Introduction

Can the mind heal the body? How are the brain, immune system, and emotions interconnected? What emotions are associated with enhanced well-being? How does mindfulness function in a medical context? Is there a biological foundation for ethics? How can death help us understand the nature of the mind? In summer 1991, ten Western scholars from a broad range of disciplines gathered with the Dalai Lama in his personal meeting room in Dharamsala, India, to grapple with these questions as the focus of the third Mind and Life Conference. This book is a compendium of the presentations and dialogue that occurred at this meeting.

Experts from the fields of psychology, physiology, behavioral medicine, and philosophy presented the quintessential discoveries of their fields and discussed the connections among these findings with the Dalai Lama and with prominent practitioners of Buddhist meditation. The purpose of this cross-fertilization was to increase mutual understanding and facilitate the emergence of new insight into the relationship between health and emotional experience.

It is only in the past twenty years that Western physicians, biologists, and psychologists have begun to comprehend the interrelationship between emotional states and mental and physical well-being. Buddhist thinkers, however, have been aware of the mind's healing capacity for more than two thousand years. The presence at this conference of the foremost leader of Tibetan Buddhism provided a unique East/West synthesis. The Dalai Lama served as a touchstone for the recent scientific discoveries reported by the other participants.

The Mind and Life Meetings
The Dalai Lama has lived in India since he led thousands of his people to freedom from Chinese oppression in 1959. Winner of the Nobel Prize for Peace in 1989, he is universally respected as a spokesman for the compassionate and peaceful resolution of human conflict. Less well known is his intense personal interest in the sciences; he has said that if he were not a monk, he would have liked to have been an engineer. As a youth in Lhasa, it was he who was called on to fix broken machinery in the Potala Palace, be it a clock or a car.

Beginning in October 1987, the Dalai Lama has met regularly with select groups of scientists to discuss bridges and interfaces with what can broadly be called the sciences of mind and life—biology, cognitive science, neuroscience, and psychology, as well as philosophy of mind—the disciplines of most immediate relevance to the Buddhist tradition. The spirit of these meetings has been one of candor and mutual respect on both sides, as seen from the careful selection and preparation of the meetings, their private nature, the attention given to excellent translation, and the extensive time devoted to them by the Dalai Lama. The books that emerge from these dialogues—including this one, it is hoped—offer readers a sense of immediacy and spontaneity in an unprecedented exchange between a spiritual path and state-of-the-art science, between an ancient wisdom and the modern quest for answers.

Background
This series of dialogues was initiated in 1985 jointly by Adam Engle, a U.S. attorney and businessman, and Dr. Francisco Varela, a Paris-based neurobiologist working with the National Center for Scientific Research who was aware of the importance of a serious dialogue between science and Buddhism. The first Mind and Life Conference was held over a period of a week in Dharamsala, India, and dealt with neuroscience and cognitive science more generally. A book based on this first conference, edited by Francisco Varela and Jeremy Hayward, has been published as Gentle Bridges: Conversations with the Dalai Lama on the Sciences of Mind (Boston: Shambhala Publications, 1993). Since that first meeting, there have been four others, each bringing the Dalai Lama together with different groups of scientists in an atmosphere of mutual respect. Topics have included emotions and health (represented in the present volume); sleeping and dreaming, to be represented in the forthcoming book Sleeping Dreaming and Dying (Boston: Wisdom Publications, 1997); and the most recent conference, held in 1996, on altruism, ethics, and compassion. (For a full account of the history of the Mind and Life Conferences, see the appendix.)

Each day began with a presentation on a scientific topic, such as the neurobiology of emotions, and was followed by dialogue and debate with His Holiness, who has consistently displayed both a keen scientific mind and a breadth and depth that stretches the borders of science. For example, in this dialogue, the Dalai Lama suggests there may be subtle levels of consciousness, which Western science has yet to learn about, that do not depend on the function of the brain, unlike grosser levels that are directly related to brain activity.

An exemplar of open-minded and bold inquiry, the Dalai Lama has taken the lead in opening a dialogue between Buddhism and modern science. He sees clearly that if Tibetan Buddhism is to survive into the future, it will do so only to the degree that it is not baldly contradicted by the findings of modern scientists; he has said that if the scientific method should prove that some tenet of Buddhism is incorrect, then Buddhism would have to change accordingly.

On the other hand, the dialogues have also shown that Western science has much to gain from these insights from the East. Tibetan explorations into the psyche have yielded a sophisticated phenomenology of mind that could guide modern scientists, if scientists would listen. These dialogues are a beginning of that conversation. One fruit of these dialogues is an ongoing research project that stems directly from this third round of the Mind and Life meetings: a neurophysiological study of brain states in adept Tibetan yogis to better understand the potentials of attentional training.

