Het spirituele hart van de Tibetaanse geneeskunde

The Spiritual Heart of Tibetan Medicine, and its Contribution to the Modern World

The first International Congress for Tibetan Medicine took place in Washington DC in November 1998. A unique gathering, opened by His Holiness the Dalai Lama, it brought together Tibetan physicians, lamas, doctors and medical specialists from many countries. Sogyal Rinpoche was invited to address the conference on its opening morning.

Your Holiness, eminent doctors and scholars, ladies and gentlemen, it is a great honour for me to address you today at this International Congress of Tibetan Medicine. What I shall endeavour to do is to explore, very briefly and with my limited understanding, the spiritual and mental dimensions of healing within the Buddhist tradition of Tibet. I will speak from my own experience of what I know to be effective in the West.  Of course, whatever I do understand is only thanks to the infinite kindness of my masters, and especially Jamyang Khyentse Chökyi Lodrö, Dudjom Rinpoche and Dilgo Khyentse Rinpoche, who embody so perfectly the wisdom and compassion of the Buddhist path.

The ancient science of Tibetan medicine is rooted in the teachings of Buddha, and the essence of these teachings is the central importance of the mind. The Buddha said:

Commit not a single unwholesome action,
Cultivate a wealth of virtue,
To tame this mind of ours—
This is the teaching of the Buddha.

He also said:

We are what we think
All that we are
Arises with our thoughts.
With our thoughts we make the world.
Speak or act with a pure mind—
And happiness will follow you.

The mind is both the source of happiness and the root of suffering; at the same time as it possesses an extraordinary capacity for healing, it also plays its part in making us ill.

But how exactly can the mind provoke physical illness? The Four Tantras, the authoritative sources for Tibetan Medicine, are quite explicit:

Here is an explanation of the general cause of all illness.  There is but one single cause… and this is said to be ignorance due to not understanding the meaning of ‘selflessness’…


Now for the specific causes: from ignorance arise the three poisons of attachment, hatred and closed-mindedness, and from these, as a result, are produced disorders of wind, bile and phlegm.

The basic source of sickness is diagnosed as ‘ignorance’, in other words attributing a false sense of a lasting and independent self to ourselves and the phenomena around us. This, the Tibetan medical tradition tells us, arouses:

craving and desire that are responsible for disorders of the ‘wind’ (lung);
hatred and pride causing disorders of the ‘bile’ (tripa);
and bewilderment and closed-mindedness provoking ailments of the ‘phlegm’ (béken).

For years now around the world there has been a growing understanding of the correlation of mind and body, and of the link between ill-health and the way we cope with stress and our emotions. In his book ‘Emotional Intelligence’, Daniel Goleman writes:

People who experienced chronic anxiety, long periods of sadness and pessimism, unremitting tension or incessant hostility, relentless cynicism or suspiciousness, were found to have double the risk of disease…. This order of magnitude makes distressing emotions as toxic a risk factor as, say, smoking or high cholesterol are for heart disease—in other words, a major threat to health.

Just as distressing states of mind can cause disorders, so positive, uplifting states can promote good health: states such as peace of mind, optimism, confidence, humour, companionship, joy, love, kindness, compassion and devotion. Again, this has also been observed countless times in the West, and more recently for example with Norman Cousins, who laughed his way back to health, and the findings of Dr. Dean Ornish, published in his ‘Love and Survival’, on the effects of emotional support and love on physical health and life expectancy.

Training the Mind
The whole thrust of Buddhist practice is, precisely, to eliminate these negative states of mind and cultivate the positive ones, so transforming our mind and its emotions, and thereby healing our entire being: body, speech, mind, and heart.

