All Good Without Anything Good. Beyond Survival: Understanding the Psychosocial Experiences of Individuals With Chronic Kidney Disease and Their Caregivers in Sri Lanka.

AIM: This study aims to explore the experiences of individuals with chronic kidney disease (CKD) undergoing haemodialysis and their caregivers, focusing on the disease's impact and the treatment process. BACKGROUND: In Sri Lanka, CKD is a growing health concern, particularly affecting farming communities and contributing to the strain on the biomedical healthcare system. Despite increasing awareness of CKD's physical implications, its psychosocial impact remains underexplored. This study seeks to fill this gap, aiming to inform culturally sensitive interventions and improve the healthcare system's responsiveness to the unique needs of Sinhala Buddhist individuals with CKD and their caregivers. DESIGN: An exploratory qualitative study. METHOD: Semistructured interviews were conducted with 10 individuals undergoing haemodialysis and 5 caregivers at a dialysis unit. The interviews were audio-recorded, transcribed and analysed using conventional qualitative content analysis. FINDINGS: The analysis revealed three interrelated main themes: (1) impact on standard of living (quality of life), (2) coping strategies and (3) medical experience, with a notable influence of traditional beliefs and practices. CONCLUSION: The findings highlight the need for a holistic approach to CKD management that integrates physical, emotional, psychological and social aspects, considering the significant role of traditional influences. Further research is essential to develop effective interventions that can enhance the quality of life for CKD. PATIENT OR PUBLIC CONTRIBUTION: The lived experiences of Sinhala Buddhist individuals with CKD and their caregivers served as a cornerstone, providing profound insights into the impact of the condition on their lives. Throughout the study, these participants played an instrumental role in refining the research's cultural sensitivity and relevance. Their engagement extended beyond the data collection phase to encompass feedback sessions, where they actively shared their perspectives. This ongoing collaboration ensured the study's depth and applicability to real-world experiences. By actively involving those directly affected by CKD, this collaborative approach safeguards that the study remains rooted in their voices and addresses their unique needs. REPORTING METHOD: This study adhered to relevant EQUATOR guidelines (the COREQ checklist). TRIAL REGISTRATION: This study is not a clinical trial, and thus, registration is not applicable.

Journey in the Impure Land: Buddhist Pilgrimage and Perceptions of Life and Old Age in Vietnam.

Religiously inspired travel has burgeoned in Vietnam in recent years, amidst rapid economic development and a booming tourist industry. Buddhist pilgrimages particularly attract older women, who compose the majority of temple goers in Vietnam. Having lived through volatile historical periods of war, economic hardship, and political transformations, travelling on pilgrimage is the first opportunity for many older Vietnamese women to enjoy new places and experiences. Drawing on data collected during my field research among Buddhist women pilgrims in their sixties and seventies from Ho Chi Minh City, I show how pilgrimage is seen as a journey of a lifetime and how it reflects the perception of life and self-transformation along the life course. Drawing on Victor and Edith Turner's (1978 [2011]) discussion of pilgrimage as the antistructure of everyday social life, this paper explains why pilgrimage is markedly different from other life experiences of Vietnamese women, and how religious travel positions old age not as the culmination of self-development, but rather as an ongoing process of gaining wisdom.

Spiritual places: Spatial recognition of Tibetan Buddhist spiritual perception.

Tibetan Buddhism, as an indigenous religion, has a significant and far-reaching influence in the Tibetan areas of China. This study, focusing on Lhasa, explores the integration of Tibetan Buddhist spiritual perceptions within urban spaces. Employing a novel approach that combines street view data and deep learning technology, the research aims to identify and map the spatial distribution of Tibetan Buddhist spiritual sites against the backdrop of the urban landscape. Our analysis reveals a notable concentration of these spiritual places near urban architectural and cultural heritage areas, highlighting the profound connection between residents' cultural life and spiritual practices. Despite challenges posed by modern urbanisation, these spiritual sites demonstrate resilience and adaptability, continuing to serve as cultural and spiritual pillars of the Tibetan Buddhist community. This study contributes to the fields of urban planning, religious studies, and digital humanities by demonstrating the potential of technology in examining the impact of urban development on cultural and religious landscapes. The research underscores the importance of protecting and integrating spaces of spiritual perception in urban development planning. It shows that safeguarding these spaces is crucial not only for cultural heritage preservation but also for achieving sustainable urban development and social harmony. This study opens new avenues for interdisciplinary research, advocating for a deeper understanding of the dynamic relationship between urban development and spiritual spaces from psychological, sociological, and environmental science perspectives. As urban landscapes evolve, the study emphasises the need to maintain a balance between material sustainability and cultural and spiritual richness in urban planning.

