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Meditation or Medication? Or Both?

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A decade ago, having recently begun Buddhist meditation practice, I attended a lecture/Q&A with a Tibetan master at a Buddhist center in Hollywood. The warm vibes and the stunning icons and paintings suggested a sacred, healing space. The speaker -- I knew so little at the time, I thought his name was "Sri" -- seemed the embodiment of enlightenment. He described how we can foster spiritual growth -- and reduce stress in the bargain -- simply by sitting still and watching, without attachment or judgment, whatever is happening in the present moment. I'll never forget his beaming, peaceful presence.

I'll also never forget the sign on the center's bathroom door that read, "Meditate, Don't Medicate." Afterwards, one of the teachers confirmed my suspicions that this was a reference to the anti-depressants and other psychoactive drugs so widely prescribed in America.

The sign struck me as the faux-spiritual version of the macho pull-yourself-up-by-your-own-bootstraps ethos that stifles so much emotional expression in our culture. (c.f. Tom Cruise's moronic public chastising of Brooke Shields for taking meds to relieve her post-partum depression, which prompted this fantastic rejoinder.)

It so happened I was at that very time receiving life-altering benefits from an anti-depressant, as were many of my friends and acquaintances. Did the fact that I was on meds disqualify me from meditation's wonders, I wondered? Considering all this, I got mad that a purported refuge of non-judgment would fall prey to such a misguided generalization.

I didn't need a finger-wagging sign to convince me that regularly taking drugs to get high or as an escape from one's problems doesn't fit in with meditation practice -- especially Vipassana, which asks only that you stay in the moment, no matter how painful. Clearly those who've been inappropriately prescribed any meds should get off them ASAP. (My internist tells me so many of his patients are on anti-depressants, "We might as well put Zoloft in the water supply and go home.") But to discourage those who need meds to function well enough to meditate is, to put it in Buddhist terms, unskillful speech.

During the Q&A at the above-mentioned event, "Sri" added genuine pearls of Buddhist thought. But for me, his last exchange, with a woman in obvious distress, underscored the need for a psychological component in teaching meditation. (The fact that such prominent Vipassana teachers as Jack Kornfield, Sylvia Boorstein and Trudy Goodman have years of experience as psychotherapists isn't a coincidence.)

The woman asked the master for suggestions on how to deal with her despair. "How often do you meditate?" the master asked. "A half hour a day," she replied." His complete answer: "Meditate one hour a day." Some in the audience giggled, while others nodded at the simplicity and profundity of the "non-advice" advice. I felt stricken, on her behalf and on behalf of all those who choose the spiritual bypass.

Last week, just before I went into surgery for a torn rotator cuff -- try meditating your way out of that! -- the hospital pharmacist reminded me of the dangers of the "no pain, no gain" attitude. I hadn't asked for pain-killers, and figured I'd get something mild and see how many macho points I could put on the board for toughing it out with Tylenol.

After the requisite moment of terror when an Anthem rep "misspoke" and claimed I had no insurance coverage at all, the pharmacist handed me handfuls of Percocet. With an expression every bit as soulful as any guru's, he said, "You must take these. Your surgery is only half the battle. Staying fit is equally essential, and if you don't take your meds, you won't be able to tolerate the pain of the prescribed exercises."

Conventional wisdom dictates that, even post-surgery, anyone with an addictive personality must avoid anything stronger than Tylenol, lest a milligram of Ambien set them back to square one in their recovery. But even among American's hardest-core drunks and addicts that attitude is waning. In Harper's this month, novelist Clancy W. Martin praises the essential role of Alcoholics Anonymous in keeping him sober -- but adds that without a cocktail of meds he'd never have survived to reap the program's benefits. He adds that after an AA meeting at which he talked about this, more than a few attendees privately shared similar stories.

When East meets West in dismissing anti-depressants and even post-surgery pain meds as signs of weakness, they both lose sight of the fact that, in many cases, mindfully prescribed medication can join hands with regular meditation practice to produce remarkable results.