Recently, I was invited to Dharamsala by the Men Tsee Khang Institute, a school of traditional Tibetan medicine sponsored by the Dalai Lama, to give a talk on the scientific basis of the mind–body connection and the techniques of self-care and mutual help that my colleagues and I at The Center for Mind-Body Medicine are using with war- and disaster-traumatized populations. In my talk, I described the ingredients of our approach: several forms of meditation; biofeedback; guided imagery; self-expression in words, drawings, and movement; and small-group support. I presented evidence that shows people who participate in 10 weekly mind–body skill groups reduce their level of post-traumatic stress disorder by as much as 80 to 90 percent. I emphasized to the audience—250 Tibetan doctors, Buddhist monks, and academics—that I believe anyone can learn and use our approach, and explained that our work—in Kosovo, Israel, Gaza, Haiti, and the United States—has been implemented by local clinicians, teachers, and community leaders whom we’ve trained.
When I’d accepted the invitation to give this talk, I’d said that I also wanted to lead a workshop for recent refugees. It felt important, if I were going to make the long trip, to give more to the community than an academic lecture. So after an audience with the Dalai Lama—who held my hand and expressed his abiding appreciation for the marriage of Western psychology and Tibetan Buddhism—I had the opportunity to lead a workshop for teenagers at The Transition School. The students here, many of whom had grown up illiterate on remote Tibetan farms, had fled Tibet in recent years and were now beginning to make their transition into the larger Indian community.
On a bright but chilly morning, after a breakfast of dosas and chai, Sonam Dolma, the physician who’d organized the academic conference and would serve as my translator, guides me into the school’s auditorium, where 200 teenagers, all in white jackets, are kneeling in rows on mats. I’ve done this kind of workshop dozens of times, in freezing bombed-out schools in postwar Kosovo, in the shelled city of Sderot in southern Israel, and most recently with Syrian refugees in Jordan. Almost always it’s part of a larger program, a way for the people we hope to train—teachers, religious leaders, and clinicians—to get to know our work and me, and for me to begin to feel connected to the kids they serve and to them. But it’s a little different in Dharamsala since I’m not sure whether they need our program here, and I have no plans or money to start one.
“We may think we don’t have the answers,” I tell the kids, “but each of us has a part inside us that knows. One of the most important ways we can use this inner knowing is to help us relieve stress.” Slowly, I go on to explain to them the biology of the fight-or-flight response, with Sonam carefully translating as I pause periodically. I talk about how our fast heart rate and breathing, our dilated pupils, the blood rushing away from our skin and filling our large muscles all make it possible to fight an enemy or run away. “Fight or flight is a survival response,” I say. “It’s crucial, lifesaving.” Many of the kids nod their heads in agreement, remembering, I imagine, their own flight and the Chinese soldiers who pursued them. “The problem,” I continue, “is when fight or flight goes on too long, when weeks or months or even years after the threat is over and you’ve escaped, your body is still acting like it has to fight or run. Then you become tense when you don’t need to be. You feel your heart racing, can’t study, have stomach and head pains. How many of you have experienced the fight-or-flight response?” I ask. Everybody’s hand goes up. Then I pose the key question: “How many of you are still feeling it?” Well over half the kids have their hands in the air. “Now,” I go on, “I’m going to show you how to quiet the fight-or-flight response, to deal with stress when it comes up.”
I ask them to sit comfortably and breathe deeply—in through the nose and out through the mouth, with bellies soft and relaxed. I suggest that they close their eyes to block out as much external stimulation as possible, and explain that when the belly is soft and relaxed, more air comes into the lower part of the lungs and more oxygen enters the bloodstream. I tell them that oxygen feeds our brains and all our body’s cells and that a soft belly helps activate the vagus nerve, which promotes relaxation and is the antidote to fight or flight. “When your bellies are soft,” I say, “all the other muscles in your body can relax as well. To help achieve this, you can say to yourself ‘soft’ as you breathe in and ‘belly’ as you breathe out. If thoughts come, let them come and let them go. Gently bring your mind back to ‘soft belly.’” We do this for six or seven minutes, and then I ask the kids to open their eyes and bring their attention back into the room.