Is mindfulness practice "at risk" of increasing spirituality? Systematic review and critical analysis of a claimed effect.

INTRODUCTION: Mindfulness meditation has gained prominence in somatic and psychiatric care in several countries including France. Studies have shown its effectiveness in various conditions, in particular the prevention of depressive relapses. However, there are criticisms and concerns about its potential links to Buddhism and spirituality, raising issues of secularism and sectarianism. This issue is particularly conflicting in France with regard its historical and political relationship with secularism. OBJECTIVES: This study aims to assess quantitative data regarding the impact of mindfulness meditation on spirituality and religiosity using quantitative validated scales. METHODS: A systematic review was conducted. PubMed was searched for relevant studies using keywords related to mindfulness and spirituality/religiosity scales. Four scales assessing spirituality were identified: FACIT-sp, INSPIRIT, DSES, and DUREL. Qualitative analysis determined if scale items pertained to spirituality or other topics considered by opponents to mindfulness as "at risk" for deviances or sectarian aberrations. Quantitative analysis assessed the effect size of changes in scale scores before and after mindfulness meditation interventions. RESULTS: Eighteen studies were analyzed, with varying scales and program durations including 1272 participants. Qualitative analysis showed that most scales contained items related to spirituality as well as "at risk" elements like religion and mysticism. Quantitative analysis revealed that a few studies reported significant increases in spirituality scores following mindfulness meditation, but the clinical relevance of these changes was questioned. In general, control groups had smaller score changes. INTERPRETATION: While some studies suggest a potential increase in spirituality due to mindfulness meditation, the clinical significance of these findings remains uncertain. Moreover, mindfulness meditation's ties to Buddhism are disputed, and its roots are intertwined with various psychotherapy traditions that incorporate spirituality. The role of secularism in psychotherapy is also debated in France, emphasizing the need for proper use and regulation policy rather than prohibition of mindfulness-based approaches. This study highlights the complexity of assessing the impact of mindfulness meditation on spirituality and religiosity. It suggests that a pragmatic approach focusing on risk and harm reduction may be more suitable than labeling the practice as "at risk". Further research is needed to clarify these issues in the specific cultural context of France.

Reincarnation Beliefs and Suicidality: Social, Individual and Theological Factors.

Among African tribes, Inuit, the Druze, Hinduism, Buddhism, Jainism, and Sikhism, a diversity of attitudes toward suicide exists. The meaning of suicide appears to be largely a reflection of the impact of the death on friends, family, and the broader community; the circumstances of the individual within their community; and the specific religious implications of suicide. The interpersonal impact is seen as consisting of the material impact of suicide; the spiritual and emotional burden endured by the community; and norms related to suicide. Individual factors include the degree of social integration; the social impact of suicide before death; and how the individual anticipates suicide affecting their afterlife. Taken together, the commonly repeated notion that reincarnation beliefs lend themselves to suicidal behavior finds little support, and instead it appears that social and pragmatic issues shape the meaning and interpretation of religious beliefs which in turn buffer or facilitate suicidal behavior.

Religious Afterlife Beliefs Decrease Behavioral Avoidance of Symbols of Mortality.

An astonishing cultural phenomenon is where, far away from or close to a city center, people in different societies localize cemeteries that function as both sites of memory of lost ones and symbols of mortality. Yet a psychological account of such differences in behavioral responses to symbols of mortality is lacking. Across five studies (N = 1,590), we tested a psychological model that religious afterlife beliefs decrease behavioral avoidance of symbols of mortality (BASM) by developing and validating a word-position task for quantifying BASM. We showed evidence that religious believers, including Christians, Muslims, Hindus, and Buddhists, exhibited decreased BASM relative to nonbelievers. We also provide evidence for a causal relationship between religious afterlife beliefs and reduced BASM. Our findings provide new insight into the functional role of religious afterlife beliefs in modulating human avoidance behavior in response to symbols of mortality.

Measuring LGBT Discrimination in a Buddhist Country.