Buddhism and Science, Emotions and Health: the Dialogue
Buddhism has as principal aims the goal of transforming perception and experience and synchronizing mind and body. According to Buddhist teaching, the process of harmonizing mind and body and transforming experience is a gradual one. This path is based on the practice of various forms of meditation, coupled with a moral imperative to engage in virtuous action. Such action is based on the awareness of the interdependence of all life and the universal compassion that emerges from this awareness.

Tibetan Buddhist thinkers have long been concerned with psychophysical health and have produced numerous medical treatises that date from as far back as the eleventh century. The four main Tantras (explanations) were translated from Sanskrit into Tibetan by the Lama Vairochana in the ninth century and have been handed down from teacher to student until the present day. According to this tradition, illness is the result of an imbalance in the psychophysical body which is produced by conflicting emotions such as anger or greed. Using modern experimental methods, the scientists who attended the Mind and Life Conference considered some of the same issues raised by Buddhist thinkers over the centuries.

We begin with Lee Yearley's overview of Western ethical systems and an enquiry into the possible foundations for an ethical system not based on religion. His Holiness the Dalai Lama expressed his sense of the need for such a system, which could appeal to the billions of people on the planet who hold no strong religious belief. Daniel Goleman then proposes that the workings of the body might offer such a basis, organized around which states of mind foster health and which make the body more vulnerable to disease. He reviews findings suggesting that distressing emotions can undermine health, whereas positive states may be protective.

The section on biological foundations considers some of the experimental research central to emotions and health. This section begins with a discussion on the immune system and its cognitive implications by Dr. Francisco Varela. The field of immunology is awakening to the realization that the immune system is almost a kind of "second brain," a network of specialized cells that give the body a flexible identity. Further, this somatic identity has very specific links with the neural networks underlying cognitive life, and makes up the basis of the new field of psychoneuroimmunology.

Dr. Varela's presentation, and the dialogue that accompanies it, is followed by Clifford Saron's discussion of how the brain regulates emotion. His and Richard Davidson's research elucidates how patterns of electrical activity in the brain are correlated with facial expression and other measures of mood state.

Daniel Brown's discussion of how stress affects the body details the biological foundations of the impact of emotions on health. Dr. Brown catalyzes a discussion of posttraumatic stress disorder and how it is treated; the Dalai Lama suggests that, unlike other victims of torture who then suffer from posttrauma symptoms, the experience of many Tibetans with torture by the Chinese suggests that faith and beliefs that give meaning to suffering may offer an inoculation, to some degree.

Mindfulness, a careful attention to moment-to-moment experience, is a classic Buddhist contemplative practice. Sharon Salzberg explains its basics as an introduction to the application of mindfulness in health. Cultivating beneficial emotions has a role in the treatment of disease across the medical spectrum. Jon Kabat-Zinn discusses the ways in which mindfulness meditation is being used, with good effect, to help patients develop an awareness that is less prone to being swayed by emotionality—an application of meditation practice that alleviates symptoms and facilitates healing.

Behavioral medicine uses psychological techniques to prevent or treat chronic illnesses. Daniel Brown describes how many medical symptoms are the result of physiological systems that are under stress and so out of equilibrium. State-of-the-art behavioral medicine techniques offer patients ways to regain control over the biological systems that are causing their symptoms. This new approach to healing includes modern methods such as biofeedback and ancient ones such as meditation.

In the West, psychologists readily assume pathologies of the self, especially low self-esteem, are rampant among modern humans. However, for the Dalai Lama, the very concept of low self-esteem is unknown; in Eastern cultures, where the "self" is a very different construct than in the individualistic West, there may not be such a problem. The roots of self-esteem are explored in a dialogue that suggests the self in the West may face unique problems rare in the East.

A sticking point between modern science and Buddhism is the relationship between mind and brain. Western science sees mind as an emergent property of consciousness that depends on the brain, while Tibetan Buddhist thought postulates a subtle order of consciousness not dependent on brain. Does the failure of Western science to identify mental processes that do not reduce to brain function mean there is no consciousness independent of brain? The Dalai Lama contends that extremely subtle levels of consciousness that have yet to be discovered by the West are accessible for advanced meditators, who can use them for lucid dreaming and conscious dying. If confirmed by science, such a realization would mean radically altering the paradigm of Western neuroscience.

Finally, there is a wide-ranging dialogue on the need for compassion and for an ethical system that can appeal to the billions of people who hold no particular religious faith. And so the dialogue ends with the question of whether science's new understanding of the links between mind, brain, and health might one day offer part of a basis for an ethic—guidelines for living—which upholds the values of the great world religions.