ทำสมาธิระงับวิตกกังวลซึมเศร้า

image140110_002นักวิจัยมหาวิทยาลัยจอห์น ฮอปกินส์ สหรัฐฯ ศึกษาพบว่าการนั่งสมาธินานวันละครึ่งชั่วโมง อาจช่วยระงับความวิตกกังวล อาการซึมเศร้าและความเจ็บปวดลงได้

คณะนักวิจัยได้พบหลักฐานระดับปานกลางยืนยันเรื่องนี้ ในรายงานผลการศึกษาในเรื่องนี้ที่แล้วมา 47 เรื่องด้วยกัน

หัวหน้านักวิจัย ดร.มัธยะ โกยัล กล่าวว่า “คนหลายคนยังคิดว่า การนั่งสมาธิคือการนั่งอยู่นิ่งๆ โดยไม่ได้ทำอะไรเลย ซึ่งไม่จริง ที่จริงแล้วเป็นการฝึกจิตให้มีสติสัมปชัญญะมากขึ้น”

เมื่อ พ.ศ. 2550 เคยมีรายงานว่า คนชาวอเมริกัน เกิดความสนใจศึกษาเรื่องนี้มากประมาณร้อยละ 9 และในจำนวนนี้ มีอยู่ร้อยละ 1 ที่แจ้งว่าได้ใช้วิธีนี้ในการรักษาโรคหรือใช้เป็นยา

ในการศึกษาครั้งล่านี้ พวกเขาได้พบว่ามีผู้ปฏิบัติประมาณร้อยละ 5-10 รายงานว่าช่วยให้คลายความวิตกกังวลลงได้ และมีมากประมาณร้อยละ 10-20 กล่าวว่าทำให้คลายความซึมเศร้าลง เมื่อเทียบกับผู้ปฏิบัติตนแบบอื่น

อย่างไรก็ดี สำหรับผลดีในการช่วยบรรเทาความเจ็บปวด ดร.มัธยะยอมรับว่ายังไม่อาจรู้ได้ว่าการนั่งสมาธิช่วยบรรเทาอาการเจ็บปวดแบบไหนลงได้มากที่สุด.

ที่มา: ไทยรัฐ 10 มกราคม 2557

.

Related Article:

.

image140110_001

Meditation may help with anxiety, depression and pain

07 Jan 2014

Using data from 47 earlier studies, researchers found moderate evidence to support the use of mindfulness meditation to treat those conditions. Meditation didn’t seem to affect mood, sleep or substance use.

“Many people have the idea that meditation means just sitting quietly and doing nothing,” wrote Dr. Madhav Goyal in an email to a news agency. “That is not true. It is an active training of the mind to increase awareness, and different meditation programs approach this in different ways.”

Goyal led the study at The Johns Hopkins University in Baltimore.

He and his colleagues write in JAMA Internal Medicine that meditation techniques emphasize mindfulness and concentration.

So-called mindfulness meditation is aimed at allowing the mind to pay attention to whatever thoughts enter it, such as sounds in the environment, without becoming too focused. Mantra meditation, on the other hand, involves focusing concentration on a particular word or sound.

Approximately 9 percent of people in US reported meditating in 2007, according to the National Institutes of Health. About 1 percent said they use meditation as some sort of treatment or medicine.

For the new report, the researchers searched several electronic databases that catalog medical research for trials that randomly assigned people with a certain condition – such as anxiety, pain or depression – to do meditation or another activity. These randomized controlled trials are considered the gold standard of medical research.

The researchers found 47 studies with over 3,500 participants that met their criteria.

After combining the data, Goyal said his team found between a 5 and 10 percent improvement in anxiety symptoms among people who took part in mindfulness meditation, compared to those who did another activity.

There was also about a 10 to 20 percent improvement in symptoms of depression among those who practiced mindfulness meditation, compared to the other group.

“This is similar to the effects that other studies have found for the use of antidepressants in similar populations,” Goyal said.

Mindfulness meditation was also tied to reduced pain. But Goyal said it’s hard to know what kind of pain may be most affected by meditation.

The benefits of meditation didn’t surpass what is typically associated with other treatments, such as drugs and exercise, for those conditions.

“As with many therapies, we try to get a moderate level of confidence that the therapy works before we prescribe it,” Goyal said. “If we have a high level of confidence, it is much better.”

But he noted that the researchers didn’t find anything more than moderate evidence of benefit from meditation for anxiety, depression and pain.

There was some suggestion that meditation may help improve stress and overall mental health, but the evidence supporting those findings was of low quality.

There was no clear evidence that meditation could influence positive mood, attention, substance use, eating habits, sleep or weight.

“Clinicians should be prepared to talk with their patients about the role that meditation programs could have in addressing psychological stress, particularly when symptoms are mild,” Goyal said.

Dr. Allan Goroll, who wrote an editorial accompanying the new study, told Reuters Health the analysis is an example of an area of much-needed scientific study, because many people make treatment decisions based on beliefs – not data.

“That is particularly the case with alternative and complimentary approaches to treating medical problems,” he said. “It ranges from taking vitamins to undergoing particular procedures for which the scientific evidence is very slim but people’s beliefs are very great.”

Goroll is professor at Harvard Medical School and Massachusetts General Hospital in Boston.

Goyal said people should remember that meditation was not conceived to treat any particular health problem.

“Rather, it is a path we travel on to increase our awareness and gain insight into our lives,” he wrote. “The best reason to meditate is to gain this insight. Improvements in health conditions are really a side benefit, and it’s best to think of them that way.”

(Agencies)

Latest News from Lifestyle News Desk

SOURCE : jagran.com

 

 

ความรักไม่ทรมาน หายเจ็บปวดร้าวราน

Credit: wugange.com

Credit: wugange.com

นักแต่งเพลงตั้งแต่ไหนแต่ไรมามักจะโทษว่า ความรักทำให้เจ็บปวดร้าวราน แต่บัดนี้นักวิทยาศาสตร์เถียงได้ว่า ความรักทำให้คลายเจ็บปวดก็มี

นักวิจัยมหาวิทยาลัยสแตมฟอร์ดของอเมริกา ได้ทดลองกับนักศึกษา 15 คน มาทรมานให้เกิดความเจ็บปวดเล็กน้อยพร้อมกับใช้เครื่องตรวจวัดคลื่นสมองคอยจับการทำงานของสมองดูด้วย เพราะเป็นที่ทราบกันว่า ความรู้สึกในความรักอย่างรุนแรงก่อให้สมองหลายส่วนเกิดปฏิกิริยาอย่างคึกคัก แล้วคอยจับตาดูว่า เมื่อพวกเขาเห็นภาพคนรักจะแสดงอาการอย่างใดบ้าง

คณะวิจัยได้พบว่า การได้เห็นรูปคนรักทำให้พวกเขาคลายความรู้สึกเจ็บปวดลงได้มากกว่าได้เห็นรูปคนที่แค่รู้จักเท่านั้น

ศาสตราจารย์ปอล กิลเบิร์ต แพทย์ผู้ชำนาญด้านประสาทและจิตเวช มหาวิทยาลัยเดอร์บี้ แสดงความเห็นว่า ความสัมพันธ์ของอารมณ์กับความรู้สึกเจ็บปวดนั้นสามารถเห็นได้ชัด “ตัวอย่างอันหนึ่ง ก็คือ นักฟุตบอลที่บาดเจ็บก็ยังโขยกเขยกทนเจ็บเล่นต่อไปได้ก็เพราะกำลังมีอารมณ์สู้”

ที่มา: ไทยรัฐ 30 กันยายน 2556

.

Related Article:

.

Credit: weheartit.com

Credit: weheartit.com

Love can ease pain, say brain researchers

14 October 2010

Love hurts, at least according to many a romantic songwriter, but it may also help ease pain, US scientists suggest.

Brain scans suggest many of the areas normally involved in pain response are also activated by amorous thoughts.

Stanford University researchers gave 15 students mild doses of pain, while checking if they were distracted by gazing at photos of their beloved.

The study focused on people early in a romance, journal PLoS One reported, so the “drug of love” may wear off.

The scientists who carried out the experiment used “functional magnetic resonance imaging” (fMRI) to measure activity in real-time in different parts of the brain.

It has been known for some time that strong feelings of love are linked to intense activity in several different brain regions.

These include areas linked to the brain chemical dopamine, which produces the brain’s feel-good state following certain stimulants – from eating sweets to taking cocaine.

“Light up”

The Stanford University researchers had noticed that when we feel pain, some of the same areas “light up” on the scans – and wondered whether one might affect the other.

They recruited a dozen students who were all in the first nine months of a relationship, defined as “the first phase of intense love”.

Each was asked to bring in a picture of the object of their affection and photos of what they deemed an equally attractive acquaintance.


