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.

Increased wakefulness as measured by the WAKE-16 is related to mindfulness and emotional self-regulation in experienced Buddhist meditators.

INTRODUCTION: We tested and validated the German version of a new instrument for measuring "wakefulness," defined as "an expansive, higher-functioning, and stable state of being in which a person's vision of and relationship to the world are transformed, along with their subjective experience, their sense of identity and their conceptual outlook" (Taylor, 2017, p. 22). METHODS: In order to test the construct validity of the new instrument (Inventory of Secular/Spiritual Wakefulness; WAKE-16), we performed a parametric comparison between a group of expert meditators (n=36) with a history of predominantly meditating in silence and demographically matched non-meditators (n=36) for the WAKE-16 and two conceptually related questionnaires of mindfulness and emotion regulation. RESULTS: Significantly higher scores for the meditators on the WAKE-16 indicate construct validity of the new instrument. Meditators scored higher on the two mindfulness subscales "presence" and "acceptance," as well as on the SEE subscales of emotion regulation and body-related symbolization of emotions. Within the group of meditators, there were significant correlations between wakefulness and mindfulness, accepting one's own emotions, and experiencing overwhelming emotions. The only significant correlation in non-meditators was found between wakefulness and accepting one's own emotions. DISCUSSION: The new instrument shows construct validity by discriminating between the two groups. Correlations between wakefulness and related psychological constructs indicate convergent validity. Future studies could attempt to increase discriminatory accuracy of the definition of wakefulness, as well as finding objective methods of measuring.

Connecting Mindfulness Practice to Generative Semiotic Activity-Self-Other Referent in Umwelt and Semiosphere.

In this comment paper on von Fircks (2023a), I would like to focus on four issues and offer some reflections on them: first, what is happening in the process of a new I arising through mindfulness meditation practice? I would like to supplement the dialogue between Buber and Rogers in 1957 on the dynamism of I and Me, which is the basis of Mead's theory of self formation, in which I and Me separate, discover and meet a new self. The second, is that meditation, which at first glance appears to be an internal meditation practice and a personal activity, leads to a semiotic mediated social process. The Tao and early Buddhist ideas that form the background to the experiential process of mindfulness meditation will be reviewed, and the significance of people experiencing the interdependence of non-human nature and the environment through the practice will be discussed. Third, connecting this to the idea of Umwelt (Uexküll) and the semiosphere (Lotman), an attempt is made to extend the otherness as a collating body of self formation to Umwelt. Fourth, mindfulness meditation focuses attention on the breath. In relation to Mead's focus on the environment under the skin, i.e. corporeality, I will supplement the psychological meaning of cultivating the body's sense of interoception through the sensing of repetitive movements of tension and relaxation. Through the above, what kind of semiotic mediating function does mindfulness meditation have in relation to the construction of the new I, and how does it lead to the creation of social meaning? We would like to discuss these points. CLINICAL TRIAL REGISTRATION: The article does not contain any studies with clinical trial. This, clinical Trial registration is not applicable.

The effect of an annual temporary abstinence campaign on population-level alcohol consumption in Thailand: a time-series analysis of 23 years.

RATIONALE: A small number of earlier studies have suggested an effect of temporary abstinence campaigns on alcohol consumption. However, all were based on self-reported consumption estimates. OBJECTIVES: Using a time series of 23-year monthly alcohol sales data, this study examined the effect of an annual temporary abstinence campaign, which has been organised annually since 2003 during the Buddhist Lent period (spanning 3 months), on population-level alcohol consumption. METHODS: Data used in the analysis included a time series of monthly alcohol sales data from January 1995 to September 2017 and the midyear population counts for those years. Generalised additive models (GAM) were applied to estimate trends as smooth functions of time, while identifying a relationship between the Buddhist Lent abstinence campaigns on alcohol consumption. The sensitivity analysis was performed using a seasonal autoregressive integrated moving average with exogenous variables (SARIMAX) model. INTERVENTION: The Buddhist Lent abstinence campaign is a national mass media campaign combined with community-based activities that encourages alcohol abstinence during the Buddhist Lent period, spanning 3 months and varying between July and October depending on the lunar calendar. The campaign has been organised annually since 2003. MAIN OUTCOME: Per capita alcohol consumption using monthly alcohol sales data divided by the midyear total population number used as a proxy. RESULTS: Median monthly per capita consumption was 0.43 (IQR: 0.37 to 0.51) litres of pure alcohol. Over the study period, two peaks of alcohol consumption were in March and December of each year. The significant difference between before-campaign and after-campaign coefficients in the GAM, -0.102 (95% CI: -0.163 to -0.042), indicated an effect of the campaign on alcohol consumption after adjusting for the time trend and monthly seasonality, corresponding to an average reduction of 9.97% (95% CI: 3.65% to 24.18%). The sensitivity analyses produced similar results, where the campaign was associated with a decrease in consumption of 8.1% (95% CI: 0.4% to 15.7%). CONCLUSIONS: This study demonstrated that the temporary abstinence campaign was associated with a decrease in population-level alcohol consumption during campaign periods. The finding contributed to a growing body of evidence on the effectiveness of emerging temporary abstinence campaigns.

