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Journal of Religion and Health
Published in: Journal of Religion and Health 3/2019

Open Access 01-06-2019 | Original Paper

Unbalanced Flows in the Subtle Body: Tibetan Understandings of Psychiatric Illness and How to Deal With It

Author: Geoffrey Samuel

Published in: Journal of Religion and Health | Issue 3/2019

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Abstract

Much of what Western medicine classifies as psychiatric illness is understood by Tibetan thought as associated with imbalance of rlung (wind, breath). Rlung has a dual origin in Indian thought, combining elements from Ayurvedic medicine and Tantric Buddhism. Tibetan theories of rlung seem to correspond in significant ways with Western concepts of the autonomic nervous system (ANS), and Western medicine too has associated psychiatric issues with ANS problems. But what is involved in relating Tibetan ideas of rlung to Western ideas of the emotions and the ANS? The article presents elements of the two systems and then explores similarities and differences between them. It asks whether the similarities could be the basis for a productive encounter between Tibetan and Western modes of understanding and treating psychiatric illness. What could Western psychiatry learn from Tibetan approaches in this area?
Footnotes
1
The same is true of ‘blood’ (khrag) which will occur later in this article.
 
2
Cf. Goleman 2004, which has some interesting material on the contrast between Western and Tibetan modes of conceptualising ‘emotions’.
 
3
Rgyud bzhi, Bshad rgyud, chapter 8: khyad par rgyu ni ma rig las byung ba’i || ’dod chags zhe sdang gti mug dug gsum las || ’bras bur lung mkhris bad kan nyes pa skyed || (Rgyud bzhi, n.d., 51).
 
4
The name is a little misleading, because while written in the style of the Tantras, the Rgyud bzhi is a medical work, not a Tantric text.
 
5
Rgyud bzhi, Man ngag rgyud, chapter 2: bye brag dbye bas srog’dzin gyen gyu dang || khyab byed me mnyam thur sel rkyang ba lnga ||.
 
6
Rgyud bzhi, Bshad rgyud, chapter 5.
 
7
Jacobson, who interprets srog rlung in general as a combination of the DMS-IV categories of Generalized Anxiety Disorder and Major Depression, describes six cases in detail in his PhD (Jacobson 2000); Kalsang (a pseudonym), one of these, is also discussed at length in Jacobson 2002 (see also Jacobson 2007). He also provides some information about treatment. Janes gives further examples of rlung disorders in his articles (e.g. Janes 1999). Another interesting case study of khrag rlung is given by Audrey Prost (Prost 2008: 93–96). Benedict et al 2009 looks at srog rlung in relation to PTSD in the context of traumatised Tibetan refugee monks, pointing out some of the differences from DSM categories (Benedict et al 2009). In a recent article, Holečko discusses the treatment of snying rlung (Holečko 2015).
 
8
On the complex relationship between thig le and bodhicitta, see also Wangchuk 2007, especially 217–225.
 
9
Hartzell suggests that the names in Hindu tradition for the two outer channels, iḍā and piṅgala, may derive ultimately from Vedic terminology (1987: 114–117).
 
10
Michael Lifshitz noted in a comment on a presentation of this material at McGill that there is extensive evidence for the role of suggestion in meditation experience, going back to early work on Transcendental Meditation. He has surveyed much of this work in his recent PhD thesis (Lifshitz 2017). He suggested in subsequent conversations that work on predictive processing (see above) provides both further support for such a self-reinforcing loop mechanism behind subtle body processes, and models for how this might work in neurophysiological terms. Lifshitz, Laurence Kirmayer, and myself hope to develop these suggestions further in a forthcoming paper.
 
11
The Hindu terminology is parallel though somewhat different.
 
12
Cf. the often-cited work of Lakoff and Johnson (1980), though they tend to see their scheme as more cross-culturally uniform than I think can be justified.
 
13
Similarly, one cannot do practices such as the long-life practices I have discussed in other writings without being caught up in the project of Buddhahood (Samuel 2013b, 2016).
 
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Metadata
Title
Unbalanced Flows in the Subtle Body: Tibetan Understandings of Psychiatric Illness and How to Deal With It
Author
Geoffrey Samuel
Publication date
01-06-2019
Publisher
Springer US
Published in
Journal of Religion and Health / Issue 3/2019
Print ISSN: 0022-4197
Electronic ISSN: 1573-6571
DOI
https://doi.org/10.1007/s10943-019-00774-1

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