Impact of Religion-Based Mindful Walking Meditation on Cardiometabolic and Mental Health.

Walking meditation or mindful walking is a widely performed form of Buddhist practice that focuses on mind-body interactions. We have found that this particular form of exercise was highly effective in eliciting improvements in cardiometabolic and functional fitness measures in a number of clinical populations. In some key measures, the magnitudes of benefits were greater than the traditional walking program.

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.

Work, Self, and Society: A Socio-historical Study of Morita Therapy.

Morita therapy is known as a psychotherapy grounded in the culture of Japan, particularly its Buddhist culture. Its popularity in Japan and other East Asian countries is cited as an example of the relevance and importance of culture and religion in psychotherapy. To complement such interpretations, this study adopts a socio-historical approach to examine the role and significance of work in Morita's theory and practice within the broader work environment and culture of the 1920s and 1930s in Japan. Morita conceptualized shinkeishitsu as a personality disease and a social illness caused by an alienating work environment. He proposed a remedy that emphasized the subjective emotional experience of work. To his primarily middle-class clients and readers, Morita's reconciliation between the self and society and that between autonomy and compliance was persuasive and useful, providing a philosophy whereby they could integrate into the work environment without loss of self-worth. The socio-historical character of Morita therapy is vital to understanding its power and appeal during Morita's time. Moreover, it sheds light on the complex interrelationships between work, mental health, and society.

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.

Mongolian philosophical underpinnings of well-being: Mythology, shamanism and Mongolian Buddhism (before the development of modern nursing).

Mongolian philosophical underpinnings of well-being were expressed in the form of mythology, shamanism and Mongolian Buddhism before the development of modern nursing in Mongolia. Among these forms, the philosophical underpinnings of well-being, mythology and shamanism were formed as a result of the roots of Mongolian philosophy, whereas Buddhism spread relatively late. As a result of Mongolian mythology, an alternative approach called dom zasal was formed, and it remains one of the important foundations of the idea of well-being among people. Among the various concepts of shamanism, the concept of sunesu best expresses the underpinning of well-being, and the idea that healing and nursing care can be provided not only by those living in this world but also by spirit beings. Since Mongolians still use these ideas even in modern times, it should be noted that following them too narrowly may conflict with concepts based on scientific evidence. Along with the development of Buddhist philosophy in Mongolia, the Oriental philosophical underpinnings of well-being have spread. One of the most important concepts is the five basic elements of life (tavan mahabhutas) and three elements of the body (khii, shar and badgan). While developing the concepts of life and the body, the arga-bileg model (yin-yang in Chinese), developed at the theoretical level in Chinese philosophy, has become a popular basis for culture and customs among Mongolians. Therefore, it has been difficult to judge whether the origin of the arga-bileg model is Mongolian or Chinese; however, this is undeniably an important underpinning for well-being in both countries.

Becoming Buddhists: The emergence of a prestigious temple.

How does a novel organizational prototype come about and succeed to the point where it becomes recognized as an icon? To address this question, this article examines the organizational emergence of a prestigious temple. Drawing on interviews and content analysis of 6320 blog entries between 2006 and 2018, we identify how an organized way of practicing Buddhism emerged in China and trace its founding monks to students from two elite universities. We argue that organizational emergence-in this case the rise of a prestigious temple and what it stands for-was manifested by identity claims of "who we are" to audiences. Declaring "who we are not" prior to establishing this temple, the founding monks subsequently claimed their organizational identity in three distinct stages: who we are in this temple, who we are as a temple, and who we are as Buddhism. As these identity claims were recognized by the audiences, a novel Buddhist organization emerged. This article contributes to an organizational perspective of religious study and provides a focused case with sufficient temporary variations to explore how identity claims facilitate organizational emergence. It has important implications for understanding incremental yet fundamental institutional changes, as it provides a template of organized religion that nurtures social skills for self-organizing. More broadly, these insights contribute toward developing a vibrant civil society.

Psychoanalysis of the unspectacular.

From the perspective of a poet and first-year psychoanalytic training candidate, this paper develops Jeremy Safran's ideas about the dialectic between psychoanalysis and Buddhism by drawing an analogy between their processes and those of a poetry practice to define an alternative to pathological dissociation under capitalist systems of value. The paper details the writer's experience of working a day job in an office and the pathological dissociation which she subsequently attempts to overcome and critique through writing poetry. Various poems written at work are shared and analyzed as evidence. Drawing from Safran's edited volume, Psychoanalysis and Buddhism, the author then identifies aspects of Zen Buddhist meditation practice and the psychoanalytic process that focus on connecting with reality, however conflicted, as opposed to escaping it. This paper was written under the mentorship of the psychoanalyst and Zen teacher Barry Magid.

Finding one's way.

The following is a meditative reflection on an anecdote from Jeremy Safran's Psychoanalysis and Buddhism. Moving through Safran's description of an important moment in his development as a student of Buddhism, the author weaves images, practices, and ways of being and feeling into an homage to Safran's legacy integrating psychoanalytic and Buddhist praxis and epistemology.