Previous literature has found that, among other religions, Buddhism tends to be relatively less discriminatory against members of the LGBT community. However, this assessment is based solely on cross-country comparisons rather than analyses of discrimination at the individual level. The present study therefore uses an individual-level dataset that comprises a national representative sample of 27,855 observations to examine discrimination against LGBT people in Thailand, as a case study of such discrimination in a Buddhist country. It also examines the influence of Buddhist thoughts concerning prosocial behavior and positive emotions, which might be expected to reduce LGBT discrimination. Using an order-probit model, we find that while those who practice Buddhism tend to discriminate against members of this community less than do adherents of other religions, older generations tend to discriminate against LGBT people more than do their younger counterparts. Buddhist teachings regarding prosocial behavior such as reciprocating benefactors and donating money and goods as well as fostering positive emotions such as sincerely forgiving others and feeling gratified after helping others tend to reduce discrimination against LGBT individuals.

Traditional Buddhist meditations reduce mismatch negativity in experienced monk- practitioners.

Thousand-year-old Buddhist traditions have developed a wide range of methods for the subjective exploration of consciousness through meditation. Combining their subjective research with the possibilities of modern neuroscience can help us better understand the physiological mechanisms of consciousness. Therefore, we have been guided by specifically Buddhist explanations when studying the physiological mechanisms of altered states of consciousness during Buddhist meditations. In Buddhism, meditations are generally divided into two large categories: (1) one-pointed concentration and (2) analytical meditation. Maintaining both one-pointed concentration and analytical meditation on 'bodhicitta' ("the thought of awakening") and 'emptiness' is a necessary condition for transitioning into tantric practices. Tantric practices involve sophisticated visualizations of Buddhist deities, the 'energy structure' of the human body, and the visualization of the stage-by-stage process of dying accompanied with the dissolution of body elements. According to Buddhism, these meditations are characterized by the gradual withdrawal from "gross levels" of consciousness associated with the five senses. From a psychophysiological perspective, this withdrawal of sensory consciousness can be considered as the decrease of sensory stimuli recognition and attentional disengagement from the external world. We concentrated on how considered meditations affect sensory and cognitive processing of external stimuli. Auditory event-related potentials (ERPs) in the passive oddball paradigm were studied both during meditations and in a controlled state of relaxed wakefulness. It was shown with a group of 115 Buddhist monks that during meditation, mismatch negativity amplitudes, amplitudes of N1 and P2 components of ERPs to deviant stimuli, and the amplitudes of the P3a component to novel stimuli all decrease. These outcomes suggest that the considered Buddhist meditations, compared to the control state of relaxed wakefulness, are accompanied by a decrease in physiological processes responsible for maintaining attention on the outside world and recognizing changes in the stream of sensory stimuli.

Progressive increase of high-frequency EEG oscillations during meditation is associated with its trait effects on heart rate and proteomics: a study on the Tibetan Buddhist.

Meditation has been a spiritual and healing practice in the East for thousands of years. However, the neurophysiologic mechanisms underlying its traditional form remain unclear. In this study, we recruited a large sample of monks (n = 73) who practice Tibetan Buddhist meditation and compared with meditation-naive local controls (n = 30). Their electroencephalography (EEG) and electrocardiogram signals were simultaneously recorded and blood samples were collected to investigate the integrative effects of Tibetan Buddhist on brain, heart, and proteomics. We found that the EEG activities in monks shifted to a higher frequency from resting to meditation. Meditation starts with decrease of the (pre)frontal delta activity and increase of the (pre)frontal high beta and gamma activity; while at the deep meditative state, the posterior high-frequency activity was also increased, and could be specified as a biomarker for the deep meditation. The state increase of posterior high-frequency EEG activity was significantly correlated with the trait effects on heart rate and nueropilin-1 in monks, with the source of brain-heart correlation mainly locating in the attention and emotion networks. Our study revealed that the effects of Tibetan Buddhist meditation on brain, heart, and proteomics were highly correlated, demonstrating meditation as an integrative body-mind training.

Imagination-Based Loving-Kindness and Compassion Meditation: A New Meditation Method Developed from Chinese Buddhism.

