Religion and Spirituality in Psychiatry

Psychiatric Care Using Buddhist Principles 321to engage in, like a job or school, and his or herschedule is highly irregular. All this combines tomake one feel very disconnected with the worldand terrible toward oneself. If she or he is a sensitiveperson, and so many who are strugglinglike this are profoundly sensitive, the intricacyof how interconnected and self-sustaining theproblems of environment are creates a hopelessstate of mind. At this point, the person’s windhorseenergy is deflated and there is little lovingkindness toward oneself. When one feels thisbad, you really believe that you are bad. This personand family feel at a loss as to where to beginthe recovery process. We know that if we wantto help a person and his or her family to breakout of the variety of cycles and compoundingfeedback loops built into this life predicament, itwill be far more effective to work with all aspectsof personal needs and the environment concurrently.By creating individually tailored recoveryenvironments, the unique strengths and difficultiesof each client and family can be simultaneouslyengaged. (11)When we create a recovery environment, we areactually forming a very specific arrangement of elementsand relationships, with a beginning, middle,and end. We attempt to create an environment thatholds all aspects of the client’s life, within optimalboundaries that are permeable yet containing,between him or her and the outer world. This environmentis a comprehensively coordinated organizationof body, speech, and mind, comprised ofthe household, the people and relationships, therapeuticmethodologies, schedules, intentions, andawareness. Influenced by the Buddhist concept of“mandala,” defined as a total environment, association,“orderly chaos,” or “gestalt,” (12) a recoveryenvironment functions as a compensatory, external,organizing entity.In many ways, families naturally work thisway. If a family member has a life situation – forinstance, a woman has a baby – it is very hard forthe first few weeks for the mother to be able toshop, cook, clean house, and take care of all thebaby’s needs. There is a good chance the mother’ssleep is disrupted, and there is simply not enoughenergy to do the tasks of life in the way that hasbeen normal. It is very common under these circumstancesfor partners to take time off fromwork to make sure that everything in the life ofthe mother and child can be accomplished asnecessary. Other family members may also helpout. In this case, the mother and the baby are thefocus, but anyone who is helping out will do theirbest to help in a balanced way, so they themselvesdon’t lose their health in the process. Likea Windhorse Therapy recovery environment, thisfamily system is compensating for a change thathas occurred, and there is a sense that this is atransitional phase.6. THERAPEUTIC ELEMENTS AND ROLESTo create a recovery environment, a team is createdmade up of the clinicians, the client, andwhenever possible, the family. These people workin a complementary system of roles, each carryingout a range of functions and therapeutic activitiesthat develop, maintain, evolve, and “are” a largepart of the environment. The cohesion and communicationof this “whole person system” is carriedout within the household, the meetings, andthe relationships of the team. To understand thecontext for much of the relationship activity ofthe team, we will now look at basic attendance.6.1. Basic AttendanceA highly flexible and innovative clinical practice,“basic attendance” is the most active, apparent,and principal therapeutic activity in a WindhorseTherapy recovery environment. Influenced bythe Buddhist practice of being attentive or simplywatching the mind without judgment inthe midst of everyday activity, basic attendanceis being actively and with helpful intention inrelationship with someone in the broad spectrumof his or her life activities, to promote thesynchronization of body, speech, and mind, andconnection to his or her fundamental health. (2)Its possibilities range from being with a client inthe ordinary domestic activity of a household,doing artwork, signing up for classes, looking foremployment, or simply having time to relax and