The nature of suffering: An appproach fusing Buddhist and Neuroscience.

Good evening everyone,

Last December I went to the Mind and its Potential conference in Sydney.
I am a doctor, ( general practitioner) who has fallen into treating Attention Deficit Disorder.
For a long while I have felt that ADHD is uncannily like the Buddhist understanding of dukkha and mara.
My suspicions were very much confirmed, and tonight I finished my first draft of my reflections on the conference.
I wonder if any of you would be so kind as to read it and offer any comments. It is still far from finished and your opinions would be valued.
I hoped to be up to Jamchen today, but had an unexpected school function for my son_ maybe next week.

There is a personal revelation about my previous health problems- but please do not be concerned. I tell everyone. Seeing the patients I see it helps everyone to appreciate that I am not making any negative judgements about them, and builds an empathic relationship. It also prevents me from backsliding.

OK here goes- the ideas are pretty good- but I think it will take me time to bring them continuously to life in my own existence:

The Nature of Suffering, and Why it Persists

For most of us mere mortals, life presents a great puzzle. We have glimpses of the good life, glimpses of a happy positive existence, but seem unable to achieve this state in a way that does not intrude on the rights to existence of other beings.
This qualification is of critical importance, for if we achieve our happiness at the expense of other individuals, they are likely to take steps, possibly violent ones, to redress the balance. Equally we imagine ourselves above nature, but we are in truth part of a bigger whole. We are an expression of nature ( or God- depending on how you choose to phrase it, it is arguable that the same concept is being discussed from different perspectives). We are part of our ecosystem, and we depend on our ecosystem to preserve us as a species and support us as individuals.

Despite our glimpses of a greater good, and our ability to sometimes “get it right”, for much of our lives we do not achieve that state. In fact, I consider that humanity can be divided into 2 major groups on the basis of this observation. There are those of us who are aware of this dichotomy, and those of us who are not ( usually because they have been able or have been forced to repress the knowledge or dissociate from it).

My division here is a little arbitrary, as most of us do retreat from the full horror of existence on the plane of appearances for at least some of the time.

For those of us who are deeply aware of this problem of suffering, our awareness poses substantial challenges.We have to continually work much harder than the unaware do, to try and act in an ethical manner. What is worse, the only option for those of us aware of the problem is to face our failings as they occur, (and they do keep on occurring) accept our weakness and work on doing better. Having your head buried in the sand becomes a great benefit in the day to day struggle for material existence, but that victory is achieved at the cost of an inner meaninglessness. I believe that that state is the true definition of what Christians would call sin, and the essence of what in the East is called delusion. The state of awareness though is much more challenging than unawareness. It is my belief that our struggles with this paradox of existence generate most of what we in the West choose to call “Mental Illness”. As a small example I can note from my own experience, that facing this challenge intellectually consumes an enormous amount of processing power. It creates too much information to handle, and the brain stutters and starts like a computer running too many programs for the available RAM. In the West we choose to call this state ADHD when it is fully expressed.

As an aside, I was formally and correctly diagnosed with this condition in October 2008 by a Dr Bill Orchard ( a man of extraordinary intellect and compassion, who throws his whole being into protecting the wellbeing of his patients). I have had stimulant treatment- and chose to use the focus and drive it gave me to learn about attentiveness. That has proved a good choice.

For myself the diagnosis was a revelation. The combination of medication, and my basic understanding of Nagarjuna's teaching (that the words we use condition the way we see reality) allowed me to embrace the idea that my real problem was in fact industrial strength disorganisation. As I had for many years attempted to study the Buddha's Dharma and apply it to my life- I actually had all the material I needed to cure myself, once I was given medication that gave me the focus and drive to move forwards. I might add that after 16 months of treatment I am now fully confident that all my previous instability is permanently behind me, and that I will continue to improve for as long as my physical body allows it.. While I battle a few residual issues with sleep, and with physical damage I accrued in the course of my struggles, I know I am on the right track, and my commitment to mindfulness deepens day by day. It was, however, ironic: studying dharma in my spare time, but doing the exact opposite of mindful behaviour!

The question is: Why do we suffer? Why do our results fall so far from our good intent. I do not believe that anyone is evil at heart, simply deluded. The people who do the most harm are the furthest from the truth, and truly live in a self maintaining hell. Sometimes we must confine them to prevent harm, but that should be the real point of imprisonment in my opinion.

The answer to this question becomes clearer when we understand that we make most decisions on the basis of emotion, and not on the basis of reasoning. Most of our “reasons” for most of our acts are post-facto justifications. Unfortunately we suffer under the delusion that our emotions are beyond control, and that it is even “wrong” or “cold” to attempt to control them. I will assert here that we are unaware of the points at which we can choose to manage our emotional state simply because our level of emotional stress cloud our consciousness and divert our attention from the supposedly subtle early signs of an oncoming emotional state.( This is an example of of what we Buddhists call delusion. There is a large and growing body of evidence to support this assertion- in the field of mindfulness based Cognitive Behavioural Therapy.

I have thought long and hard about the reason for our stress, and I believe that the answer is surprisingly simple: The problems of day to day existence in our overcrowded world simply prevent us from achieving our basic needs as embodied beings. The real question is “What are those needs”. The answer is surprisingly simple for those who accept evolution ( for those who do not there is a simple way to make this answer work for you too – see below).

