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Mindfulness meditation is an effective approach to dealing with depression and anxiety disorders, according to Dr Caroline Van Damme who says that mindfulness-based stress reduction is an organised practice to deal with mental health issues.

Caroline, an adult psychiatrist at Brussels Night Hospital talked about “Dharma Practice and Mental Health” during the fourth international conference on Vajrayana Buddhism held at Zhichenkhar from October 1 to October 4. She said that dharma practice has become increasingly popular to promote more mental and emotional well-being where several evidence has shown it is helpful in recovery.

Also, a family and systemic psychotherapist, Caroline shared that, especially in the case of depression and anxiety, meditation helps one avoid relapse and is efficient for those suffering from anxiety. The other two positive effects are mantra recitation and loving-kindness meditation.

“Mediation is for everyone, but we should adapt the practices to the individuals. There is no standard approach which works for all,” Caroline said.



Explaining the metaphor of doctor, she said dharma practice is medicine, meaning teaching/meditation can act as medicine like how a psychiatrist prescribes medicine to the patients and in terms of the doctor, a dharma teacher can be considered a doctor that prescribes dharma practices. “The monks (Sangha) are the nurses.”

“However, we should regard meditation as a medicine – or poison, depending on the type and intensity of meditation on the one hand, and on the individual predispositions of the practitioner on the other,” she said.

It includes typology and genetic factors, personal history, environment, and the practitioner’s culture. But teachers should know the therapeutic effects of meditation on their students and be aware of the risks it can have on the individual practitioner, she said.

“I would advise being careful with those who suffer from a psychotic illness from trying mindfulness-based therapy. Although I have tried simple meditation with certain patients keeping in mind all the risks and it has worked, one should not try until standardised dharma practice is maintained,” Caroline said.

A meditation practice adapted to the individual circumstances and previous experience of the practitioner will increase the benefits while reducing the risks of mental breakdown.



Explaining trauma, she said trauma takes a long time to heal especially if there is a history of trauma in the family so, in terms of trauma, it would be rather good to let them talk about it until they feel safe to share. “This is why in such cases, we must give them time and listen and when we do this, they gain confidence and feel safe to share more. It will also create space for them to trust their therapist which is the basic element for any psychiatrist to treat the patient.”

Putting it in context for Bhutanese, she said that Bhutanese are lucky to have already explored dharma practice which is ingrained in the culture. This is why it would not take time for the Bhutanese to adopt dharma practice in terms of handling mental health too.

In western countries, especially talking of modern society in Belgium, she expressed there is a lack of community ties where a community starts with a family having support for each other or for the victim. Community ties are important dharma practice to help and tackle mental illness in the family where one can listen and show support towards the victim.

“It starts with small things like picking up a call and talking with the victim, finding out their issues because the basic human need is they feel part of a community that cares. But it’s nice to see most family ties are usually strong in the Bhutanese community and caring society that you should not lose.”



She advised that if you have a teacher that you trust in terms of dharma practice and have a good relationship with, do not hesitate to be honest if their practice is stressing you out more than the help or not hesitate to share your problem.

Caroline said that it is important to note that human relationships take time. So, such practices might take time to implement and the most important is teachers should take time to get to know the student and vice-versa.

Who is at risk of mental health?

To start with, there is genetic mental illness but it is not sure that if one family suffers from mental illness, another will also have it. However, many recent studies have proven that even if there is a genetic risk it doesn’t mean another one will get it.

Stress and trauma in life will contribute to the development of mental health like abuse history and difficult family situations. Mental health stress can vary from one person to another. A sibling might suffer from depression from their parent’s divorce but another sibling may not develop any mental illness.



“That is why we need to study what stress a person is carrying. People need to be careful with the stress they are going through to diagnose mental health.”

Contributed by 

Yangchen C Rinzin 

Research Fellow

Centre for Bhutan and GNH Studies

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