It’s important to recognise that people who feel alone and depressed may have very low pain thresholds, whereas the reverse can be true for people who feel secure and cared for”

Professor Paul GilbertUniversity of Derby

While their brains were scanned, they were shown these pictures, while a computer controlled heat pad placed in the palm of their hand was set up to cause them mild pain.

They found that viewing the picture of their beloved reduced perceptions of pain much more than looking at the image of the acquaintance.

Dr Jarred Younger, one of the researchers involved, said that the “love-induced analgesia” appeared to involve more primitive functions of the brain, working in a similar way to opioid painkillers.

“One of the key sites is the nucleus accumbens, a key reward addiction centre for opioids, cocaine and other drugs of abuse.

“The region tells the brain that you really need to keep doing this.”

Professor Paul Gilbert, a neuropsychologist from the University of Derby, said that the relationship between emotional states and the perception of pain was clear.

He said: “One example is a footballer who has suffered quite a painful injury, but who is able to continue playing because of his emotionally charged state.”

He added that while the effect noticed by the Stanford researchers might only be short-lived in the early stages of a love affair, it may well be replaced by something similar later in a relationship, with a sense of comfort and wellbeing generating the release of endorphins.

“It’s important to recognise that people who feel alone and depressed may have very low pain thresholds, whereas the reverse can be true for people who feel secure and cared for.

“This may well be an issue for the health service, as patients are sometimes rushed through the system, and perhaps there isn’t this focus on caring that might have existed once.”

SOURCE : www.bbc.co.uk

น้ำตาลหนึ่งเข็มสามารถบรรเทาอาการปวดเข่าจากข้อเสื่อม

New solution: A sugar solution injected into the knee may be a new method of treating osteo-arthritis

New solution: A sugar solution injected into the knee may be a new method of treating osteo-arthritis

น้ำตาลหนึ่งเข็มสามารถบรรเทาอาการปวดหัวเข่าจากการปล่อยเซลล์ซ่อมแซมเอ็นที่เสียหาย

  • การบำบัดแบบ Prolotherapy เกี่ยวข้องกับการฉีดสารละลายน้ำตาลที่หัวเข่า
  • การกระตุ้นนี้ปล่อยเซลล์ที่สามารถช่วยให้เกิดกระบวนการเยียวยาข้อเสื่อม

การใช้สารละลายน้ำตาลเดกซ์โทรส 10 -25 % ฉีดเข้าไปในข้อเข่าอาจเป็นวิธีใหม่ในการรักษาโรคข้อเสื่อม โดยน้ำตาลและน้ำจะช่วยลดอาการปวดและตึงโดยการกระตุ้นกลไกการซ่อมแซมร่างกายตามธรรมชาติ

โซลูชั่นหวานทำงานโดยทำหน้าที่เป็นระคายเคืองอ่อนภายในข้อต่อวิกฤติการอักเสบในระดับต่ำ

การอักเสบนี้ไม่เพียงพอที่จะก่อให้เกิดอันตรายใด ๆ ที่รุนแรง แต่เพียงจะกระตุ้นการปล่อยเซลล์ที่สามารถช่วยในการรักษาความเสียหายบางส่วนที่เกิดจากโรค

มีการศึกษาล่าสุดที่มหาวิทยาลัยวิสคอนซินในสหรัฐอเมริกา

อ่านเพิ่มเติม

.

Sweet release: The treatment, known as prolotherapy, is thought to work by triggering the release of cells that repair damaged ligaments in the knee

Sweet release: The treatment, known as prolotherapy, is thought to work by triggering the release of cells that repair damaged ligaments in the knee

A dose of sugar can ease the pain of creaky knees by releasing cells that repair damaged ligaments

  • Prolotherapy involves injecting a sugar solution into the knee
  • This stimulates the release of cells that can help the healing process

By PAT HAGAN

PUBLISHED: 21:11 GMT, 8 July 2013

A sugar solution injected into the knee could be a new way to treat osteo-arthritis. Research suggests the sugar and water mixture reduces pain and stiffness by stimulating the body’s natural repair mechanisms.

The sweet solution works by acting as a mild irritant inside the joint, triggering low-level inflammation.

This inflammation is not enough to cause any severe harm, but is sufficient to stimulate the release of cells that can help to heal some of the damage caused by the disease.

Doctors use a solution containing water and between 10 and 25 per cent dextrose, a type of sugar.

They use dextrose because it is cheap, readily available and safe – causing only mild irritation inside the knee joint. The treatment, known as prolotherapy, is thought to work by triggering the release of fibroblasts, cells that build and maintain connective tissue such as ligaments.

The fibroblasts repair damaged ligaments in the knee, making it more stable and relieving discomfort.

In a recent study at the University of Wisconsin in the U.S., researchers recruited 90 men and women with painful knee osteoarthritis and split them into three groups.

One group received three separate sugar jabs, each one four weeks apart, and another had injections of a salt water solution.

The last group did not have any injections but instead followed an at-home exercise regimen designed to alleviate some of the pain and discomfort.

Each volunteer was monitored using a scoring  system, called the Western Ontario McMaster University Osteo-arthritis Index, to measure the severity of the condition. The 12-minute test uses a 100-point scale  and includes questions on how easy it is to use the stairs, get in and out of a car or put on a pair of socks.

The results, published in the Annals of Family Medicine, showed that one year after the treatment began, the sugar jab group had the biggest improvement in symptoms and were better able to carry out everyday activities.

On average, the sugar group improved by a total of 16 points, compared with five points for salt water jabs and seven for the exercise group. The team are unsure why salt water was not as effective as sugar.

This technique is also being tried in other conditions such as chronic back pain and tennis elbow.

Commenting on the approach, Professor Alan Silman, medical director of Arthritis Research UK, said: ‘Though some “irritant” treatments can be effective, much more work is needed before a treatment based on sugar solution could be recommended to patients.’

Meanwhile, scientists have designed a special glove that may ease the pain of hand arthritis.

Around 130 people who suffer from rheumatoid and osteoarthritis are being treated with the compression glove in a new clinical trial.

The gloves are made from a special fabric that when stretched (when it is worn) puts pressure on the hand and joints.

It’s thought that the pressure might trigger mild inflammation, which, unlike severe inflammation, eases pain although it is not clear why.

In the year-long trial, due to start in September and being  co-ordinated by the University of Salford, patients will be given the compression gloves as part of their usual care.

They will be assessed before and after for pain and stiffness.

SOURCE: www.dailymail.co.uk

อานุภาพความรัก ทนกับความเจ็บปวด

นักวิทยาศาสตร์พบอานุภาพของความรักอีกอย่างหนึ่งว่าสามารถทำให้ทนกับความเจ็บปวดทรมานได้

นักวิจัยมหาวิทยาลัยสแตนฟอร์ดของสหรัฐฯ ได้ทดลองกับนักศึกษาชาย 15 คน ด้วยการทำให้รู้สึกเจ็บ ในขณะที่ให้ดูรูปภาพของคนรักไปด้วย พร้อมกับใช้เครื่องเอกซเรย์คอมพิวเตอร์สนามแม่เหล็กไฟฟ้า ที่สามารถแสดงให้เห็นภาพส่วนต่างๆของสมอง ในการวิเคราะห์พวกเขาได้พบว่านักศึกษาสามารถทนกับความเจ็บปวดเมื่อได้เห็นภาพของคนรักได้สูงกว่าธรรมดา

นักวิจัยยังได้รู้ว่าอานุภาพของความรักทำให้สมองหลายส่วนแสดงปฏิกิริยาขึ้นอย่างคึกคัก ตั้งแต่ส่วนที่เกี่ยวกับการสร้างสารเคมีโดปามีน  อันเป็นสารที่บันดาลให้เกิดความรู้สึกเป็นสุข

ศาสตราจารย์ปอล กิลเบิร์ท อาจารย์ด้านประสาทและจิตเวช มหาวิทยาลัยดาร์บี้ กล่าวว่า ความสัมพันธ์ของสภาวะอารมณ์กับความรู้สึกเจ็บปวดเห็นได้ไม่ยาก เหมือนอย่างที่นักฟุตบอล แม้จะได้รับบาดเจ็บ ก็ยังแข็งใจเล่น เพื่อชื่อเสียงและชัยชนะของทีม.

ที่มา : ไทยรัฐ 19 เมษายน 2556

.

Related Article :

.

bbc101014_001

Love can ease pain, say brain researchers

14 October 2010

Love hurts, at least according to many a romantic songwriter, but it may also help ease pain, US scientists suggest.

Brain scans suggest many of the areas normally involved in pain response are also activated by amorous thoughts.

Stanford University researchers gave 15 students mild doses of pain, while checking if they were distracted by gazing at photos of their beloved.

The study focused on people early in a romance, journal PLoS One reported, so the “drug of love” may wear off.

The scientists who carried out the experiment used “functional magnetic resonance imaging” (fMRI) to measure activity in real-time in different parts of the brain.