Being able to think when caught in the maelstrom - how adolescents used mindfulness when facing exams.

PURPOSE: Research indicates that exam anxiety may decline with mindfulness-based interventions but there is a lack of research on adolescents' accounts of the processes involved. We explored high-school students' descriptions of how they perceived and applied mindfulness in managing anxiety-inducing thoughts related to academic performance following an 8-week Mindfulness-Based Stress Reduction (MBSR) course. METHOD: Post-course individual semi-structured interviews with 22 high school students (2 males, mean age 17.8 years) were transcribed verbatim and analysed using reflexive thematic analysis. RESULTS: The analyses identified six themes: (1) Noticing and attending to the attention-binding "maelstrom" of anxious thoughts and feelings (2) Attending to the breath to cope with the maelstrom, (3) "removing" and "getting rid of" anxious thoughts (4) Being able to "think" (5) awareness of more helpful thoughts, and (6) Agency and control. The findings are discussed in light of the Buddhist notion of "unwholesome thoughts" and the distinction between thought suppression and the use of breathing as a benign distraction. We propose that mindfulness encompasses both a receptive, nonjudgmental awareness and an active, intentional redirection of attention. CONCLUSION: Mindfulness training aided participants by enhancing their capacity to disengage from fear-engaging thoughts, thereby maintaining them within their window of tolerance and facilitating cognitive processing.

Mindfulness, Buddhist Modernity and Cultural Psychology.

I will in this article use Fircks as a point of departure for trying to understand the complexities involved in the use of the concept of mindfulness. As will be seen, mindfulness can be traced to a decoupling from a religious background and subsequent appropriation within several Western contexts. This will then be used for a discussion of how to deal with the historicity of the phenomena studied within cultural psychology. Here two reminders will be suggested, namely understanding phenomena through a context-sensibility and at the same time being aware of any disciplinary parochialism.

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.

Both religious and secular ethics to achieve both happiness and health: Panel data results based on a dynamic theoretical model.

This paper evaluates the direct and indirect impacts (and their interactions) of individual and social ethics from (primary, secondary, tertiary) education and religion (Buddhism, Christianity, Hinduism, Islam, Judaism) on health and happiness in alternative religious contexts (majority and minority religions) and for alternative education policies (gross enrolment and per-student expenditure). It also specifies the time lag for the short-run indirect impact (and its size) of happiness on health and the long-run equilibria of both happiness and health. The statistical results show that there is no religious or secular ethics with beneficial impacts on both happiness and health at both the individual and social levels. Next, education policies have similar impacts on both happiness and health in all religious contexts, while most religious ethics have larger beneficial impacts on health and happiness if coupled with social and individual education policies, respectively. Combined statistical and analytical results show that the largest short-run indirect impact of happiness on health occurs after 4 years, where 1 out of 10 points of happiness produces approximately 3 additional years of healthy life expectancy at birth. Next, the long-run equilibria of both happiness and health are globally stable and are achieved after 8 years through oscillation dynamics.

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.

The Therapist as a Collaborative Pianist.

In this article we seek to examine what we might learn about the therapist/psychoanalyst's function as selfobject by examining the relationship between the "vocal persona" and the "instrumental persona" in the art song. The comparison was born out of our own life partnership as a therapist, currently studying in a psychoanalytic-Buddhist training program that stresses the presence of the therapist/psychoanalyst as selfobject; and a collaborative pianist who instructs and performs with singers onstage. The concept of selfobject has offered a compelling and fruitful analogy. We explain and demonstrate this analogy using the terms selfobject and instrumental persona, which have in common the willingness to suspend selfhood in order to stand by another- a patient or a vocal persona- so that the latter might take root and flourish.