The Buddhist approach to transforming the mind begins by working with our attitudes to life, using the power of reason to analyze our delusions, disturbing emotions and even basic assumptions, so as to find, simply speaking, a way of being happy. A Tibetan master Dodrupchen Jikmé Tenpé Nyima spells out the link between peace of mind, happiness and health:

Whenever you are harmed by sentient beings, or anything else, if you make a habit out of just perceiving only the suffering, then when even the smallest problem comes up, it will cause you enormous anguish in your mind. This is because the nature of any perception or idea, be it happiness or sorrow, is to grow stronger and stronger by being repeated. When the power of this repetitive experience gradually increases, after a while most of what you perceive will become the cause of actually attracting unhappiness towards you, and happiness will never get a chance…


When you are not at the mercy of the suffering caused by anxiety, then not only will all other kinds of suffering evaporate like weapons dropping from the hands of soldiers, but even illnesses will normally disappear on their own.


The saints of the past used to say: ‘When you are not unhappy, or discontent about anything, then the mind will not be disturbed. If the mind is not disturbed, the inner air (wind) will not be disturbed. That means the other elements of the body will not be disturbed either. Because of this your mind will remain undisturbed, and the wheel of constant happiness will turn.

Such a contemplation forms part of the Buddhist Training of the Mind in loving kindness and compassion, which is called ‘Lojong’.  When the ultimate cause of all our suffering and sickness is our holding onto a false view of self, our constant selfish grasping and the negative emotions it provokes, then nothing could be more effective or skilful as a remedy than to steep the mind in love, compassion, altruism and thinking of others.

The Buddhist practices of compassion and love are immensely powerful at transforming the emotions, and healing ourselves and others, and one which has had an enormous impact among western people is Tonglen, the practice of ‘giving and taking’. In their imagination, the practitioner summons all their resources of positive emotion, and trains in taking, through compassion, the suffering and illnesses of others,  and giving, with love, every source and kind of happiness and well-being.

Tonglen practice reduces and eliminates the grasping ego, while enhancing our concern for others.  As a result, what has been discovered is that it is deeply therapeutic, especially for those who feel the sense of lack in their lives or unfulfilment or even ‘self-hate’ which are so prevalent these days. This is why I have developed a series of practices applying Tonglen, in order to help bring about such healing.

In Tibet, the healing power of Tonglen was legendary; in the West today, the potential of such practices rests largely unexplored, but they could, I feel, have astounding results if applied more widely in cases of mental and physical illness.

The other practice I would like to mention, one which so many who are working with the sick have, in one context or another, found to be a profound source of healing, is meditation. The spirit of Buddhist meditation is captured so beautifully by Nyoshul Khen Rinpoche:

Rest in natural great peace
This exhausted mind
Beaten helpless by karma and neurotic thought,
Like the relentless fury of the pounding waves
In the infinite ocean of samsara.
Rest in natural great peace.

Through the practice of ‘calm abiding’, or tranquillity meditation, our restless, thinking mind subsides into a state of deep inner peace. The warring, fragmented aspects of ourselves begin to settle and become friends; negativity and aggression are disarmed; frustration, tension and turbulent emotions are defused; and the unkindness and harm in us is removed, revealing our inherent ‘good heart’. So meditation is real ‘inner disarmament’.

From this state of ‘calm abiding’ comes the expansive clarity and insight of ‘clear seeing’: duality dissolves; ego dwindles and confusion evaporates; the whole way we look at ourselves changes; and we give space to emotions, learn from them, and become free from their sway.

As this ‘clear seeing’ progressively deepens, it leads us to an experience of the intrinsic nature of reality, and the nature of our mind. For when the cloud-like thoughts and emotions fade away, the sky-like nature of our true being is revealed, and, shining from it, our buddha nature—bodhichitta—like the sun. And just as both light and warmth blaze from the sun, wisdom and loving compassion radiate out from the mind’s innermost nature. Grasping at a false self, or ego, has dissolved, and we simply rest, inasmuch as we can, in the nature of mind, this most natural state which is without any reference or concept, hope or fear, yet with a quiet but soaring confidence—the deepest form of well-being imaginable.