“How many of you noticed a change?” I ask. At least 80 percent of them raise their hands. “What kind of change?” I want to know and pick a few eager students to answer.
When I point to her, one girl calls out, “Calmer.”
“Brighter colors in the room,” another girl says.
“I’m smiling,” offers a boy in the middle of the room.
“Good,” I say. “This means that most of you can relax the first time you do this, in just six or seven minutes. This tells you that relaxation is possible and, even more importantly, that you can make it happen yourself. And if you’re one of those who doesn’t feel more relaxed, don’t worry, it’ll probably happen next time.”
After I finish, the kids applaud, and Sonam tells them that anyone who wants to can have an individual meeting with me. We hadn’t arranged this ahead of time, but Sonam whispers to me that many of the kids are deeply troubled and need more help. I don’t usually do individual consultations because our goal is to equip local people—clinicians, teachers, and other leaders—to help the population. It runs counter to our approach for the “big Western doctor” to come up with answers to individual problems. But I don’t want to disappoint or be rude to my hosts. Maybe it’ll be fine, I think, not expecting more than a couple of kids to respond to her invitation. To my surprise, more than 20 of them line up to talk with me.
I first speak with an 18-year-old boy whose black hair falls across his broad forehead. He’s had “terrible neck pain” following a fall during his escape. Having been trained by osteopaths, I can feel the shift in his cervical vertebrae. Using my hands to manipulate his head and neck, I put the bones back in place. “Do the shaking and dancing to stay loose. And get one of your buddies to massage your neck and shoulders regularly,” I tell him. “That will relax the muscles so the bones can stay in place.”
Next, a 15-year-old girl whose narrow pale face is clenched in pain tells me she is “so lonely” for her family and anxious about the revenge the Chinese may exact on them because of her flight. I prescribe soft-belly breathing and frequent sharing of her frightening feelings with her friend, who’s standing behind her in line.
The consultations seem to be helping, but I worry it’ll take far too long to get to everyone. There’s also something more important nagging at me: I don’t like the image or the feeling of being the expert bringing cures or dispensing advice. Instead, I want these kids to feel they have some tools they can use for themselves.
In Dharamsala, I put on Native American flute music and ask the kids to close their eyes. Once again, I begin with soft-belly breathing. After a few minutes, I say, “Now, let the sound of the music and the sound of my voice take you to a country road. As you walk down that road, notice what you see, hear, feel, smell, and think.” After a few minutes more, I suggest that they come to a place that’s safe or special for them. “This is somewhere you can go when you’re feeling anxious or troubled,” I explain. “It can be a place you know or remember or one that just comes to you now.” I tell them to take their time and notice how the place looks, feels, and smells. “What sounds are there? What clothes are you wearing in this place?” I prompt.
After they’ve had time to settle into this safe place, I suggest that a wise guide will appear—a human or an animal, a relative or a friend, or a figure from scripture or books. This guide represents the part of them that knows what their conscious mind doesn’t. It’ll answer the questions that trouble them, and tell them what they need to know to feel better, more secure and happy. After they’ve had time to silently ask their guides questions and receive their answers, I guide them slowly back down the country road and into the room where we’re sitting. I then invite them to share their experiences.
Before we sit quietly to close the session, the kids ask when I’ll return. Suddenly, I find myself in tears. I hadn’t planned to return, but these kids—so sweet, tender, and brave, so open to shaking and dancing with me, and looking into themselves and sharing with me—have opened my heart. “Soon,” I find myself saying, wondering how I’ll make it happen.
As I return to the crowded streets of Dharamsala beyond the school walls, I hope that this experience of loving self-care stays with these children, who’ve already gone through so much, so early in their lives, and that, whatever happens, they find a way to maintain their connection with the guides they’ve just discovered and the invaluable gifts they’ve revealed—the wealth of their own inner wisdom.
James Gordon, MD, a psychiatrist, is founder and director of The Center for Mind-Body Medicine and author of Unstuck: Your Guide to the Seven Stage Journey Out of Depression.
Photo provided by James Gordon/The Center for Mind-Body Medicine
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