It has been known for some time that strong feelings of love are linked to intense activity in several different brain regions.

These include areas linked to the brain chemical dopamine, which produces the brain’s feel-good state following certain stimulants – from eating sweets to taking cocaine.

“Light up”

The Stanford University researchers had noticed that when we feel pain, some of the same areas “light up” on the scans – and wondered whether one might affect the other.

They recruited a dozen students who were all in the first nine months of a relationship, defined as “the first phase of intense love”.

Each was asked to bring in a picture of the object of their affection and photos of what they deemed an equally attractive acquaintance.


It’s important to recognise that people who feel alone and depressed may have very low pain thresholds, whereas the reverse can be true for people who feel secure and cared for”

Professor Paul GilbertUniversity of Derby

While their brains were scanned, they were shown these pictures, while a computer controlled heat pad placed in the palm of their hand was set up to cause them mild pain.

They found that viewing the picture of their beloved reduced perceptions of pain much more than looking at the image of the acquaintance.

Dr Jarred Younger, one of the researchers involved, said that the “love-induced analgesia” appeared to involve more primitive functions of the brain, working in a similar way to opioid painkillers.

“One of the key sites is the nucleus accumbens, a key reward addiction centre for opioids, cocaine and other drugs of abuse.

“The region tells the brain that you really need to keep doing this.”

Professor Paul Gilbert, a neuropsychologist from the University of Derby, said that the relationship between emotional states and the perception of pain was clear.

He said: “One example is a footballer who has suffered quite a painful injury, but who is able to continue playing because of his emotionally charged state.”

He added that while the effect noticed by the Stanford researchers might only be short-lived in the early stages of a love affair, it may well be replaced by something similar later in a relationship, with a sense of comfort and wellbeing generating the release of endorphins.

“It’s important to recognise that people who feel alone and depressed may have very low pain thresholds, whereas the reverse can be true for people who feel secure and cared for.

“This may well be an issue for the health service, as patients are sometimes rushed through the system, and perhaps there isn’t this focus on caring that might have existed once.”

SOURCE : www.bbc.co.uk

นอนเพิ่มเป็นสิบชั่วโมงต่อคืนช่วยสยบความปวดได้

More sleep, less pain: A solid ten hours of sleep is more effective than taking codeine to reduce pain

More sleep, less pain: A solid ten hours of sleep is more effective than taking codeine to reduce pain

การนอนเพิ่มจากเดิม 8 ชั่วโมง เป็น 10 ชั่วโมง มีผลลดปวดคล้าย ยาโคเดอีน

Sleeping for an extra hour a night ‘helps beat pain’

  • Sleeping ten hours instead of eight is more effective than codeine medicine

By DAILY MAIL REPORTER

PUBLISHED: 00:15 GMT, 1 December 2012 |

Sleeping for an hour or more extra a night  can dramatically improve an individual’s alertness and reduce their sensitivity to pain, say scientists.

In fact, say the researchers, getting nearly ten hours a night – rather than the recommended eight – is more effective at reducing pain than taking the drug codeine.

The study used 18 healthy, pain-free volunteers who were randomly assigned either four nights of their normal sleep pattern or four nights of ten hours in bed.

The American researchers measured daytime sleepiness using the multiple sleep latency test – a standard method used by doctors to diagnose sleep problems in which brain waves, eye movement, heart rate and muscle tone are measured.

Pain sensitivity was assessed using a heat source.

Results showed the extended sleep group slept 1.8 hours more per night than those on a regular sleeping pattern. This was associated with increased daytime alertness and significantly less pain sensitivity.

Those getting more sleep were able to keep their finger on a heat source for 25 per cent longer, showing a loss of pain sensitivity.

The findings, published in the journal Sleep, also revealed the magnitude of this increase is greater than the effect found in a previous study of 60mg  of codeine.

The results, combined with data from previous research, suggest increased pain sensitivity in tired people is the result of their underlying sleepiness.

Dr Timothy Roehrs, an expert in sleep disorders and their treatment based at the  Henry Ford Hospital in Detroit, said: ‘Our results suggest the importance of adequate sleep in various chronic pain conditions or in preparation for elective surgical procedures.

‘We were surprised by the magnitude of the reduction in pain sensitivity, when compared to the reduction produced by taking codeine.’

SOURCE: dailymail.co.uk

“A Good Dose of Dhamma: For Meditators When They Are Ill” by Upasika Kee Nanayon

A Good Dose of Dhamma

For Meditators When They Are Ill

by
Upasika Kee Nanayon
translated from the Thai by
Thanissaro Bhikkhu

I

Normally, illness is something we all have, but the type of illness where you can still do your work isn’t recognized as illness. It’s called the normal human state all over the world. Yet really, when the body is in its normal state, it’s still ill in and of itself — simply that people in general are unaware of the fact that it’s the deterioration of physical and mental phenomena, continually, from moment to moment.

The way people get carried away with their thoughts and preoccupations while they’re still strong enough to do this and do that: That’s really complacency. They’re no match at all for people lying in bed ill. People lying in bed ill are lucky because they have the opportunity to do nothing but contemplate stress and pain. Their minds don’t take up anything else, don’t go anywhere else. They can contemplate pain at all times — and let go of pain at all times as well.

Don’t you see the difference? The “emptiness” of the mind when you’re involved in activities is “play” emptiness. Imitation emptiness. It’s not the real thing. But to contemplate inconstancy, stress, and not-selfness as it appears right inside you while you’re lying right here, is very beneficial for you. Just don’t think that you’re what’s hurting. Simply see the natural phenomena of physical and mental events as they pass away, pass away. They’re not you. They’re not really yours. You don’t have any real control over them.

Look at them! Exactly where do you have any control over them? This is true for everyone in the world. You’re not the only one to whom it’s happening. So whatever the disease there is in your body, it isn’t important. What’s important is the disease in the mind. Normally we don’t pay too much attention to the fact that we have diseases in our minds, i.e., the diseases of defilement, craving, and attachment. We pay attention only to our physical diseases, afraid of all the horrible things that can happen to the body. But no matter how much we try to stave things off with our fears, when the time comes for things to happen, no matter what medicines you have to treat the body, they can give you only temporary respite. Even the people in the past who didn’t suffer from heavy diseases are no longer with us. They’ve all had to part from their bodies in the end.

So when you continually contemplate in this way, it makes you see the truth of inconstancy, stress, and not-selfness correctly within you. And you’ll have to grow more and more disenchanted with things, step by step.

When you give it a try and let go, who’s there? Are you the one hurting, or is it simply an affair of the Dhamma? You have to examine this very carefully to see that it’s not really you that’s hurting. The disease isn’t your disease. It’s a disease of the body, a disease of physical form. In the end, physical form and mental events have to change, to be stressful in the change, to be not-self in the change and the stress. But you must focus on them, watch them, and contemplate them so that they’re clear. Make this knowledge really clear, and right there is where you’ll gain release from all suffering and stress. Right there is where you’ll put an end to all suffering and stress. As for the aggregates, they’ll continue to arise, age, grow ill, and pass away in line with their own affairs. When their causes and conditions run out, they die and go into their coffin.

Some people, when they’re healthy and complacent, die suddenly and unexpectedly without knowing what’s happening to them. Their minds are completely oblivious to what’s going on. This is much worse than the person lying ill in bed who has pain to contemplate as a means of developing disenchantment. So you don’t have to be afraid of pain. If it’s going to be there, let it be there — but don’t let the mind be in pain with it. And then look — right now — is the mind empty of “me” and “mine”?

Keep looking on in. Keep looking on in so that things are really clear, and that’s enough. You don’t have to go knowing anything anywhere else. When you can cure the disease, or the pain lightens, that’s something normal. When it doesn’t lighten, that’s normal, too. But if the heart is simply empty of “me” and “mine,” there will be no pain within it. As for the pain in the aggregates, don’t give it a second thought.

So see yourself as lucky. Lying here, dealing with the disease, you have the opportunity to practice insight meditation with every moment. It doesn’t matter whether you’re here in the hospital or at home. Don’t let there be any real sense in the mind that you’re in the hospital or at home. Let the mind be in the emptiness, empty of all labels and meanings. You don’t have to label yourself as being anywhere at all.

This is because the aggregates are not where you are. They’re empty of any indwelling person. They’re empty of any “me” or “mine.” When the mind is like this, it doesn’t need anything at all. It doesn’t have to be here or go there or anywhere at all. This is the absolute end of suffering and stress…

The mind, when it doesn’t get engrossed with the taste of pleasure or pain, is free in and of itself, in line with its own nature. But I ask that you watch it carefully, the behavior of this mind as it’s empty in line with its own nature, not concocting any desires for anything, not wanting pleasure or trying to push away pain.