To put it simply, we evolved as a hunter- gatherer species, and our body evolved to meet the existence of hunter gatherers. To the extent that we are forced away from the sort of physical activities of that existence, we will have difficulties keeping our bodies in good order. To the extent that prevailing social conditions do not resemble the type of life that bands of mobile hunter gatherers had, we will suffer emotionally and spiritually.

The Characteristics of Hunter Gatherer existence, the Functions of the Prefrontal Cortex, and the Seven Factors of Awakening.

Hunter gatherers would have lived in bands probably no larger than 150 or so- in other words- in small village sized groups. They would have been active, they would have been good at following trails and making deductions about food and predators. They would have worked as a cohesive group. They would have valued wisdom, and respected wise elders. Hence some hierarchy would be natural to humans. Wise elders who cared about their tribe and families would have known that the best learning occurs through attachment- through admiring a person and wanting to be like them. ( Didactic teaching is a very second rate means of teaching.)
Hunter gatherers would have had to be able to put the interests of the tribe first, to cooperate, to be sensitive to tiny gestures when hunting, to have wide open attention in the hunt- and be totally in the moment. They would be good at defending the tribe.

These skills would be actively chosen for by millions of years of evolution.
At the “Mind and Its Potential” conference in Sydney 2009 Daniel Siegel listed these functions as:
Bodily regulation, attuned communication, emotional balance , flexibility, fear modulation empathy insight, morality and intuition ( subtle pattern recognition).
These are the functions of the middle prefrontal cortex. This is that part of the brain that grew most when we became human. All of these functions can be trained and enhanced if we are explicit enough about what we are doing. The principals of neuroplasticity are clear on that point- do it, repeat it, learn it. Neurones that fire together wire together. This is how the brain changes itself.

All these skills are enhanced by mindfulness meditation.

The interesting thing is that the list of functions is remarkably close to “The Seven Factors of Awakening” famous to Buddhism.

This list is
Mindfulness
Concentration
Tranquillity
Equanimity
Energy
Joy
Investigation

add in Bodhichitta- or loving kindness and the picture is complete.

To to the Zen master who asked “What was our face before we were born?” , my answer is the face of a hunter gatherers. Learn to live a life that fits the needs of a body that has evolved to fit into that niche, and one will truly be living in accordance with “The Way, or The Tao, or God's Will” or whatever else you like to call it.

This also solves the problem of conflict of interest between individuals. In my books no human has the right to put their needs first with no thought for his fellows. THe best solution to any problem always produces no losers and as many winners as possible. We know enough now to know that it is a perversion to declare any human “the other” and to understand that our tribe is the whole human race, and, in fact, all sentient beings. (As an example- our dogs are very knowing, caring individuals. I sometimes wonder if they were sent to watch over our family in a time of crisis. They are definitely sentient. ) We suffer a shortage of resources because so many of us foolishly believe that money and material goods bring happiness. Once one's basic needs for food, shelter, exercise and safety are met, one really does not need much in the way of material wealth to be happy. The need we have to live a resource hogging life becomes irrelevant once we learn how to live in accordance with our natures, and to put happiness first.

( To put it simply- make a vow never to watch another advertisement- they are usually designed to get you to do somebody else's will and participate in their delusion that greater wealth will make them happy).

The “other” that we need to unite against is darkness, confusion, unknowing. That is the devil or Mara. Being the very essence of entropy though, it is powerless against love- which brings us together into cohesive groups.

Evolution for Creationists

A very smart man pointed out to me some years ago that we do not know for sure that the World was not created an instant ago, or last Saturday around about lunchtime, or any other time. If, for instance the world were created an instant ago, all the objects in it would appear to have a history. For example if you cut down a tree it would still have growth rings referring to a past and ongoing existence. The same applies to fossils, radioactive decay etc. On this point at least there is no need for any dispute between science and fundamentalist Christianity. Science is talking about the world of appearances.

A footnote on ADHD
At the age of 46 I was diagnosed with ADHD. It was a matter of some surprise to me. I had an excellent academic record- and just thought of myself as an “absent minded professor”. I was working as a doctor so the idea of ADHD seemed rather odd to me. After all I was that disorganised, and I was a doctor. The whole concept must me imaginary I thought. I was wrong. Life got harder and finally overwhelmed my overstretched executive functions. However diagnosis and treatment turned that around.

What I did not expect to find that so many adult ADHD sufferers had characteristics I admired- compassion, curiosity, enthusiasm, drive ( often to the point of stupidly overloading themselves) and sensitivity. None of us will let anyone else tell us what to do unless we are confused. ( Oppositionality anyone? All the best people have it- maybe we should call it integrity)

None of my ADHD friends are harsh or judgemental, unless in a state of deep distress or confusion. We all had great senses of humour and all of them are people I enjoy being round. Curiously many of us feel strangely at ease in the natural environment.

I feel that ADHD people in fact have a core attention difference, that we have an attention style that sets naturally to wide angle and high emotional sensitivity. This leaves us vulnerable to many wounds from harsh and judgemental people. Sometimes those wounds cause serious damage. We call those people neurotypicals, not out of endearment.

In many ways most of us are deeply asleep, and the story of “The Matrix” is an exceptionally good analogy for human existence. ADHD sufferers though sleep lighter than the others. We have not been fully conditioned to accept the reality of the world of appearances. Our sensitivity is too strong for that.
Maybe that is why we are called old souls.

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