Meditation in Long-term Illness

Dr. Swami Karmananda Saraswati MB, BS (Syd)

There is a small but growing number of reports in world medical and psychiatric journals on the value of meditation in transforming the lives of isolated patients suffering from major debilitating or terminal illnesses. The prognosis or outlook for these patients Was previously complicated by depression, negative and self-defeating concepts, poor adaptation and lost motivation in the face of the life situation imposed by such diseases.

Several doctors have reported that introduction of meditation therapy seemed to be the turning point in the history of a patient whose prognosis was going from bad to worse, with seemingly no other therapy or regime remaining, which could effectively restore the will to live. It is the motivation to live and enjoy life at any cost which has often been found to be the most important single factor in the outcome of many major and long term diseases. The patient who cannot accept his illness and gives up hope and interest in life as a whole, always makes a poor or slow recovery and suffers far more in the process. Alternatively, he declines inevitably towards death, without offering more than token resistance. Similarly, his relatives and loved ones suffer much more as well.

Meditation has been found to play a crucial role in bringing about this reversal of attitude, leading chronically sick, depressed and unhappy individuals towards assuming full responsibility for their health, their relationships and their lives. Meditation leads to a new appreciation of the value and beauty of life, to be cherished and savoured at any price. Several studies have reported that self-obsessed, unhappy patients who genuinely adopted meditation were rapidly transformed over a period of months into brave and inspiring souls who enjoy life and give love to others. They are always happy and cheerful, seemingly oblivious to their own personal impediment or illness.

This effect of meditation is not distinct and separate from the actual healing process and recovery of good health. Several people have used meditation to regain full health or vast improvement after suffering from serious illnesses such as cancer and rheumatoid arthritis. It appears that the healing of physical illnesses is an extension of the process which begins when the meditating patient's perception of himself and his personal situation undergoes a gradual but fundamental change and reorientation.

At least one researcher, Dr. Ainslie Meares of Melbourne, Australia, has observed that terminal cancer patients whom he can successfully lead into meditation therapy, come to have a different, but profoundly significant experience of life. Living comes to have a meaning it previously lacked and the patient becomes more interested in his changed experience of life than in his cancer, writes Dr. Meares in 'The Practitioner'.*1

It is this change of attitude, generated by meditation, which appears to be the crucial step in acceptance of, and the possibility of recovery from, major illnesses such as cancer and malignant processes, and degenerative conditions such as rheumatoid arthritis and multiple sclerosis.

There was a similar report in the American Journal of Psychiatry' recently, written by Dennis J. Gersten MD, a UCLA California psychiatrist.*2 He has begun to use meditation based techniques to enhance the effects of psychotherapy and to facilitate relaxation in his patients.

Gersten describes the successful use of meditation therapy in a 43 year old man suffering from the stigmata of multiple sclerosis, complicated by severe long term decubitus ulcers (bed sores).

Multiple sclerosis is a disease of the central nervous system of unknown origin, in which the myelin sheath of supporting and nourishing tissue surrounding nervous fibres gradually begins to erode in an unsystematic, random way throughout the brain, cranial nerves and spinal cord. Although the symptoms and signs are variable and undergo exacerbations and remissions over a period of months or years, they commonly include a degree of mental disorientation and disturbance- visual disturbances; disturbances of gait, posture and balance, partial paralysis; loss of co-ordination and disturbance of speech.

Multiple sclerosis is characteristically a disease which first affects men in their twenties, or thirties. Because these patients are used to a full, active and responsible life, they succumb frequently to complications of severe mental depression when they suddenly find themselves stricken and unable to move freely, think clearly or help themselves in any way. Decubitus ulcers are the deep sores which develop on the hips and buttocks of patients long confined to bed unable to move freely from side to side because of nervous disability such as paraplegia or quadriplegia (partial or total paralysis). They present a special problem requiring skilled and attentive nursing care.