Many loving-kindness and compassion meditation methods used in psychological research are derived from Theravada and Tibetan Buddhism. Zhiyi (), a representative figure of Chinese Buddhism, proposed a different meditation method, namely, imagination-based loving-kindness and compassion meditation. The current article introduces the imagination-based loving-kindness and compassion meditation proposed by Zhiyi and compares it with meditation methods from Theravada and Tibetan Buddhism. Zhiyi's method limits the content of imagination during meditation, which can be an essential supplement to the free association method derived from Theravada Buddhism. Zhiyi's method of helping others entirely through imagination differs significantly from the tonglen method derived from Tibetan Buddhism and may be more suitable for participants without religious beliefs. Based on Zhiyi's source text and previous psychological studies, a mental-health training program for imagination-based loving-kindness and compassion meditation is proposed. The limitations of Zhiyi's method and the future directions for empirical research on Zhiyi's method are also discussed. The differences between Zhiyi's method and other methods in terms of effects and applicable populations need to be examined in future studies.

Understanding of Self: Buddhism and Psychoanalysis.

The healing of the self-or the psychological health of the self-has been an intensely studied issue in the traditions of both Buddhism and psychoanalysis. It is easy to suppose that the understanding of self in Buddhism cannot coexist with the understanding of self in psychoanalysis because the self in Buddhist tradition is mainly regarded as an illusion and needs to be deconstructed, whereas in psychoanalysis, it should be re-constructed for mental health through analysis. Because of this difference in the understanding of self, one may also suppose that these two respective paths to a balanced mind would inevitably be different.

Covid-19, global ethics, and Jihi: A voice from East Asian philosophy.

As the Covid-19 situation has developed rapidly into a pandemic of unprecedented scale, ethicists and philosophers must work to comprehend this tragic historical scene from a macroscopic perspective, striving to create peace in the minds of people worldwide. The Buddhist concept of Jihi is a key idea in East Asian philosophy and implies concern for others. Specifically, it requires its constituents to pray sincerely for the well-being and peace of mind of those who are suffering, regardless of nationality, age, gender, or family origin, and mourn this situation together. Accordingly, Jihi may represent a vital component of global ethics, particularly in situations involving the Covid-19 crisis.

Listening to Sutra-Chanting Reduces Bereavement Stress in Japan.

Buddhist Chaplains chanting sutras after the Great East Japan Earthquake in 2011 often encountered survivors who felt that hearing sutra chanting itself ameliorated their bereavement grief. This research is the first experimental examination of the effects of sutra chanting on listeners' bereavement stress. Prior research demonstrates that sudden pet loss causes bereavement stress in students and that physiological stress can be noninvasively measured by salivary alpha-amylase. We asked Japanese college students to raise pet goldfish until they developed an attachment to them, then confiscated the fish, and told the students that they had to be killed. To compare the bereavement stress of groups listening and not listening to sutra chanting, we used psychological and salivary analyses. Perceived Stress Scale (PSS), Multidimensional Empathy Scale (MES), and State half of the State Trait Anxiety Inventory (STAI) psychological scales showed no statistically significant differences between sutra and control groups, but salivary analyses indicated measurable stress reduction in the sutra-listening group only. This pilot study tentatively confirmed the hypothesis that listening to Buddhist sutra chanting reduces Japanese bereavement stress. Further research is needed both to verify these stress-reduction effects and to determine whether such effects are primarily musical or cultural/spiritual.

Death acceptance from a Thai Buddhist perspective: A qualitative study.

PURPOSE: To have more in-depth understanding of death acceptance among patients with terminal cancer in Thailand. METHODS: A qualitative descriptive research approach was used to capture the perspectives of patients with terminal cancer about death acceptance. Purposive sampling was used to recruit the participants. A semi-structured interview guide was used during data collection to obtain in-depth interviews with 12 patients diagnosed with terminal cancer. An interpretive descriptive method was used for analyzing data. Analysis of the data for this study was conducted by the analytic team beginning at initial data collection. RESULTS: The findings of this study revealed six major themes relating to death acceptance: 1) perceiving death as a natural part of life; 2) perceiving that death cannot be controlled; 3) thinking that death can come at any time; 4) letting everything go before dying: finding a calmness; 5) additional Buddhist practices: clean living and making merit; and 6) additional means for attaining a peaceful death and peaceful life before death. CONCLUSION: Understanding death acceptance is important for nurses providing care for patients with terminal cancer in order to find strategies and support for patients to accept death and live peacefully with their family in the time they have left.

Mindfulness Meditation, Mental Health, and Health-Related Quality of Life in Chinese Buddhist Monastics.