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.

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.

Thinking in a marrow Bone: Embodiment in Vajrayana Buddhism and Psychoanalysis.

Nondualistic conceptions of the body in Vajrayana Buddhism and some schools of Zen potentially extend the range for imagining and conceptualizing the analyst's body. They add dimension to psychoanalytic explorations of nonverbal, body-to-body communication in the analytic dyad. Vajrayana Buddhism posits that the body that we have from the point of view of the conceptual mind is not our only body. The body that we are, known as the Vajra body, is experientially available only when the conceptual mind is relaxed. The Vajra body suggests an aspect of embodiment that upsets distinctions of subject/object, mind/body, and internal/external. From a Vajrayana perspective, some psychoanalytic views of the body blunt our bodies' potential sensitivity and then theorize in response to this objectified body. Thinking that the body is primitive and requires the transformative capacities of the mind distorts modes of sentience that are bodily. From a Vajrayana perspective, this assumption locks in an overreliance on the conceptual mind that is self-perpetuating. It also inhibits a useful, though at times disturbing potential for intercorporeal communication. A detailed clinical example illustrates how these nondualistic ideas about embodiment might influence analytic work.

Allergic Contact Dermatitis Associated With Religious Practices: Review of the Literature.

Allergic contact dermatitis (ACD) may occur secondary to devotional practices in various religions. A systematic review of PubMed was conducted from inception of database to September 9, 2022. Key terms were "contact dermatitis" or "devotional dermatosis" in association with major world religions including "Christianity," "Islam," "Hinduism," "Buddhism," "Sikhism," and "Judaism." Inclusion criteria were determined by presence of a religious practice and associated ACD. Articles referencing other cutaneous reactions such as chemical leukoderma were excluded. In total, 36 of 102 unique articles identified met inclusion criteria. Twenty-two articles referenced Hinduism, 8 referenced Judaism, 5 referenced Islam, 3 referenced Christianity, and 1 article each mentioned Buddhism and Sikhism. Four articles referenced multiple religions. Para-phenylenediamine was the most common contact allergen overall and is found in blackening ingredients mixed with henna for temporary tattoos. Henna tattooing is a cultural practice associated with Hinduism, Islam, and Judaism. Nine unique contact allergens associated with religious practices were identified. Increasing awareness of religious practices that cause ACD will facilitate culturally competent dermatological care.

The role of mindfulness, meditation, and peer support in recovery capital among Recovery Dharma members.

INTRODUCTION: Recovery Dharma (RD) is a Buddhist-based peer support program for the treatment of addiction that incorporates mindfulness and meditation into meetings, program literature, and the recovery process, creating the opportunity to study these variables in a peer-support program context. Mindfulness and meditation are beneficial for people in recovery, yet we know little about their relationship to recovery capital, a positive indicator of recovery outcomes. We explored mindfulness and meditation (average length of sessions and average frequency per week) as predictors of recovery capital and examined perceived support in relation to recovery capital. METHODS: The study recruited participants (N = 209) through the RD website, newsletter and social media pages for an online survey that included measures of recovery capital, mindfulness, perceived support, and questions about meditation practices (e.g., frequency, duration). Participants' mean age was 46.68 years (SD = 12.21), with 45 % female (5.7 % non-binary), and 26.8 % from the LGBTQ2S+ community. The mean time in recovery was 7.45 years (SD = 10.37). The study fitted univariate and multivariate linear regression models to determine significant predictors of recovery capital. RESULTS: As anticipated, multivariate linear regressions indicated that mindfulness (ß = 0.31, p < .001), meditation frequency (ß = 0.26, p < .001), and perceived support from RD (ß = 0.50, p < .001) were all significant predictors of recovery capital when controlling for age and spirituality. However, longer time in recovery and the average duration of meditation sessions did not predict recovery capital as anticipated. CONCLUSIONS: Results indicate the importance of a regular meditation practice for recovery capital rather than engaging in prolonged sessions infrequently. The results also support previous findings, which point to the influence of mindfulness and meditation on positive outcomes for people in recovery. Further, peer support is associated with higher recovery capital in RD members. This study is the first examination of the relationship between mindfulness, meditation, peer support, and recovery capital in recovering people. The findings lay the groundwork for the continued exploration of these variables as they relate to positive outcomes both within the RD program and in other recovery pathways.

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.