When the mind is empty in line with its nature, there’s no sense of ownership in it; there are no labels for itself. No matter what thoughts occur to it, it sees them as insubstantial, as empty of self. There’s simply a sensation that then passes away. A sensation that then passes away, and that’s all.

So you have to watch the phenomena that arise and pass away. In other words, you have to watch the phenomenon of the present continuously — and the mind will be empty, in that it gives no meanings or labels to the arising and passing away. As for the arising and passing away, that’s a characteristic of the aggregates that has to appear as part of their normal nature — simply that the mind isn’t involved, doesn’t latch on. This is the point you can make use of.

You can’t go preventing pleasure and pain, you can’t keep the mind from labeling things and forming thoughts, but you can put these things to a new use. If the mind labels a pain, saying, “I hurt,” you have to read the label carefully, contemplate it until you see that it’s wrong. If the label were right, it would have to say that the pain isn’t me, it’s empty. Or if there’s a thought that “I’m in pain,” this type of thinking is also wrong. You have to take a new approach to your thinking, to see that thinking is inconstant, stressful, and not yours.

So whatever arises, investigate and let go of what’s right in front of you. Just make sure that you don’t cling, and the mind will keep on being empty in line with its nature. If no thoughts are bothering you, there may be strong pain, or the mind may be developing an abnormal mood, but whatever is happening, you have to look right in, look all the way in to the sensation of the mind. Once you have a sense of the empty mind, then if there’s any disturbance, any sense of irritation, you’ll know that the knowledge giving rise to it is wrong knowledge, in and of itself. Right knowledge will immediately take over, making the wrong knowledge disband.

In order to hold continuously to this foundation of knowing, you first have to start out by exercising restraint over the mind, at the same time that you focus your attention and contemplate the phenomenon of stress and pain. Keep this up until the mind can maintain its stance in the clear emptiness of the heart. If you can do this all the way to the end, the final disbanding of suffering will occur right there, right where the mind is empty.

But you have to keep practicing at this continuously. Whenever pain arises, regardless of whether it’s strong or not, don’t label it or give it any meaning. Even if pleasure arises, don’t label it as your pleasure. Just keep letting it go, and the mind will gain release — empty of all clinging or attachment to “selfness” with each and every moment. You have to apply all your mindfulness and energy to this at all times.

You should see yourself as fortunate, that you’re lying here ill, contemplating pain, for you have the opportunity to develop the Path in full measure, gaining insight and letting things go. Nobody has a better opportunity than what you have right now. People running around, engaged in their affairs: Even if they say their minds are disengaged, they’re really no match for you. A person lying ill in bed has the opportunity to develop insight with every in-and-out breath. It’s a sign that you haven’t wasted your birth as a human being, you know, because you’re practicing the teachings of the Lord Buddha to the point where you gain clear knowledge into the true nature of things in and of themselves.

The true nature of things, on the outside level, refers to the phenomenon of the present, the changing of the five aggregates. You can decipher their code, decipher their code until you get disenchanted with them, lose your taste for them, and let them go. When the mind is in this state, the next step is to contemplate it skillfully to see how it’s empty, all the way to the ultimate emptiness — the kind of emptiness that goes clearly into the true nature lying most deeply inside where there is no concocting of thoughts, no arising, no passing away, no changing at all.

When you correctly see the nature of things on the outer level until it is all clear to you, the mind will let go, let go. That’s when you automatically see clearly the nature of what lies on the inner level — empty of all cycling through birth and death, with nothing concocted at all… The emptiest extreme of emptiness, with no labels, no meanings, no clingings or attachments. All I ask is that you see this clearly within your own mind.

The ordinary emptiness of the mind is useful on one level, but that’s not all there is. True emptiness is empty until it reaches the true nature of things on the inner level — something really worth ferreting out, really worth coming to know…

This is something you have to know for yourself… There are really no words to describe it… but we can talk about it by way of guidance, because it may happen that ultimately you let go of everything, in what’s called disbanding without trace.

The mind’s point of disbanding without trace, if you keep developing insight every day, every moment like this, will happen on its own. The mind will know on its own. So don’t let the mind bother itself by getting preoccupied with pleasure or pain. Focus on penetrating into the mind in and of itself relentlessly.

Do you see how different this is from when you’re running around strong and healthy, thinking about this, that, and the other thing?… This is why there’s no harm in having lots of pain. The harm is in our stupidity in giving labels and meanings to things. People in general tend to reflect on the fleeting nature of life with reference to other people, when someone else grows sick or dies, but they rarely reflect on the fleeting nature of their own lives. Or else they reflect for just a moment and then forget all about it, getting completely involved in their other preoccupations. They don’t bring these truths inward, to reflect on the inconstancy occurring within themselves with every moment.

The fact that they can still do this and that, think this and that, say this and that, makes them lose all perspective. When you practice insight meditation, it’s not something that you take a month or two off to do on a special retreat. That’s not the real thing. It’s no match for what you’re doing right now, for here you can do it all day every day and all night, except when you sleep. Especially when the pain is strong, it’s really good for your meditation, because it gives you the chance to know once and for all what inconstancy is like, what stress and suffering are like, what your inability to control things is like.

You have to find out right here, right in front of you, so don’t try to avoid the pain. Practice insight so as to see the true nature of pain, its true nature as Dhamma, and then keep letting it go. If you do this, there’s no way you can go wrong. This is the way to release from suffering.

And it’s something you have to do before you die, you know, not something you wait to do when you die or are just about to die. It’s something you simply keep on doing, keep on “insighting.” When the disease lessens, you “insight” it. When it grows heavy, you “insight” it. If you keep on developing insight like this, the mind will get over its stupidity and delusion. In other words, things like craving and defilement won’t dare hassle the mind the way they used to…

So you have to give it your all — all your mindfulness, all your energy — now that you have the opportunity to practice the Dhamma. Let this be your last lifetime. Don’t let there be anything born again. If you’re born again, things will come back again just as they are now. The same old stuff, over and over and over again. Once there’s birth, there has to be aging, illness, and death, in line with your defilements, experiencing the good and bad results they keep churning out. It’s a cycle of suffering. So the best thing is to gain release from birth. Don’t let yourself want anything any more. Don’t let yourself want anything any more, for all your wants fall in with what’s inconstant, stressful, and not-self.

Wanting is simply a form of defilement and craving. You have to disband these things right at the instigator: the wanting that’s nothing but craving for sensuality, craving for becoming, or craving for no becoming — the germs of birth in the heart. So focus in and contemplate at the right spot, seeing that even though craving may be giving rise to birth at sensory contact, you can set your knowing right at the mind, right at consciousness itself, and let there just be the knowing that lets go of knowing. This is something to work at until you have it mastered.

Setting your knowing at the mind, letting go of knowing like this, is something very beneficial. There’s no getting stuck, no grabbing hold of your knowledge or views. If the knowledge is right, you let it go. If the knowledge is wrong, you let it go. This is called knowing letting go of knowing without going and getting entangled. This kind of knowing keeps the mind from latching onto whatever arises. As soon as you know something, you let it go. As soon as you know something, you’ve let it go. The mind just keeps on staying empty — empty of mental formations and thoughts, empty of every sort of illusion that could affect the mind. It quickly sees through them and lets them go, knows and lets go, without holding onto anything. All it has left is the emptiness…

You’ve already seen results from your practice, step by step, from contemplating things and letting them go, letting go even of the thought that you are the one in pain, that you are the one who’s dying. The pain and the dying are an affair of the aggregates, pure and simple. When this knowledge is clear and sure — that it’s not “my” affair, there’s no “me” in there — there’s just an empty mind: an empty mind, empty of any label for itself. This is the nature of the mind free of the germs that used to make it assume this and that. They’re dead now. Those germs are now dead because we’ve contemplated them. We’ve let go. We’ve set our knowing right at the mind and let go of whatever knowing has arisen, all along to the point where the mind is empty. Clear. In and of itself…

Consciousness, when you’re aware of it inwardly, arises and passes away by its very own nature. There’s no real essence to it — this is what you see when you look at the elemental property of consciousness (viññana-dhatu), pure and simple. When it’s not involved with physical or mental phenomena, it’s simply aware of itself — aware, pure and simple. That’s called the mind pure and simple, or the property of consciousness pure and simple, in and of itself, and it lets go of itself. When you’re told to know and to let go of the knowing, it means to know the consciousness that senses things and then lets go of itself.

As for the aggregate of consciousness (viññana-khandha), that’s a trouble-making consciousness. The germs that keep piling things on lie in this kind of consciousness, which wants to hang onto a sense of self. Even though it can let go of physical pain, or of physical and mental events in general, it still hangs onto a sense of self. So when you’re told to know the letting go of knowing, it means to let go of this kind of consciousness, to the point where consciousness has no label for itself. That’s when it’s empty. If you understand this, or can straighten out the heart and mind from this angle, there won’t be anything left. Pain, suffering, stress — all your preoccupations — will become entirely meaningless. There will be no sense of good or bad or anything at all. Dualities will no longer be able to have an effect. If you know in this way — the knowing that lets go of knowing, consciousness pure and simple — it prevents any possible fashioning of the mind.

