Talking Back to Prozac
Thank you so much for printing the article “Prozac & Enlightened Mind.” As a person who has experienced depression and as a physician who treats depression, it is helpful to find that others are asking the questions I’ve asked of myself.
Without medication (Prozac in my case), I might well not be here to be trying to walk the eightfold path. It is difficult to practice when one is dead emotionally and impossible if dead physically.
When the black hole had swallowed me, I doubt that I would have had the energy to practice. The darkness would likely have consumed my meditation. Despair would have convinced me of the worthlessness of my practice. Instead of seeing the fleeting nature of all experience I would likely have felt trapped or wallowed in the mire of my feelings. Medication brought me from there to here, and now I can face the dukkha that is in life and see its changing nature. I can see the blackness and emptiness without it being "me."
Dukkha was not masked, but became less overwhelming. That has allowed me to do the work of getting well.
Jerry Douglas, M.D.
I enjoyed the [Prozac] article very much but felt that a certain thought went uncovered. The belief that taking medication is going to make you different would traditionally be seen as an attachment to the idea of your self. The idea of being enlightened must be that wherever you go, there you are. Prozac is no more cheating than a retreat, as long as in both cases you are in the moment, so to speak.
As a registered pharmacist, a recovering alcoholic/drug addict, a 20-year Buddhist practitioner, and someone recovering from major depression, I read with great interest your piece on the use of antidepressant therapy relative to Buddhist doctrine, and have approached this issue from many personal levels.
As a pharmacist, I am aware of the benefits and risks of pharmacotherapy for depression, and I also know that all the “happy pill” hype that has arisen over the newer antidepressants is overblown. Antidepressants are chemical entities designed to correct neurotransmitter imbalances that seem to be the cause of major depression; they have never been considered by the medical community as 'personality designers’. As a recovering addict, I was naturally hesitant to embark on a venture that relied on drugs to change the nature of my consciousness. As a committed Buddhist, I struggled with the core issue in your article; is it a cosmic cop-out to even consider this course?
Nonetheless, I had not gotten sober to be miserable; I spent many years in agony. After dialogues with physicians I agreed to take antidepressants.
The change was subtle, and almost unnoticeable at first, but my meditations were deepening and my negative obsessing was from time to time giving way to periods of peace, and sometimes gratitude and joy.
Perhaps antidepressants are simply one more method of skillful means to those for whom they are medically appropriate.
I feel that Judith Hooper’s article “Prozac and Enlightenend Mind” failed to mention a higher perspective surrounding people’s use of the drug. Everything we do in life is part of our karma. A Prozac pill is a karmic field of energy. All the issues that emerge around Prozac use, especially ingestion, can be worked on as a beautiful karma yoga. For some, Prozac will appear to assist one, others will feel it an obstacle. Both are dualistic views that can be transcended. Enlightenment is beyond both joy and pain. Why one person chooses to stay on it and another rejects it is all part of each person’s journey, one choice no more enlightened than another. Furthermore, as the ninja in the jungle flexibly discovers a new branch on a tree to use in combat (never shown in training) resulting in greater victory, so the Prozac user can introduce the regular ingestion of the drug as a beautiful part of his or her practice.
Finally, from an absolute perspective, the use or nonuse of Prozac is irrelevant in its proximity to enlightenment—the bird or garbage floating on the water do not effect the nature of the water. When Ram Dass gave an absurd extraordinary amount of LSD to his guru in India, Baba Neem Karoli, the guru remained unchanged in his equanimity. We all have weeds and brambles to stand in and run through in the murk of life, till we permanently transcend duality. We must remain open to let diversified and numerous forms of wisdom shine through around Prozac use.
It was gratifying to read Judith Hooper’s article, “Prozac and Enlightened Mind,” because it addressed an issue of deep, if often secret, concern to many contemporary Western practitioners of Buddhism. However, I think both the author and the authorities she interviewed neglected to bring a key point to light: there is a quantum leap between the quality of meditation that can be achieved by even an exceptionally dedicated meditator living a life in the world, versus that experienced by a long-term retreatant living in a total immersion situation.
Is it possible to effect psycho-biological transformation through meditation alone? Assuredly, as the life stories of Milarepa and some of the eighty-four Mahasiddhas attest. But such results seem to require both the remote environment of the retreatant’s cave and a practice which (if one is to include dream yoga) extends twenty-four hours a day. Is it realistic to expect the same from practitioners facing the constant distractions of the urban environment and concomitant living concerns? I think not. It is simply not feasible in such conditions to achieve the long periods of one-pointed concentration necessary to effect major biochemical change.
After reading your article on anti-depressants and the enlightened mind, I feel compelled to make the following observations. I am not precisely sure what affect my maintenance dose of an antidepressant has on my mind. I expect it would be only conjecture and speculation for anyone to measure this authentically. I will, however, state with conviction that antidepressants have been an extremely valuable contribution to my continued existence as well as allowing me to pursue my dharma path with acts of compassion and kindness to a much greater extent than if handicapped by the bondage of depression. For me, it is acts of kindness and compassion that are the measure of all peoples’ journey toward spiritual progress.
Richard H. Grace
St. Helena, CA
Although Ms. Hooper noted that depression is seen by some as caused by a chemical imbalance (the medical model) and by others as caused by inaccurate cognitions or belief systems (the cognitive-behavioral model), the relationship between depression and anger was not mentioned. It has been my experience that depression most frequently presents clinically as an inability to acknowledge and appropriately express affective experience, especially the experience of anger.
