not just in paintings but all around you. You've gained a heightened sensitivity. The same with the meditation: Try to take the sensitivity that comes with the meditation and apply it to the way you relate to your thoughts and emotions as they arise.
This sensitivity is what enables you to start seeing the subtle causes of the diseases in the mind. You come to realize that if the mind doesn't wound itself, it doesn't leave an opening for anything to come in from outside and wound it. We're the ones who lower our own resistance to the outside diseases, allow them to come in and infect the mind in one way or another. If it weren't for these internal tendencies, there wouldn't be any problem with living in the world. The mind would be totally resilient-but not insensitive. It simply wouldn't pick up any diseases from outside. The reason it does pick up those diseases is because it leaves an opening from inside, in the way it mistreats itself.
So we're learning new skills in how the mind can treat itself, how it can relate to itself, taking the breath as our foundation because it's an excellent barometer for what's going on in the mind.
Try to get as familiar as you can with this basic medicine. Once you've got the basic medicine down, learn what other ingredients you need to add for specific ailments as they come: what you should do in the case of anger, what you should do in the case of greed, what you should do in the case of fear, worry, or whatever. But the basic treatment is just this: learning to be with the breath, allowing the breath to be comfortable, and letting that comfortable breath spread throughout the whole body. This is the basic skill upon which all the other skills are based. This is the foundation, so you want to make sure the foundation is solid. Even when you move on to more advanced stages of the meditation, you always want to keep coming back to the breath because it forms the basis for the whole course of treatment.