OBJECTIVE: To determine associations between mindfulness meditation and mental health and health-related quality of life among Buddhist monastics. METHODS: This is a cross-sectional study of Chinese Buddhist monastics aged ≥18 years who practised mindfulness meditation daily. Mental health was assessed by the 12-item General Health Questionnaire (GHQ-12), whereas health-related quality of life was assessed by the 12-item Short Form Health Survey (SF-12). The number of years and the average daily amount of time spent in mindfulness meditation were collected. RESULTS: 47 monastics completed the interview. They practised mindfulness meditation for a mean of 7.3 years, 1.1 hours per day. Both the number of years (ß = -0.48, p = 0.03) and amount of daily practice (ß = -0.53, p < 0.001) of mindfulness meditation were associated with the GHQ-12 score, after adjusting for age, sex, education, and years of being a monastic. Only the amount of daily practice (ß = 0.44, p = 0.004) was associated with the mental component summary of SF-12. Neither was associated with the physical component summary of SF-12. CONCLUSIONS: Among Chinese Buddhist monastics who practise daily mindfulness meditation, spending more time each day and having longer years of practice were associated with better mental health.

Hypnotic-like Aspects of the Tibetan Tradition of Dzogchen Meditation.

Dzogchen meditation has been practiced by Bonpo and Buddhist yogis for at least 1,200 years. Dzogchen utilizes methods of meditation and yogic exercises that are said to help one fully awaken from illusions of self and reality that cause suffering in life. The philosophy and experiential practice of Dzogchen is very similar to hypnosis. Dzogchen techniques utilize hypnotic-like practices of selective attention, visualization, and posthypnotic suggestion to help yogis experience advanced insights into the nature of mind. The experience of Dzogchen can be likened to the experience of hypnosis in terms of their phenomenological and psychophysiological effects. Finally, there are also many theoretical similarities between aspects of the ego state therapy, neo-dissociation, sociocognitive, and Ericksonian theories of hypnosis with the tradition of Dzogchen meditation.

Spiritual dimension in palliative care from the perspective of Thai palliative caregivers.

BACKGROUND: In Thailand, most terminally ill patients die in hospital and are looked after by health professionals. Terminally ill patients tend to receive physical care only, while in the main, spiritual care is neglected. This study aimed to explore spirituality in palliative care health professionals and spiritual leaders in the Thai Buddhist context. METHOD: In this qualitative case study, seven experienced palliative caregivers took part in in-depth interviews. Thematic analysis and a trustworthiness process were used to analyse the data. FINDINGS: Three themes emerged: (1) the ability for self-awareness and faith; (2) acceptance and compassion for others; and (3) spiritual behaviour while nursing. CONCLUSION: The results revealed the meaning of spirituality and the necessary characteristics for spirituality in palliative care for the participants, which could serve as a basis for further development.

Collaborative dialogue between Buddhism and science: A contribution to expanding a science of consciousness.

Investigation of consciousness (experience, mind, awareness, subjectivity) has become an accepted endeavor in contemporary neuroscience. However, current work is largely limited to study of neural correlates of consciousness. While this is interesting and important, it may not be sufficient to carry us to a place of truly new insight regarding consciousness. I argue that one element of expanding a science of consciousness is appreciation of the interdependent co-creation or enfolding of mind and world. Addressing this interdependence is an aspect of the collaborative engagement of the traditions of Buddhism and science-a project that is exploring how complementary worldviews and analytic procedures might further the development of an expanded science of mind. In this essay, written for a collection honoring the life and work of Jack Pettigrew, I describe his connection to this project.

Depression prevention in adolescents based on Buddhism and Sufficiency Economy Philosophy.

Depression among young adolescents can affect the learning performance and quality of life, and increase suicidal risk. Depression prevention (DP) intervention at the early onset is thus important. The participants were 20 adolescents aged between 10 and 14, 5 parents, and 7 teachers who resided in the same province in northern Thailand. Descriptive statistics were employed for data analysis, while qualitative data from four focus group discussions (FGDs) and 17 in-depth interviews (IDIs) were analyzed through content analysis. The findings revealed that the critical component of depression prevention model for adolescents is self-worth enhancement, which comprises of the enhancement of self-esteem, problem-solving skills, and relaxation based on Buddhism and Sufficiency Economy Philosophy (SEP) for emotional balancing in order to prevent depression in adolescents.