The dualities that fashion good and bad: There’s really nothing to them. They arise, and that’s all there is to them; they disband, and that’s all there is to them. So now we come to know the affairs of the dualities that fashion the mind into spirals, that fashion the mind or consciousness into endless cycles. When you know the knowing that lets go of knowing, right at consciousness in and of itself, dualities have no more meaning. There’s no more latching onto the labels of good and bad, pleasure and pain, true and false, or whatever. You just keep on letting go…

Even this knowing that lets go of knowing has no label for itself, saying, “I know,” or “I see.” But this is something that lies a little deep, that you have to make an effort to see clearly and rightly. You have to keep looking in a shrewd way. The shrewdness of your looking: That’s something very important, for only that can lead to Awakening. Your knowledge has to be shrewd. Skillful. Make sure that it’s shrewd and skillful. Otherwise your knowledge of the true nature of things — on the inner or outer levels — won’t really be clear. It’ll get stuck on only the elementary levels of emptiness, labeling and latching onto them in a way that just keeps piling things on. That kind of emptiness simply can’t compare with this kind — the knowing that lets go of knowing right at consciousness pure and simple. Make sure that this kind of knowing keeps going continuously. If you slip for a moment, just get right back to it. You’ll see that when you don’t latch onto labels and meanings, thoughts of good and bad will just come to a stop. They’ll disband. So when the Buddha tells us to see the world as empty, this is the way we see.

The emptiness lies in the fact that the mind doesn’t give meaning to things, doesn’t fashion things, doesn’t cling. It’s empty right at this kind of mind. Once you’re correctly aware of this kind of empty mind, you’ll no longer get carried away by anything at all. But if you don’t really focus down like this, there will only be a little smattering of emptiness, and then you’ll find yourself getting distracted by this and that, spoiling the emptiness. That kind of emptiness is emptiness in confusion. You’re still caught up in confusion because you haven’t contemplated down to the deeper levels. You simply play around with emptiness, that’s all. The deeper levels of emptiness require that you focus in and keep on looking until you’re thoroughly clear about the true nature of things in the phenomenon of the present arising and disbanding right in front of you. This kind of mind doesn’t get involved, doesn’t latch on to meanings or labels.

If you see this kind of emptiness correctly, there are no more issues, no more labels for anything in this heap of physical and mental phenomena. When the time comes for it all to fall apart, there’s nothing to get excited about, nothing to get upset about, for that’s the way it has to go by its nature. Only if we latch onto it will we suffer

The Dhamma is right here in our body and mind, simply that we don’t see it — or that we see it wrongly, latching on and making ourselves suffer. If we look at things with the eyesight of mindfulness and discernment, what is there to make us suffer? Why is there any need to fear pain and death? Even if we do fear them, what do we accomplish? Physical and mental phenomena have to go their own way — inconstant in their own way, stressful in their own way, beyond our control in their own way. So what business do we have in reaching out and latching on and saying that their stress and pain is our stress and pain? If we understand that the latching on is what makes us suffer over and over again, with each and every breath, then all we have to do is let go and we’ll see how there is release from suffering right before our very eyes…

So keep on looking in to know, in the way I’ve described, right at the mind. But don’t go labeling it as a “mind” or anything at all. Just let there be things as they are, in and of themselves, pure and simple. That’s enough. You don’t need to have any meanings or labels for anything at all. That will be the end of all suffering… When things disband in the ultimate way, they disband right at the point of the elemental property of consciousness free of the germs that will give rise to anything further. That’s where everything comes to an end, with no more rebirth or redeath of any kind at all…

The practice is something you have to do for yourself. If you know things clearly and correctly with your own mindfulness and discernment, that’s your tool, well-sharpened, in hand. If the mind is trained to be sharp, with mindfulness and discernment as its tool for contemplating itself, then defilement, craving, and attachment will keep getting weeded out and cleared away. You can look and see, from the amount you’ve already practiced: Aren’t they already cleared away to some extent? The mind doesn’t have to worry about anything, doesn’t have to get involved with anything else. Let go of everything outside and then keepletting go until the mind lets go of itself. When you do this, how can you not see the great worth of the Dhamma?…

So I ask that this mind empty of attachment, empty of any sense of self whatsoever, be clear to you until you see that it’s nothing but Dhamma. Get so that it’s nothing but Dhamma, perfectly plain to your awareness. May this appear to you, as it is on its own, with each and every moment.

=====================================================

II

Listening to the Dhamma when the mind has already reached a basic level of emptiness is very useful. It’s like an energizing tonic, for when we’re sick there’s bound to be pain disturbing us; but if we don’t pay it any attention, it simply becomes an affair of the body, without involving the mind at all. Notice this as you’re listening: The mind has let go of the pain to listen to the words, leaving the pain to its own affairs. The mind is then empty…

Once the mind honestly sees the truth that all compounded things are inconstant, it will have to let go of its attachments. The problem here is that we haven’t yet really seen this, or haven’t yet reflected on it in a skillful way. Once we do, though, the mind is always ready to grow radiant. Clear knowing makes the mind immediately radiant. So keep careful watch on things. Even if you don’t know very much, just be aware of the mind as it maintains a balance in its basic level of neutrality and emptiness. Then it won’t be able to fashion the pains in the body into any great issues, and you won’t have to be attached to them.

So keep your awareness of the pain right at the level where it’s no more than a mere sensation in the body. It can be the body’s pain, but don’t let the mind be in pain with it. If you do let the mind be in pain with it, that will pile things on, layer after layer. So the first step is to protect the mind, to let things go, then turn inward to look for the deepest, most innermost part of your awareness and stay right there. You don’t have to get involved with the pains outside. If you simply try to endure them, they may be too much for you to endure. So look for the aspect of the mind that lies deep within, and you’ll be able to put everything else aside.

Now, if the pains are the sort that you can watch, then make an effort to watch them. The mind will stay at its normal neutrality, calm with its own inner emptiness, watching the pain as it changes and passes away. But if the pain is too extreme, then turn around and go back inside; for if you can’t handle it, then craving is going to work its way into the picture, wanting to push the pain away and to gain pleasure. This will keep piling on, piling on, putting the mind in a horrible turmoil.

So start out by solving the problem right at hand. If the pain is sudden and sharp, immediately turn around and focus all your attention on the mind. You don’t want to have anything to do with the body, anything to do with the pains in the body. You don’t look at them, you don’t pay them any attention. Focus on staying with the innermost part of your awareness. Get to point where you can see the pure state of mind that isn’t in pain with the body, and keep it constantly clear.

Once this is constantly clear, then no matter how much pain there is in the body, it’s simply an affair of mental and physical events. The mind, though, isn’t involved. It puts all these things aside. It lets go.

When you’re adept at this, it’s a very useful skill to have, for the important things in life don’t lie outside. They lie entirely within the mind. If we understand this properly, we won’t have to go out to grab this or that. We won’t have to latch onto anything at all — because if we do latch on, we simply cause ourselves needless suffering. The well-being of the mind lies at the point where it doesn’t latch onto anything, where it doesn’t want anything. That’s where our well-being lies — the point where all suffering and stress disband right at the mind…

If we don’t really understand things, though, the mind won’t be willing to let things go. It will keep on holding tight, for it finds so much flavor in things outside. Whatever involves pain and stress: That’s what it likes.

We have to focus on contemplating and looking, looking at the illusions in the mind, the wrong knowledge and opinions that cover it up and keep us from seeing the aspect of the mind that’s empty and still by its own internal nature. Focus on contemplating the opinions that give rise to the complicated attachments that bury the mind until it’s in awful straits. See how mental events — feelings, perceptions, and thought-formations — condition the mind, condition the property of consciousness until it’s in terrible shape.

This is why it’s so important to ferret out the type of knowing that lets go of knowing, i.e., that knows the property of consciousness pure and simple when mental events haven’t yet come in to condition it, or when it hasn’t gone out to condition mental events. Right here is where things get really interesting — in particular, the thought-formations that condition consciousness. They come from ignorance, right? It’s because of our not knowing, or our wrong knowing, that they’re able to condition things.

So I ask that you focus on this ignorance, this not-knowing. If you can know the characteristics of not-knowing, this same knowledge will know both the characteristics of thought-formations as they go about their conditioning and how to disband them. This requires adroit contemplation because it’s something subtle and deep.

But no matter how subtle it may be, the fact that we’ve developed our mindfulness and discernment to this point means that we have to take an interest in it. If we don’t, there’s no way we can put an end to stress or gain release from it.