One oral instruction from the great masters of the past, for me, resonates this innermost nature of mind. In Tibetan:

Chu  ma  nyok  na  dang
Sem  ma  chö  na  dé

Nothing could be simpler, yet more powerful:

“Water, if unstirred, will become clear—that’s a fact. In just the same way, the very nature of mind is such that if you do not alter, fabricate, or manipulate it with needless thinking, it will, by itself,  find its own natural state of peace and well-being.”

So many have found that even a glimpse of the nature of mind is utterly transforming, nourishing, and purifying. For if disease is due to our losing sight of our true nature, to recognize the nature of our mind must be the ultimate healing.

Padmasambhava, who introduced Buddhism into Tibet in the eighth century,  clarifies this even further:

Don’t regard illness as a hindrance, or consider it a virtue. Leave your mind unfabricated and free… cutting through the flow of conceptual thoughts… old illnesses will disappear by themselves and you remain unharmed by new ones.

Healing practices generally fall into three different approaches:  prevention; applying antidotes; or transformation. They could be compared, to take an everyday example, to avoiding your enemy, facing him and dealing with him, or turning him into a friend. Today I have touched only on meditation and on training the mind in loving kindness and compassion, but there is a vast range of healing practices, especially within the Vajrayana Buddhist tradition where healing is achieved through transformation. Some of these will be presented during this Congress. They employ every kind of skilful means—visualization, mental imagery, sound, mantra, movement and yoga—and embrace every facet of the human mind—imagination, intellect and emotion. A number of these methods have been used to great effect to help combat illnesses such as cancer and AIDS.

Finally, the real power and strength of the lineage of Tibetan Buddhism is, I feel, seen most clearly in its great practitioners and masters, whose mere presence is deeply healing in itself.  Our good fortune is that someone such as this is here with us today, in the person of HH the Dalai Lama.

It is largely due to His Holiness, I believe, that Tibetan medicine has endured and thrived in the way that it has. I would like to salute here the Tibetan Medical and Astrological Institute in Dharamsala in India, which was one of the very first Tibetan institutions to have been established by His Holiness in exile.  At the same time, let me also pay tribute to all the other Tibetan physicians and centres of Tibetan Medicine around the world.

To see a major conference like this on Tibetan Medicine, attended by so many eminent doctors, scientists and scholars from all over the globe, gives me enormous pleasure; I applaud it and con-gratulate the organizers with all my heart. It presents us with an exciting opportunity, and I hope that in the wake of this Congress, the dialogue will continue. The holistic approach of Tibetan Medicine, which deals with both mind and body, holds out tremendous promise, but so far we have only skimmed the surface of what it has to offer the world. As we enter the 21st century we can, and should, imagine research of many kinds, for example into how to make these amazing Buddhist healing methods available alongside Tibetan medicine, in the right environment and to patients who would be receptive, and so explore their combined power of healing. And yet, in order for the Tibetan medical tradition to be more effective in serving people’s needs, two things I feel are required:

a greater understanding and communication between Tibetan doctors themselves, and
a greater exchange and collaboration between Tibetan physicians and western doctors and scientists, one which never compromises the integrity of Tibetan Medicine.

For as His Holiness says:

Tibetan medicine is an integrated system of health care that has served the Tibetan people well for many centuries and which, I believe, can still provide much benefit to humanity at large. The difficulty we face in bringing this about is one of communication, for like other scientific systems, Tibetan medicine must be understood in its own terms, as well as in the context of objective investigation.

Then, I feel certain, Tibetan medicine will take its rightful place as a universally respected, major system of medicine and healing, and prove itself to have more and more to offer, in a world increasingly beset with diseases and disorders, towards relieving suffering everywhere.

A modified version of this article appeared in Alternative Therapies in Health and Medicine, May 1999, Vol 5. No. 3, pp.70-72. H. H. the Dalai Lama’s paper at the congress: ‘The Relevance of Tibetan Medicine Today’ appears in the same issue, pp. 67-69.

Reproduced from ‘The Future of Buddhism’ by Sogyal Rinpoche with kind permission of Rider Books, Ebury Press.