Letting go to let be: Psychoanalysis as creative flow.

This paper explores experiences of surrender to an aspect of mind that is unconfined, empty of dualistic concepts, and lucidly aware. Ghent's concept of surrender, Farber's unconscious will, and Buddhist philosophers' essence of mind all link to creative processes described by Poincaré and Mozart. This impressionistic collage points to the spaciousness to know beyond our usual stories. From this essential mind more wholesome actions proceed.

Remembering Jeremy Safran: continuing the conversation.

This introduction provides an overview to this special issue honoring the work and legacy of Jeremy D. Safran. Born of the Jeremy Safran Memorial Conference, held on April 2nd, 2023, this issue features a wide range of contributions from leaders in the field, former students, and early career professionals whose work engages and develops central ideas from Safran's work and reflects on his impact on their own clinical work and scholarship. Themes center around the three domains of Safran's major contributions: pedagogy; psychotherapy integration; and Buddhism, spirituality, and psychoanalysis. We observe among the contributions an experiential reconnecting with the deeply relational commitments of our friend and colleague.

Samsara in psychotherapy. A rebirth of Jeremy Safran's Buddhist dialogue.

This paper reflects the legacy of Jeremy Safran's application of Buddhist principles to clinical practice and supervision. The rebirth of his life and work in the clinical work and supervision of his students is examined. The paper explores transformation or enlightenment in cyclical spaces of loss and suffering or samsara.

Buddhism.

After Christianity, Judaism, and Hinduism, Buddhism is the 4th major religion of the world. The Pew Research Center estimates that as of 2020, about 500 million people (or 6.6% of the world's population) practice Buddhism. China has the largest Buddhist population at 254 million, followed by Thailand at 66 million, and then Myanmar and Japan at about 41 million.

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.

Study of medication use and effects of medication among hospitalized older Buddhist monks: An embedded mixed-method study.

AIM: The aim was to study medication use, effects of medication and perspective of participants involved in medication use among hospitalized older Buddhist monks. DESIGN: An embedded mixed-method study. METHODS: This study included 71 hospitalized older Buddhist monks and 23 participants involved in medication use. Quantitative data were collected from medical and medication records. Meanwhile, qualitative data were collected by using in-depth interviews. Data were analysed using descriptive statistics and content analysis. The study lasted from February to July 2021. RESULTS: Over 77% of the monks had chronic diseases. The median of medicine use was seven medicines/person and 6 days of use. Effects of the medication were as expected (52.04%), not as expected (2.22%) and unmeasurable results (45.74%). Unexpected results were hypo-hyperglycaemia, nausea/vomiting, high blood pressure and confusion. From the interview, participants perceived and did not perceive unique practices and medication use in Buddhist monks. In addition, the Buddhist monks received medication following standards and Buddhist doctrine. Finally, recommendations for medication use were adhering to the standard, following Buddhist doctrine and being flexible as deemed necessary. CONCLUSION: The results revealed medication use problems and medication effects among hospitalized older Buddhist monks. IMPACT: Older adults and Buddhist monks have specific needs and practices related to culture and religion, affecting typical treatment, especially medication use. Cultural diversity and sensitivity should be a concern for healthcare staff. The results can be utilized to promote an understanding of cultural diversity and increase the safety of medication administration for hospitalized older Buddhist monks. PATIENT AND PUBLIC CONTRIBUTION: Patient and public contributions were involved in this study. Participants involved in medication use were interviewed to answer the research objective. Moreover, a senior Buddhist monk at Wat Thai Washington D.C. reviewed content related to the Pali Canon for the final draft of the manuscript. CLINICAL TRIAL REGISTRATION NUMBER: https://osf.io/b6p3e.

Person-Centered Mindfulness: A Culturally and Spiritually Sensitive Approach to Clinical Practice.

Mindfulness meditation is rapidly being integrated into many different forms of counseling and psychotherapy, and there is a growing evidence base for its effectiveness. It is important to understand the spiritual roots of mindfulness, and to apply it in a patient-centered manner, sensitive to the patient's own faith tradition rather than taking a one-size-fits-all approach, assuming that mindfulness-based practice is a purely secular approach. The philosophical underpinning of mindfulness lies squarely in the Buddhist faith tradition. Indeed, mindfulness is the 7th step on the Eightfold Path, which is the heart of Buddhist teachings. Many practitioners, however, may not realize that there are Western meditative techniques that are very similar to mindfulness and that have deep roots within Christian, Jewish, and Muslim faith traditions. Patient-centered mindfulness involves the use of mindfulness and other meditation methods that are based on the patient's own faith tradition, rather than applying Eastern forms of mindfulness claiming these are a secular approach appropriate for everyone regardless of religious beliefs, even if those beliefs are not consistent with the Buddhist religious or philosophical approach. In this article, I briefly examine the evidence for the clinical effectiveness of mindfulness meditation, and then go into greater depth on Hindu, Buddhist, Christian, Jewish, and Muslim forms of mindfulness or similar meditative practices, providing resources that will better equip clinicians and researchers to provide patient-centered culturally-sensitive care.