Or, if you want, you can approach it like this: Focus exclusively on the aspect of the mind that’s constantly empty. If any preoccupations appear to it, be aware of the characteristics of bare sensation when forms make contact with the eye, or sounds with the ear, and so forth. There’s a bare sensation, and then it disbands before it can have any such meaning as “good” or “bad.” If there’s just the bare sensation that then disbands, there’s no suffering.

Be observant of the moment when forms make contact with the eye. With some things, if you’re not interested in them, no feelings of liking or disliking arise. But if you get interested or feel that there’s a meaning to the form, sound, smell, taste, or tactile sensation, you’ll notice that as soon as you give a meaning to these things, attachment is already there.

If you stop to look in this way, you’ll see that attachment is something subtle, because it’s there even in the simple act of giving meaning. If you look in a superficial way, you won’t see that it’s attachment — even though that’s what it is, but in a subtle way. As soon as there’s a meaning, there’s already attachment. This requires that you have to be good and observant — because in the contact at the eyes and ears that we take so much for granted, many sleights-of-hand happen all at once, which means that we aren’t aware of the characteristics of the consciousness that knows each individual sensation. We have to be very observant if we want to be able to know these things. If we aren’t aware on this level, everything will be tied up in attachment. These things will keep sending their reports into the mind, conditioning and concocting all kinds of issues to leave the mind, or consciousness, in an utter turmoil.

So if we want to look purely inside, we have to be very, very observant, because things inside are subtle, elusive, and sensitive. When the mind seems empty and neutral: That’s when you really have to keep careful watch and control over it, so as to see clearly the sensation of receiving contact. There’s contact, pure and simple, then it disbands, and the mind is empty. Neutral and empty. Once you know this, you’ll know what the mind is like when it isn’t conditioned by the power of defilement, craving, and attachment. We can use this emptiness of the mind as our standard of comparison, and it will do us a world of good…

Ultimately, you’ll see the emptiness of all sensory contacts, as in the Buddha’s teaching that we should see the world as empty. What he meant is that we observe bare sensations simply arising and passing away, knowing what consciousness is like when it does nothing more than receive contact. If you can see this, the next step in the practice won’t be difficult at all — because you’ve established neutrality right from the start. The act of receiving contact is no longer complicated: The mind no longer grabs hold of things, no longer feels any likes or dislikes. It’s simply quiet and aware all around within itself at all times. Even if you can do this much, you find that you benefit from not letting things get complex, from not letting them concoct things through the power of defilement, craving, and attachment. Even just this much gets rid of lots of problems.

Then when you focus further in to see the nature of all phenomena that are known through sensory contact, you’ll see that there’s simply bare sensation with nothing at all worth getting attached to. If you look with the eyes of true mindfulness and discernment, you’ll have to see emptiness — even though the world is full of things. The eye sees lots of forms, the ear hears lots of sounds, you know, but the mind no longer gives them meanings. At the same time, things have no meanings in and of themselves.

The only important thing is the mind. All issues come from the mind that goes out and gives things meanings and gives rise to attachment, creating stress and suffering for itself. So you have to look until you see all the way through. Look outward until you see all the way out, and inward until you see all the way in, all the way until you penetrate inconstancy, stress, and not-selfness. See things as they are, in and of themselves, in line with their own nature, without any meanings or attachments. Then there won’t be any issues. The mind will be empty — clean and bright — without your having to do anything to it.

Now, the fact that the mind has the viruses of ignorance, or of the craving that gives rise to things easily, means that we can’t be careless. In the beginning, you have to supervise things carefully so that you can see the craving that arises at the moment of contact — say, when there’s a feeling of pain. If you don’t label it as meaning your pain, craving won’t get too much into the act. But if you do give it that meaning, then there will be the desire to push the pain away or to have pleasure come in its place.

All this, even though we’ve never gotten anything true and dependable from desiring. The pleasure we get from our desires doesn’t last. It fools us and then changes into something else. Pain fools us and then changes into something else. But these changes keep piling up and getting very complicated in the mind, and this is what keeps the mind ignorant: It’s been conditioned in so many ways that it gets confused, deluded, dark, and smoldering.

All kinds of things are smoldering in here… This is why the principle of the knowing that lets go of knowing is such an important tool. Whatever comes at you, the knowing that lets go of knowing is enough to get you through. It takes care of everything. If you let it slip, simply get back to the same sort of knowing. See for yourself how far it will take you, how much it can keep the mind neutral and empty.

You can come to see this bit by bit. In the moments when the mind isn’t involved with very much, when it’s at a basic level of normalcy — empty, quiet, whatever — keep careful watch over it and analyze it as well. Don’t let it just be in an oblivious state of indifference, or else it will lose its balance. If you’re in an oblivious state, then as soon as there’s contact at any of the sense doors, there’s sure to be attachment or craving giving rise to things the instant in which feeling appears. You have to focus on keeping watch of the changes, the behavior of the mind at every moment. As soon as your mindfulness lapses, get back immediately to your original knowing. We’re all bound to have lapses — all of us — because the effluent of ignorance, the most important of the effluents, is still there in the mind.

This is why we have to keep working at our watchfulness, our investigation, our focused awareness, so that they keep getting clearer and clearer. Make your mind ripe in mindfulness and discernment, continuously…

Once they’re ripe enough for you to know things in a skillful way, you’ll be able to disband the defilements the very minute they appear. As soon as you begin feeling likes and dislikes, you can deal with them before they amount to anything. This makes things a lot easier. If you let them loose so that they condition the mind, making it irritated, murky, and stirred up to the point where it shows in your words and actions, then you’re in terrible straits, falling into hell in this very lifetime.

The practice of the Dhamma requires that we be ingenious and circumspect right at the mind. The defilements are always ready to flatter us, to work their way into our favor. If we aren’t skillful in our awareness, if we don’t know how to keep the mind under careful supervision, we’ll be no match for them — for there are so many of them. But if we keep the mind well supervised, the defilements will be afraid of us — afraid of our mindfulness and discernment, afraid of our awareness. Notice when the mind is empty, aware all around, with no attachments to anything at all: The defilements will hide out quiet, as if they weren’t there at all.

But as soon as mindfulness slips, even just a little, they spring right up. They spring right up. If you recognize them for what they are the moment they spring up, they’ll disband right there. This is a very useful skill to have. But if we let them get to the point where they turn into issues, they’ll be hard to disband. That’s when you have to bear with the fight and not give up.

Whatever happens, start out by bearing with it — not simply to endure it, but so as to examine it, to see what it’s like, how it changes, how it passes away. We bear with things so that we can see through their deceits: the way they arise, persist, and disband on their own. If they disband while we’re examining them and clearly seeing their deceitfulness, we can have done with them for good. This will leave the mind in a state of freedom and independence, empty entirely within itself.

If you can learn to see through things right away the moment they arise — what you might call your own little instantaneous awakenings — your aware- ness will keep getting brighter and brighter, stronger and more expansive all the time.

So work at them — these little instantaneous understandings — and eventually, when things come together in an appropriate way, there will be the moment where there’s the instantaneous cutting through of defilements and effluents once and for all. When that happens, then — nibbana. No more taking birth. But if you haven’t yet reached that point, just keep sharpening your knives: your mindfulness and discernment. If they’re dull, they won’t be able to cut anything through, but whatever shape they’re in, keep cutting through bit by bit whatever you can…

I ask that you keep at this: examining and understanding all around within the mind until you reach the point where everything is totally clear and you can let go of everything with the realization that nothing in the five aggregates or in physical and mental phenomena is me ormine. Keep trying to let go, and that will be enough. Each moment as they’re taking care of you here in the hospital, do what has to be done for your illness, but make sure that there’s this separate, special awareness exclusive to the mind — this knowing that simply lets go of itself. That will end all your problems right there…

———————————————————————-

Kee Nanayon, Upasika (Kor Khao-suan-luang) (1901-1979) Upasika Kee Nanayon, who wrote under the penname, K. Khao-suan-luang, was one of the foremost woman teachers of Dhamma in modern Thailand. Born in 1901, she started a practice center for women in 1945 on a hill in the province of Rajburi, to the west of Bangkok, where she lived until her death in 1979. Known for the simplicity of her way of life, and for the direct, uncompromising style of her teaching, she had a way with words evident not only in her talks, which attracted listeners from all over Thailand, but also in her poetry, which was widely published.