My experience with clients who have taken medication to relieve depression is that the antidepressant medication works to alleviate the symptoms of depression but does not treat the psychological structure of the person who is depressed. For example, a depressed person on medication may be able to get out of bed and go to work, his mood might be good, and his eating and sleeping patterns may be undisturbed. However, in a medication-only treatment approach, patients will continue to have problems in their relationships because the internal (and frequently implicit) prohibitions against the experience or the expression of anger have not been changed. Moreover, not only does the denial of affective experience cut people off from a very rich source of interpersonal information, anger which is disavowed or denied almost always becomes indirectly communicated in ways which are likely to be quite problematic. Passive/aggressive behavior, somatization, and paranoia are just three examples of the many problems that arise from the attempt to deny or to indirectly express angry feelings.
I should note that I am not suggesting, as Dr. Weitzman has, that SSRI’s are a spiritual or psychological disaster. On the contrary, it is my view that the alleviation of symptoms (lethargy, withdrawal, isolation) provided by antidepressant medication frequently makes it possible for patients to engage in activities—like psychotherapy, meditation, and even exercise - which help them to more fully integrate their affective experience. And it is this acceptance and integration of one’s emotional life which brings about authentic change.
David T. Andersen, Ed. M., M.A.
New Haven, CT
In the Doghouse
I think it is a bit ridiculous to publish 23 pages of Dharma Dog nonsense. I love my dog as much as the next person, but a few pages on this subject would have sufficed.
With this exception keep up the good work.
Joseph J. Kubovcik
When I saw the picture of a robed dog on the cover of your recent issue I thought. “There goes Tricycle down the tubes of a trendy commercial magazine. Soon we’ll have a centerfold of a nun naked, except for her dharma.”
I flipped through the pages of dogs’ legs and read “The Land of Identities” by Bhikshuni Thubten Chodron, and quickly barked with joy, as she banged my head against the Wailing Wall, chanting the mantra of Chenresig.
I have always known I am not a Jew, though my mother was.
Tricycle has my tail wagging.
Santa Monica, CA
I thought I should add one American Buddhist's experience of the FWBO to Henry Shukman's well-written and even-handed account. When I first encountered the FWBO, I was a 38-year-old family man, a rapidly rising corporate executive and a former Marine Corps fighter pilot. I was also completely dried up inside.
Sangharakshita's teachings hit home with me. They were clear, understandable with effort and often challenging. The methods he outlined represented a straightforward approach to spiritual development. I put them to the test to see if they would yield whatever was missing from my life.
I continue to practice today as a 53-year-old member of the Western Buddhist Order. How do I respond to the controversy surrounding Sangharakshita and the movement he founded? I just keep asking myself if, spiritually speaking, I'm better off now than I was four years ago. As long as the answer comes up yes, I find it hard to get all worked up about it.
I just wanted to write and say how impressed and moved I was by Wendy Johnson’s article “Heavy Grace” in the Spring 1999 issue. I always turn to her writing first and each time it surprises me with its interweaving of spiritual practice, everyday life and the bittersweet ironies that working directly with the earth throws at us.
Even in the coming to terms with the death of ones parents, Wendy Johnson managed to capture her sense of desolation, fear and hope by invoking the textures and colours in her garden and poetically juxtaposing them with memories of her mother and father and the wisdom of her Zen teachers. The truly honest admission that “nothing helps. Nothing.” made it all the more poignant.
As a gardener in the process of setting up a nursery who also practices in the Dzogchen tradition, I find it a wonderful inspiration to share in the humor (and profound seriousness) that gardening brings into our lives. I look forward to Wendy Johnson’s book on meditation and gardening.
A Japanese garden cannot be a Japanese garden without moss. Sometimes moss is intentionally planted as a ground cover in a Japanese garden. When time passes and a garden matures, inevitably moss grows on certain spots of the garden and is accepted as a part of the garden.
I really don’t know if the famous Moss Garden in Kyoto was planned to be a moss garden or happened to be one. The Moss Garden belongs to Saihoji Temple and was designed by a Zen monk, Muso Kobushi (a.k.a. Muso Soseki), in 1339. A Japanese garden cannot be a Japanese garden without Zen.
After reading your review of my book, Lotus in the Fire: The Healing Power of Zen, I said to myself, “Whoever wrote this, did not read Lotus in the Fire.”
Marilyn Webb writes: “the downside of his story is the inadvertent message that if one meditates diligently enough one needn’t die.”
For the record, I have never professed that Zen practice healed me. The doctors did that. Nor do I believe Zen can cure cancer. However, a determined spiritual practice can help us deal with the fear, anxiety, confusion, and emotional turmoil that accompany life-threatening illness. The Buddha’s teaching helped me perceive all these states as transitory.
To claim victory over my illness because this body still functions would be a victory short lived. Lotus in the Fire is a book about impermanence. How could Webb have missed it?
Marilyn Webb responds:
Sometimes as writers we think the obvious comes through to readers, yet it may not. In this case, it didn't; at least not to this reader.
I am very heartened, however, to hear Bedard's response that “a determined spiritual practice can help us deal with the fear, anxiety, confusion, and emotional turmoil that accompany life-threatening illness” for that is the gift that practice can give all of us.
Image 1: By Neal Crosbie.
Image 2: By Frank Olinsky.
Image 3: By Paul Volker.
Image 4: By Mike Taylor.