Thursday, September 18, 2014

The Medical Model

Reposted from November 2012

While I believe mindfulness meditation has been the keystone to my recovery, I still think of it as an adjunct therapy.  I couldn’t manage mental illness as well as I do now if I did not meditate.  But I acknowledge that the medication my doctor prescribes and the therapy visits I have with him are crucial as well.  Only through the consistent application of all three therapies am I well.

Mindfulness meditation is currently all the rage, and it works.  But I am wary of its proponents who claim it can treat (or even cure) mental illness by itself.  Meditation is a powerful tool when used to decrease stress and increase well-being.  But if we are to maintain that mental illnesses are biochemical malfunctions of the brain and nervous system, then we must allow room in treatment for medicine.  Therapy also has a long history of positively impacting the lives of those challenged by psychiatric illness.  Meditation, when added to more traditional and well-tested methods of treatment, can help a patient successfully manage a challenging life.  I, and so many others like me, am proof of that.

I am sure that there are people who face serious mental illness well using only meditation.  Dan Siegel writes of one teenager who manages bipolar disorder with meditation alone in his excellent book Mindsight.  But the popularization of such case studies may lead people to stop taking medication and pick-up meditation in a hope to finally be done with meds.  Anyone who hopes for this and changes his own medication regimen without proper medical oversight is asking for relapse and worse.

Another book on the benefits of meditation, Transcendence by Norman E Rosenthal, clearly states that meditation for mental illnesses such as bipolar disorder and schizophrenia should only be administered in conjunction with medication and therapy and should be monitored by a physician (This book deals with Transcendental Meditation, not mindfulness meditation).  I believe this more balanced view will help more people manage the symptoms of mental illness successfully.

Since I have become a disciplined meditator I have had little difficulty with my bipolar disorder.  It is only natural to wonder if I could manage as well if I continued to meditate and came off the drugs.  In fact, it is very tempting.  But my doctor advises me not to and, after much reflection and concern for my family, I agree.  Just as I couldn’t manage this well without the meditation, much research evidence supports the idea that I couldn’t manage without the medication and therapy either.  I’m not willing to take the chance.

Every consumer to whom I have taught meditation has asked me if I think serious mental illness can be cured.  At this point in time, with what science has discovered, I don’t.  But it can be managed, and managed well, if meditation is added to the medical model of drugs and therapy.  Just as the person with diabetes will take insulin indefinitely, I must continue to take psychotropics.  And just as one with diabetes must adopt a healthy lifestyle to best complement his medication, the patient with mental illness must as well.  What I am sure of is that meditation is one of the best complements available.


  1. The National Alliance for the Mentally Ill (NAMI) states that 16 percent of the prison population can be classified as severely mentally ill. This means that they fit the psychiatric classification for illnesses such as schizophrenia, bipolar disorder, and major depression.

  2. Both have their own benefits. As confidence grows, organically like a seedling planted in nourishing soil, our addictions to the trinkets of the world begin to fade. We find our self wanting to sit more, to be more mindful at work, and to relish in the sweetness of contemplating the dharma.
    Mindfulness meditation