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Dharma Care

Pastoral Care and Counseling from Buddhist Perspectives


     Much has been made by many people over the centuries about the differences between Buddhism and Christianity. Some Christians have criticized Buddhism for being faithless. Many Buddhists believe faith like Christians talk about it, is not part of Buddhism. Buddhist pastoral caregivers and counselors would do well to examine the teachings on faith and understand the importance of faith, especially for those who are gravely ill.

     In the suttas it is said that The Buddha approached the venerable Mahakassapa who was gravely ill. The Buddha said, “I hope you are bearing up, Kassapa, I hope you are getting better. I hope that your painful feelings are subsiding and not increasing, and that their subsiding, not their increase, is to be discerned.” Kassapa replied that he was not getting better and that his pain was increasing. The Buddha replied, “These seven factors of enlightenment, Kassapa, have been rightly expounded by me…mindfulness, discrimination of states, energy, rapture, tranquility, concentration and equanimity… These seven factors of enlightenment, Kassapa, have been rightly expounded by me; when developed and cultivated, they lead to direct knowledge, to enlightenment, to Nibbana.” Upon hearing the factors from the Buddha, Kassapa became elated and was cured of his illness. (SN 49)

     Reflecting on this story, we can see that faith healing is part of the Buddhist story. The Buddha administered the medicine of faith (through his presence and through reflecting on his teachings) and we can deduce that the medicine of faith heals those who have lost faith. What are they healed from? I have not proved this scientifically, but the loss of faith can lead to a lack of zest for life. A lack of zest for life is about the loss of energy which can be manifested in the mind and body. The loss of energy in mind and body can become depression. Is is possible that Mahakassapa was depressed?

     People in our sanghas and elsewhere experience a loss of faith in the practice and in us as teachers, leaders, caregivers and counselors. Do we overpromise the benefits of the practice? Sometimes we do. Do we not live up to practitioners' expectations? Many times we do not. And what about when practitioners are gravely ill, thinking to themselves that their practice was supposed to protect them from immense and intense suffering? Do we wallow in the failures of the practice or are we willing to embrace faith as medicine? Let's embrace faith as medicine for those who are sick from a lack of faith. The Buddha said that the seven factors of enlightenment when cultivated, ultimately lead to Nibbana. It takes faith to believe that assertion, it takes faith to practice these factors, it takes faith to believe there is a progression in the practice and it certainly takes faith to believe we can experience ultimate realms of existence. If arousing faith can lead to energy and zest where energy and zest are absent, embracing faith, as Buddhist pastoral caregivers and counselors, is worth serious consideration.


     It is said that the Venerable Ananda visited the householder Sirivaddha who was gravely ill. Ananda shared his well wishes for Sirivaddha, but Sirivaddha told Ananda that he was becoming more ill. Ananda advised Sirivaddha to practice the four foundations of mindfulness, removing covetousness and displeasure in regard to the world. Sirivaddha, while practicing mindfulness, was not coveting and was not displeased, and Ananda declared him having gone from ordinariness to arahantship. (SN 47)

     Pastoral caregivers and counselors would do well to remember that just because a practitioner is in pain, does not mean they do not have a strong practice in mindfulness that may be utilized during times of distress. Pastoral caregivers and counselor would do well to practice wisdom as to the timing of such practice interventions, especially if the practitioner is new to the practice. A caregiver should ask herself or himself, what is the goal of this practice at this time? Pain relief, cure, spiritual attainment or all three? From a psychological point of view, to let go of greed, hatred and delusion is good psychological health which is connected to good physical health even if that improved physical health does not result in a cure. To be established in mindfulness may ease psychological and physical pain, but is believed by some to ultimately lead to liberation from greed, hatred and delusion. As caregivers we should often ask ourselves, trusting in our own practice and expertise, "What is the root of suffering? Where is it located?"

     Sirivaddha professed his faith and practice in mindfulness, but also acknowledged that his faith and practice did not relieve the pain and did not cure him. In this way, he was not deluded. Let us also be free of delusion about these practices. Being established in mindfulness may or may not ease pain, but it is not established as a cure for physical and psychological diseases. Our first job, as pastoral caregivers, is to keep our eyes on the ball of spirituality, remembering there is a connection between spirituality and one's overall health. On this note, Buddhist pastoral caregivers should be in communication with other caregivers to coordinate care so that the whole person is acknowledged, understood, and treated.


     It is said that the venerables Sariputta and Ananda visited a householder named Anathapindika who was gravely ill. (MN 143) They shared their well wishes with Anathapindika but he said he wasn't getting better, but worse. He likening his pain to being tortured by a variety of methods throughout his entire body. Sariputta instructed Anathapindika in the ways of Right View and instructed him to let go, bit by bit, of his body and the consciousness attached to his body. He was advised to let go of the great elements within him, of air, fire, and so on. After running down the list of all Anathapindika should let go of, Sariputta advised Anathapindika to say to himself, ‘I will not cling to what is seen, heard, sensed, cognized, encountered, sought after, and examined by the mind, and my consciousness will not be dependent on that.’ Anathapindika wept.

     Weeping on letting go is a normal response to loss, but emotions can be more complicated than that. The tears may have also been tears of joy or sadness or a mixture. Sariputta wondered if Anathapindika was becoming depressed at the advice to let go. Anathapindika was probably not depressed. I think it is possible he was touched by the beauty of the teachings and the relief and release he experienced. He observed that this teaching had been reserved for monastics and kept from lay people. In the footnote, the authors state that the statement should not be construed to suggest that there was inherent exclusivity or arbitrary discrimination in how the Dhamma was taught, but that it would be inappropriate to teach householders complete detachment because of their responsibilities. In other words, be wise with this teaching, sharing it with people who will not recover from their grave illness, in a way that is timely and gentle so as not to cause resistance in the care receiver, and with no agenda for the outcome.