SIURCE : “A Good Dose of Dhamma: For Meditators When They Are Ill”, by Upasika Kee Nanayon, translated from the Thai by Thanissaro Bhikkhu. Access to Insight, 7 June 2010

http://www.what-buddha-taught.net/accesstoinsight/html/lib/thai/kee/gooddose.html

วิธีเมินเข็มระหว่างฉีดยา ช่วยบรรเทาความเจ็บได้

แต่ดั้งแต่เดิมมาพยาบาลที่ต้องไปฉีดวัคซีนตามโรงเรียน มีวิธีแก้ปัญหาเด็กกลัวเข็มฉีดยาง่ายๆ โดยการบอกให้หนูๆ หันไปมองทางอื่นเวลาถูกเข็มจิ้ม บัดนี้นักวิทยาศาสตร์ได้ออกมายืนยันผ่านงานวิจัยที่ตีพิมพ์ในวารสารการแพทย์ Pain แล้วว่า คำแนะนำแสนล้าสมัยนี้สามารถลดความเจ็บปวดเมื่อถูกฉีดยาได้จริง ไม่ต้องพึ่งเทคโนโลยีใดๆ ให้เปลืองเงิน

นักวิจัยจากวิทยาลัยแพทยศาสตร์ในกรุงเบอร์ลินและกรุงฮัมบูร์ก ได้ไหว้วานให้อาสาสมัครดูคลิปวิดีโอซึ่งแสดงภาพแขนคนที่กำลังถูกฉีดยา ภาพต่อมาเป็นรูปแขนที่ถูกสำลีแปะทาบ และภาพสุดท้ายเป็นรูปแขนในอากัปกิริยาปกติ นักวิจัยพบว่า มีกระแสไฟฟ้าแล่นผ่านแขนอาสาสมัครขณะรับชมวิดีโอ บางคนไม่รู้สึกอะไร ขณะบางคนก็แสดงความเจ็บปวดออกมา

จอภาพที่ฉายคลิปวิดีโอถูกจัดวางมาให้เสมือนว่า ท่อนแขนในจอเป็นของผู้รับชมจริงๆ พวกเขาเผยว่า รู้สึกเจ็บปวดที่สุดตอนเห็นเข็มฉีดยาเมื่อเทียบกับฉากอื่นๆ นักวิจัยชี้ว่าเป็นผลจากการเพ่งมองภาพและการขยายของรูม่านตา ซึ่งเป็นสัญญาณตอบสนองความเจ็บปวดจากระบบประสาท

มาริยง โฮเฟิล ผู้นำทีมวิจัยกล่าวว่า “เราเข้าใจมาตลอดว่าเมื่อถูกเข็มฉีดยาทิ่มจะต้องเจ็บ แต่การประเมินความเจ็บปวดล่วงหน้าจากการถามพยาบาล ก็สามารถส่งอิทธิพลต่อความรู้สึกเราได้เช่นกันเมื่อเห็นเข็มทิ่มลงบนผิวหนัง” เธอชี้แจงว่า คำแนะนำง่ายๆ จากพยาบาลได้ผลดี เนื่องจากคนไข้จะประเมินความเจ็บปวดจากการถูกเข็มทิ่มต่ำลง

“การมองเข็มขณะถูกฉีดยาทำให้ภาวะการรับรู้ความเจ็บปวดของเราแย่ลงไปอีก ระบบประสาทก็จะถูกกระตุ้นให้ตอบสนองมากขึ้นเช่นกัน เรามีหลักฐานเชิงประจักษ์ยืนยันชัดว่า วิธีลดความเจ็บปวดจากการถูกฉีดยาโดยหันไปมองอย่างอื่นแทนเข็มได้ผลดีจริง” โฮเฟิลกล่าวเสริม.

ที่มา: ไทยโพสต์ 31 พฤษภาคม 2555

.

Related link:

To Avoid Pain During an Injection, Look Away

ScienceDaily (May 14, 2012) — Health professionals commonly say, “Don’t look and it won’t hurt” before administering an injection, but is there any scientific basis for the advice? A group of German investigators has found that, in fact, your past experience with needle pricks, along with information you receive before an injection, shape your pain experience.

Their research is published in the May issue of Pain®.

“Throughout our lives, we repeatedly experience that needles cause pain when pricking our skin, but situational expectations, like information given by the clinician prior to an injection, may also influence how viewing needle pricks affects pain,” says lead author Marion Höfle, a doctoral student in the research Multisensory Integration group led by Dr. Daniel Senkowski, at the Charité — Universitätsmedizin Berlin and the University Medical Center Hamburg-Eppendorf.

While watching video clips showing a needle pricking a hand, a Q-tip touching the hand, or a hand alone, study participants concurrently received painful or non-painful electrical stimuli applied to their own hand. The clips were presented on a screen located above the participants’ hand, giving the impression that the hand on the screen belonged to them.

Participants reported that their pain was more intense and more unpleasant when they viewed a needle pricking a hand than when they saw a hand alone. In addition, observing needle pricks increased the unpleasantness of pain compared to viewing Q-tip touches. These findings were paralleled by enhanced activity of the autonomic nervous system, as measured by pupil dilation responses. This demonstrates that previous painful experiences with needles enhance unpleasantness of pain when viewing needle pricks.

Situational expectations also influenced perceived pain intensity. Prior to the stimulation, participants were told that either the needle or the Q-tip clip was more likely to be associated with painful than with non-painful electrical stimulation. The researchers found that presentation of clips that were more likely to be associated with pain lead to higher pain intensity experiences than the presentation of clips that were less likely to be associated with pain. This shows that expectations regarding the painfulness of medical treatments influence the intensity of pain that the treatment ultimately produces.

Taken together, the study reveals several important findings. “Clinicians may be advised to provide information that reduces a patient’s expectation about the strength of forthcoming pain prior to an injection,” Höfle notes. She further states that, “because viewing a needle prick leads to enhanced pain perception as well as to enhanced autonomic nervous system activity, we’ve provided empirical evidence in favor of the common advice not to look at the needle prick when receiving an injection.”

Story Source:

The above story is reprinted from materials provided byElsevier Health Sciences, via AlphaGalileo.

Journal Reference:

  1. Marion Höfle, Michael Hauck, Andreas K. Engel, Daniel Senkowski. Viewing a needle pricking a hand that you perceive as yours enhances unpleasantness of pain.Pain, 2012; 153 (5): 1074 DOI: 10.1016/j.pain.2012.02.010

Data from: sciencedaily.com

Arthritis sufferers have to wait THREE YEARS to be diagnosed condemning them to ‘unbearable pain’

Arthritis sufferers have to wait THREE YEARS to be diagnosed condemning them to ‘unbearable pain’
By SOPHIE BORLAND
PUBLISHED: 00:17 GMT, 9 May 2012

More than a quarter of arthritis sufferers have to visit their GP at least three times to get a diagnosis, a report reveals.

Patients with osteoarthritis, the most common form, wait an average of nearly three years to be diagnosed and referred for treatment.

The number of Britons suffering from the crippling condition is expected to double over the next 20 years due to the ageing population and higher levels of obesity.

There are an estimated 8.5million people with osteoarthritis but by 2030 this will have reached 17million, according to the report by Arthritis Care.

The charity is concerned that many patients are enduring ‘unbearable’ pain, seeing it as an inevitable part of old age but wrongly believing nothing can be done about it.

A survey of 2,000 patients carried out on behalf of the charity found that nearly three-quarters (71 per cent) are in constant pain.

For one in eight, the symptoms severely restrict their daily lives, preventing them from walking or going upstairs.

On average the patients waited 2.8 years from noticing symptoms to being given a diagnosis by their family doctor.

Judith Brodie, chief executive of the charity, blamed the delay on patients’ reluctance to seek help and a lack of awareness among GPs.

She said: ‘Many people, particularly the elderly, are very stoical about pain. They may well think nothing can be done.

‘There’s an issue of awareness among GPs and in primary care about osteoarthritis. It could be a lot better.

‘But our message is that there is something you can do. A lot of people are really denying themselves a good old age.’ The poll also found that patients spent an average of £500 a year of their own money on treatment and travel costs.

A third said the condition had forced them to retire early or substantially reduce the numbers of hours they worked.

Osteoarthritis, which normally develops after the age of 50, causes damage to the cartilage, the smooth tissue covering joint surfaces, which leads to pain in the hips, knees, hands and feet.
It is more common among the overweight.

There is no cure but the pain can be substantially reduced through exercise, weight loss and some complementary therapies such as acupuncture.

Many patients take regular painkillers such as paracetamol or non-steroidal anti-inflammatory drugs.

Experts warn that the surge in the numbers of patients will place huge strain on the health service.

Already the condition is estimated to cost the economy £3.2billion in lost working time.

About 140,000 hip and knee replacements a year are performed on the NHS because of osteoarthritis at a cost of at least £700million.

Philip Conaghan, professor of musculoskeletal medicine at the University of Leeds, said: ‘Britain is facing a tsunami of pain due to osteoarthritis as the number of people over 50 increases dramatically and obesity levels continue to rise.

‘Action is needed immediately. We have to bust this myth that painful joints are an inevitable part of getting older that we have to put up with.’