The patient in question was first seen by Dr. Gersten in exactly this condition. He had a 25 year history of multiple sclerosis with paraplegia (paralysis of the lower limbs), and three major decubitus ulcers, one at each hip and one at the sacrum. On examination, the three ulcers were measuring 5x10 cm, 5 x 10 cm and 8x6 cm, extending down to muscle and bone, and complicated by osteomyelitis (infection of the bone). The patient was significantly depressed, as exhibited by marked psychomotor slowing (i.e. slowness in movement, response to questions etc.), weight loss, depression of mood, and hopeless and helpless ideation (i.e. patient had given up hope for himself and his situation). At the same time, he had a mild organic brain syndrome (i.e. a small degree of mental disorder) secondary to multiple sclerosis, as exhibited by his inability to perform simple counting and memory procedures.

Therapy

Dr. Gersten visited his patient three or four times a week, for about half an hour per session, for four months. At the beginning his treatment was 'predominantly supportive, anxiety suppressing psychotherapy'. In spite of significant physical setbacks, including bilateral removal of the femoral heads (an operation made necessary because of osteomyelitic infection of the upper ends of both thigh bones), the patient's mood gradually improved.

When the patient's decubitus ulcers failed to heal despite seven months of intensive care, antibiotics and a high protein, high calorie diet (which is often the case in multiple sclerosis sufferers) Gersten introduced the idea of meditation, suggesting the following techniques:

  1. Relax your muscles, moving slowly from the feet up to the head.
  2. Focus on your breathing, paying attention to the movement of your diaphragm.
  3. After 2 days practice, shift your attention to the wound sites. Visualise them healing, and concentrate your awareness on the wound sites.

(Stages 1 and 2 are very similar to yoga nidra practices of rotation of consciousness and abdominal breath awareness, while stage 3 introduces prana vidya).

After the patient had used this technique for 10 days (15 minutes, 3 times a day), there was slight but measurable closure in the wounds, with 30 to 40% closure in 2 months. Although he suffered several further setbacks, his wounds finally closed enough to be skin grafted, the first two after 7 months and the last one after a further 5 months.

Once successful wound closure had been established, the patient began to use the same meditative technique to see if either his diplopia (double vision) or ataxia (tremor and jerkiness) of his hands could be similarly improved. Both these symptoms had been present for over 3 years, with the longest remission being a week. After 3 weeks meditation both symptoms went into remission for 1 month. These symptoms were known to be very sensitive to stress, flaring up with surgery or other trauma, but diminishing with the practice of meditation. Subsequently, consistent improvement in these symptoms has not been observed over an 8 month period.

Following discharge to a rehabilitation centre the patient continued to meditate 6 to 7 times a day in 15 to 30 minute sessions. His mood continued to improve and he adapted satisfactorily to his new environment.

Quoting Dr. Gersten's report: 'Meditation became an organising factor around which he structured his time and to which he attributed his improved sense of well being. The patient himself believes that meditation has been the sole reason for his physical and emotional recovery, although obviously without good nursing, surgical and supportive care, no recovery could have been possible.

Conclusion

Again, we are reporting die summary of an isolated case history where meditation was used as a therapy of last resort in a young patient whose fate was almost certainly a quick demise, having given up all self-motivation, and with virtually no hope of a foreseeable recovery. In this light, Gersten stresses the importance of the patient's self-motivation in recovery from any illness. This is mirrored in prior research which has found that poorly motivated patients tend to recover from surgery more slowly than motivated patients, and other studies suggesting that severe or prolonged depression often precedes cancer development. It is unclear by what mechanism meditation exerts its influence, beyond awakening the patient's own self-motivation for recovery, and resulting in improved mood and improved physical symptoms.

This patient's recovery came about following a variety of therapies: meditation, psychotherapy, and non-psychiatric intervention. However Gersten himself believes that meditation was the most significant factor in the patient's healing, because:

  1. Success followed by an A B A pattern i.e. active meditation treatment associated with healing, discontinuation of meditation treatment associated with relapse, and reinstitution of meditation followed by resumption of healing.
  2. Meditation was the only new variable in a very long treatment which had little previous success.

References

*1. Meares, A., "Meditation: a Psychological Approach to Cancer Treatment", 'The Practitioner' 222, 119-122 1979.
*2. Gersten, Dennis J., "Meditation as an Adjunct to Medical and Psychiatric Treatment", Am. .1. Psychiatry' 135:5, May 1978.