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.

Noncommunicable diseases and social determinants of health in Buddhist monks: An integrative review.

The prevalence of noncommunicable diseases (NCDs) is increasing worldwide. Buddhist monks in Thailand play a critical role in health as community leaders accounting for 0.3% of the population. However, some monks require treatment and hospitalization to alleviate the burden of NCDs due to religious beliefs and practices during ordainment. Risk factors for NCDs among Buddhist monks, and the relationship to social determinants of health (SDH) remain unclear. This integrative review examined the prevalence of NCDs and explored the relationship between SDH and health outcomes among Buddhist monks. Cohort, descriptive, and correlational studies published in both English and Thai languages were identified from the PubMed, Science Direct, CINAHL, and Thai journal databases. Keywords included "Thai Buddhist monks," "non-communicable diseases," and "prevalence". Twenty-two studies were selected. Obesity and hypertension were the most prevalent NCDs. Religious beliefs and practices influence SDH domains and play an important role in the lifestyle and health behaviors among Buddhist monks. Further understanding of the impact of the religious lifestyle is needed, particularly given the role and influence of monks in society.

Assessment of the Perceived Importance of Religion in Couple Relationships in Christians, Muslims, Buddhists, and the Nonreligious.

Couple relationship standards (beliefs about what makes for a satisfying couple relationship) have not included standards held about religion, which is surprising given how important religion is in many parts of the world. In the current study, we developed the Importance of Religion in Couple Relationships Scale (IRCRS) with the aim of having a scale suitable for use across different cultural and religious groups. The IRCRS was administered to three samples: 354 Pakistani residents (178 females, 176 males) who identified as Muslim; 274 Thai residents (157 females, 117 males) who identified as Buddhist; and 165 Westerners (resident in Australia or the United States, 60 males, 105 females) who identified as either not religious (n = 74) or Christian (n = 91). We developed a 13-item measure with a two level structure yielding an overall importance of religion score. The items in the IRCRS had acceptable cross-cultural structural invariance in a multi-group confirmatory factor analysis of the Pakistani Muslims, Thai Buddhists, and Westerners. Pakistani Muslims endorsed IRCRS standards most strongly, Western Christians next most strongly, Thai Buddhists next, and Westerners with no religion least strongly. There were no gender differences, and only very small differences by relationship status. The IRCRS can be used in future research to investigate the association of religious relationship standards with couple relationship satisfaction and might be a useful clinical tool to assess the importance of religion to couples.

Los estándares de las relaciones de pareja (las creencias acerca de lo que conduce a una relación de pareja satisfactoria) no han incluido los estándares relacionados con la religión, lo cual es sorprendente teniendo en cuenta cuán importante es la religión en muchas partes del mundo. En el presente estudio desarrollamos la Escala de la Importancia de la Religión en las Relaciones de Pareja (IRCRS, por sus siglas en inglés) con el objetivo de tener una escala apta para el uso en diferentes grupos religiosos y culturales. Se administró la IRCRS a tres muestras: 354 residentes pakistaníes (178 mujeres, 176 hombres) que se identificaron como musulmanes; 274 residentes tailandeses (157 mujeres, 117 hombres) que se identificaron como budistas; y 165 occidentales (residentes en Australia o en EE. UU., 60 hombres, 105 mujeres) que se identificaron como irreligiosos (n = 74) o como cristianos (n = 91). Desarrollamos una escala de 13 ítems con una estructura de dos niveles que da un puntaje de la importancia general de la religión. Los ítems de la IRCRS tuvieron una invarianza estructural intercultural aceptable en un análisis factorial confirmatorio multigrupo de los musulmanes pakistaníes, los budistas tailandeses y los occidentales. Los musulmanes pakistaníes confirmaron los estándares de la IRCRS más marcadamente, luego le siguieron los cristianos occidentales, los budistas tailandeses y finalmente los occidentales irreligiosos. No hubo diferencias de género y solo muy pequeñas diferencias según el estado civil. La IRCRS puede utilizarse en investigaciones futuras para averiguar la asociación de los estándares religiosos de las relaciones con la satisfacción con la relación de pareja, y podría ser una herramienta clínica útil para evaluar la importancia de la religión para las parejas.

Theravada Buddhism and Roman Catholicism on the Moral Permissibility of Palliative Sedation: A Blurred Demarcation Line.

Although Theravada Buddhism and Roman Catholicism agree on the moral justification for palliative sedation, they differ on the premises underlying the justification. While Catholicism justifies palliative sedation on the ground of the Principle of Double Effect, Buddhism does so on the basis of the Third Noble Truth. Despite their theological differences, Buddhism and Catholicism both value the moral significance of the physician's intent to reduce suffering and both respect the sanctity of life. This blurs the demarcation line between Buddhism and Catholicism regarding the moral justification of palliative sedation.

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.