Data from: dailymail.co.uk

ยาฉีดใหม่สำหรับผู้ป่วยโรคข้อ

นักวิทยาศาสตร์พบว่าการฉีดสารคาร์โตจีนินช่วยลดภาวะความเสื่อมของข้อได้

ในอนาคตคาดว่าจะนำสารนี้ไปใช้สำหรับการบำบัดรักษาโรคเกี่ยวกับข้อและกระดูกเสื่อมเนื่องจากการสึกของกระดูกอ่อนผิวข้อ

Read more…

 

New injection could offer hope to millions of arthritis sufferers

  • Molecule found to encourage cartilage regeneration
  • Could form the basis of new drug-based therapy

By SADIE WHITELOCKS

PUBLISHED: 10:03 GMT, 6 April 2012 | UPDATED: 14:51 GMT, 6 April 2012

An injection could help cure the crippling symptoms of arthritis, say scientists.

A study found that a molecule, called kartogenin, encourages damaged cartilage to regenerate.

It is now hoped that the substance could form the basis of a new drug-based therapy, targeting the degenerative joint and bone disease which causes cartilage to wear away.

In the UK, arthritis affects over 9 million people, the most common forms being osteoarthritis and rheumatoid arthritis

Main symptoms of arthritis include pain, stiffness and restricted movement in the joints, and in the UK it affects more than 9 million people.

Currently these is no cure for the condition, only anti-inflammatory painkillers to relieve symptoms, and in severe cases, costly joint replacements are advised.

Commenting on the latest study researchers at the Genomics Institute of the Novartis Research Foundation in San Diego and Scripps Research Institute in La Jolla, California said: ‘This may ultimately lead to a stem-cell based therapy for osteoarthritis.’

While Dr Kristen Johnson, added: ‘We’re excited about the biology because it’s a new way of targeting the stem cells.’

It is thought that kartogenin would be administered via injection to the areas affected (stock picture) During the study, published in the journal Science, 22,000 drug-like molecules were tested using a robotic screen, applying each one to bone marrow stem cells.

When kartogenin was administered to mice with osteoarthritis-like symptoms, it prompted stem cells to change into cartilage cells.
A patent has already been filed, however more work is needed to understand exactly how the molecule works.

Judith Brodie, chief executive of Arthritis Care, said: ‘We are delighted with any potential breakthrough for people with arthritis.

‘We hear every day about the pain suffered by people with osteoarthritis and, although treatments are some years away, we look forward to anything that will help relieve their condition.’

The most common forms of arthritis are osteoarthritis and rheumatoid arthritis.

Around eight million people in Britain suffer from osteoarthritis and 140,000 hip and knee replacements are performed on the NHS as a result of the illness, at a cost of more than £1 billion.

Data from: dailymail

วิจัยพบผู้หญิงรู้สึกเจ็บปวดมากกว่าผู้ชาย

มีความเชื่อกันโดยทั่วไปว่า ผู้หญิงทนความเจ็บปวดได้มากกว่าผู้ชาย แต่ผลวิจัยล่าสุดชี้ว่า ผู้หญิงมีความรู้สึกเจ็บปวดมากกว่าผู้ชายเมื่อเผชิญกับอาการป่วยต่างๆ เช่น โรคไขข้ออักเสบ ระบบย่อยอาหาร

ทีมวิจัยของมหาวิทยาลัยสแตนฟอร์ดได้ศึกษาคนไข้ 11,000 ราย พบว่า ผู้หญิงให้ค่าคะแนนต่อความรู้สึกเจ็บปวดของตัวเองสูงกว่าผู้ชาย โดยนักวิจัยได้ใช้มาตรวัดความรู้สึกเจ็บปวดจาก 0-10 โดยค่าศูนย์หมายถึงไม่รู้สึกเจ็บปวดเลยแต่ ค่าสิบหมายถึงเจ็บปวดที่สุด

ปรากฏว่า ผู้หญิงให้ค่าคะแนนสูงกว่าผู้ชาย 14 โรคในบรรดาโรค 47 ชนิด ผู้ชายไม่ได้ให้ค่าคะแนนความรู้สึกเจ็บปวดสูงกว่าผู้หญิงในกรณีโรคใดๆ เลย ส่วนโรคที่เหลือนอกนั้นมีการให้ค่าคะแนนในระดับพอๆ กัน

ความเจ็บปวดจะต่างกันมากในกรณีโรคเกี่ยวกับการหมุนเวียนโลหิต ไขข้ออักเสบ ทางเดินหายใจ และการย่อยอาหาร

นอกจากนี้ ความรู้สึกยังต่างกันในเรื่องเกี่ยวกับกระดูกและกล้ามเนื้อ ปัญหาโพรงจมูกขั้นรุนแรง คอ ข้อต่อ และความดันโลหิตสูง

หัวหน้าทีมวิจัย ดร.อาตุล บัต แห่งภาควิชากุมารเวช คณะแพทยศาสตร์ มหาวิทยาลัยสแตนฟอร์ด บอกว่า การค้นพบความแตกต่างนี้เป็นเรื่องน่าประหลาดใจ ซึ่งไม่คาดคิดว่าผู้หญิงจะรู้สึกเจ็บปวดมากกว่าผู้ชาย

อย่างไรก็ดี ผู้เชี่ยวชาญบางคนบอกว่า ผู้ชายมีแรงกดดันที่จะไม่แสดงความรู้สึก และไม่ค่อยยอมรับว่าตัวเองรู้สึกเจ็บปวด

ดร.แคโรล วอร์ฟีลด์ แห่งศูนย์การแพทย์บอสตันเบธ อิสราเอล ดีคอนเนส บอกว่า มีรายงานจำนวนมากระบุว่า ในสังคมของเรานี้ ผู้ชายมักมีความคิดในเชิงการยอมรับชะตากรรม ถือว่าความคิดเช่นนี้เป็นคุณธรรมอย่างหนึ่ง

“ดังนั้น ผู้ชายจึงมีแนวโน้มน้อยกว่าผู้หญิง ที่จะบอกว่าตัวเองรู้สึกเจ็บปวดแม้ว่าจะรู้สึกเช่นนั้น พูดอีกอย่างหนึ่งก็คือ ผู้ชายกับผู้หญิงอาจรู้สึกเจ็บปวดในระดับเดียวกัน แต่ผู้หญิงมีแนวโน้มสูงกว่าที่จะยอมรับว่าตัวเองรู้สึกเจ็บปวด”.

ที่มา: ไทยโพสต์ 10 กุมภาพันธ์ 2555

Related link:

This will hurt, but women feel pain more than men


By DANIEL BATES
Last updated at 1:52 AM on 24th January 2012

The argument that women handle pain better than men has been debated many times in the long-running battle of the sexes.
Now scientists have come down on the side of women in one regard – after concluding that they endure more pain than their male counterparts.
Researchers have discovered that across a range of conditions from arthritis to digestive problems, female patients typically experience greater discomfort than men.

They looked at the records of 11,000 patients and found that, overall, women rated their pain higher on an 11-point scale of how bad they were feeling.

As part of their routine medical care, the patients had been asked to rate how they felt on a scale of 1 to 10, with 0 being ‘no pain’ and 10 being ‘worst pain imaginable’.

Women reported more intense pain than men in 14 of 47 disease categories. Men did not report more intense pain in any category and in the rest they were even.

The differences between the sexes were notable in circulation, arthritis, respiratory and digestive problems.

There was also a difference in issues with bones and muscles, plus severe nasal problems, neck and joint pain and high blood pressure.

The typical difference between men and women was just one point on the pain scale, but that could be the difference between a drug working and not working.

Lead author Dr Atul Butte, chief of systems medicine in the department of pediatrics at Stanford University School of Medicine, said that the disparity was ‘the most surprising finding’.

He said: ‘We completely wouldn’t have expected such a difference where women were reporting a whole pain point higher on the 0-to-10 scale than men.’

He was supported by Jeffrey Mogil, a pain expert at McGill University in Montreal who said: ‘What this paper does above and beyond what came before is a matter of sheer size. In my mind, it puts the story to bed forever.’

Previous studies have suggested the difference between the sexes may be due to oestrogen in women dampening pain receptors which helps them endure more pain when they are not menstruating.

Some experts however said that men feel pressure not to show their emotions and keep themselves in check so might be less willing to admit they are suffering.

Dr Carol Warfield, chairman of the department of anesthesia, critical care and pain medicine at Boston’s Beth Israel Deaconess Medical Centre, said: ‘There have been a number of reports indicating that in our society stoicism is often considered virtuous, especially in men.

‘Therefore, men may be less likely to report high levels of pain even if they perceive them. In other words, men and women may experience the same levels of pain but women are more likely to actually admit that they have pain.’

Dr Irene Wu, assistant clinical professor of anaesthesiology at UCLA Medical Centre, added: ‘Women take it (pain) in a lot more and for longer periods of time, so when it does accumulate, it may seem like at the doctor’s office their pain is so much more severe than men’s pain is’.