The Spiritual Heart of Tibetan Medicine, and its Contribution to the Modern World

The Spiritual Heart of Tibetan Medicine, and its Contribution to the Modern World

The first International Congress for Tibetan Medicine took place in Washington DC in November 1998. A unique gathering, opened by His Holiness the Dalai Lama, it brought together Tibetan physicians, lamas, doctors and medical specialists from many countries. Sogyal Rinpoche was invited to address the conference on its opening morning.

Your Holiness, eminent doctors and scholars, ladies and gentlemen, it is a great honour for me to address you today at this International Congress of Tibetan Medicine. What I shall endeavour to do is to explore, very briefly and with my limited understanding, the spiritual and mental dimensions of healing within the Buddhist tradition of Tibet. I will speak from my own experience of what I know to be effective in the West.  Of course, whatever I do understand is only thanks to the infinite kindness of my masters, and especially Jamyang Khyentse Chökyi Lodrö, Dudjom Rinpoche and Dilgo Khyentse Rinpoche, who embody so perfectly the wisdom and compassion of the Buddhist path.


The ancient science of Tibetan medicine is rooted in the teachings of Buddha, and the essence of these teachings is the central importance of the mind. The Buddha said:

“Commit not a single unwholesome action,

Cultivate a wealth of virtue,

To tame this mind of ours—

This is the teaching of the Buddha.”

He also said:

"We are what we think

All that we are

Arises with our thoughts.

With our thoughts we make the world.

Speak or act with a pure mind—

And happiness will follow you.”

The mind is both the source of happiness and the root of suffering; at the same time as it possesses an extraordinary capacity for healing, it also plays its part in making us ill.

But how exactly can the mind provoke physical illness? The Four Tantras, the authoritative sources for Tibetan Medicine, are quite explicit:

“Here is an explanation of the general cause of all illness.  There is but one single cause... and this is said to be ignorance due to not understanding the meaning of ‘selflessness’..."

“Now for the specific causes: from ignorance arise the three poisons of attachment, hatred and closed-mindedness, and from these, as a result, are produced disorders of wind, bile and phlegm.”

The basic source of sickness is diagnosed as ‘ignorance’, in other words attributing a false sense of a lasting and independent self to ourselves and the phenomena around us. This, the Tibetan medical tradition tells us, arouses:

craving and desire that are responsible for disorders of the ‘wind’ (lung);

hatred and pride causing disorders of the ‘bile’ (tripa);

and bewilderment and closed-mindedness provoking ailments of the ‘phlegm’ (béken).

For years now around the world there has been a growing understanding of the correlation of mind and body, and of the link between ill-health and the way we cope with stress and our emotions. In his book ‘Emotional Intelligence’, Daniel Goleman writes:

“People who experienced chronic anxiety, long periods of sadness and pessimism, unremitting tension or incessant hostility, relentless cynicism or suspiciousness, were found to have double the risk of disease.... This order of magnitude makes distressing emotions as toxic a risk factor as, say, smoking or high cholesterol are for heart disease—in other words, a major threat to health.”

Just as distressing states of mind can cause disorders, so positive, uplifting states can promote good health: states such as peace of mind, optimism, confidence, humour, companionship, joy, love, kindness, compassion and devotion. Again, this has also been observed countless times in the West, and more recently for example with Norman Cousins, who laughed his way back to health, and the findings of Dr. Dean Ornish, published in his ‘Love and Survival’, on the effects of emotional support and love on physical health and life expectancy.

Training the Mind

The whole thrust of Buddhist practice is, precisely, to eliminate these negative states of mind and cultivate the positive ones, so transforming our mind and its emotions, and thereby healing our entire being: body, speech, mind, and heart. 

The Buddhist approach to transforming the mind begins by working with our attitudes to life, using the power of reason to analyze our delusions, disturbing emotions and even basic assumptions, so as to find, simply speaking, a way of being happy. A Tibetan master Dodrupchen Jikmé Tenpé Nyima spells out the link between peace of mind, happiness and health:

“Whenever you are harmed by sentient beings, or anything else, if you make a habit out of just perceiving only the suffering, then when even the smallest problem comes up, it will cause you enormous anguish in your mind. This is because the nature of any perception or idea, be it happiness or sorrow, is to grow stronger and stronger by being repeated. When the power of this repetitive experience gradually increases, after a while most of what you perceive will become the cause of actually attracting unhappiness towards you, and happiness will never get a chance..."

“When you are not at the mercy of the suffering caused by anxiety, then not only will all other kinds of suffering evaporate like weapons dropping from the hands of soldiers, but even illnesses will normally disappear on their own."

“The saints of the past used to say: ‘When you are not unhappy, or discontent about anything, then the mind will not be disturbed. If the mind is not disturbed, the inner air (wind) will not be disturbed. That means the other elements of the body will not be disturbed either. Because of this your mind will remain undisturbed, and the wheel of constant happiness will turn.’”

Such a contemplation forms part of the Buddhist Training of the Mind in loving kindness and compassion, which is called ‘Lojong’.  When the ultimate cause of all our suffering and sickness is our holding onto a false view of self, our constant selfish grasping and the negative emotions it provokes, then nothing could be more effective or skilful as a remedy than to steep the mind in love, compassion, altruism and thinking of others. 

The Buddhist practices of compassion and love are immensely powerful at transforming the emotions, and healing ourselves and others, and one which has had an enormous impact among western people is Tonglen, the practice of ‘giving and taking’. In their imagination, the practitioner summons all their resources of positive emotion, and trains in taking, through compassion, the suffering and illnesses of others,  and giving, with love, every source and kind of happiness and well-being.

Tonglen practice reduces and eliminates the grasping ego, while enhancing our concern for others.  As a result, what has been discovered is that it is deeply therapeutic, especially for those who feel the sense of lack in their lives or unfulfilment or even ‘self-hate’ which are so prevalent these days. This is why I have developed a series of practices applying Tonglen, in order to help bring about such healing.

In Tibet, the healing power of Tonglen was legendary; in the West today, the potential of such practices rests largely unexplored, but they could, I feel, have astounding results if applied more widely in cases of mental and physical illness.


The other practice I would like to mention, one which so many who are working with the sick have, in one context or another, found to be a profound source of healing, is meditation. The spirit of Buddhist meditation is captured so beautifully by Nyoshul Khen Rinpoche :

“Rest in natural great peace

This exhausted mind

Beaten helpless by karma and neurotic thought,

Like the relentless fury of the pounding waves

In the infinite ocean of samsara.

Rest in natural great peace.”

Through the practice of ‘calm abiding’, or tranquillity meditation, our restless, thinking mind subsides into a state of deep inner peace. The warring, fragmented aspects of ourselves begin to settle and become friends; negativity and aggression are disarmed; frustration, tension and turbulent emotions are defused; and the unkindness and harm in us is removed, revealing our inherent ‘good heart’. So meditation is real ‘inner disarmament’.

From this state of ‘calm abiding’ comes the expansive clarity and insight of ‘clear seeing’: duality dissolves; ego dwindles and confusion evaporates; the whole way we look at ourselves changes; and we give space to emotions, learn from them, and become free from their sway.

As this ‘clear seeing’ progressively deepens, it leads us to an experience of the intrinsic nature of reality, and the nature of our mind. For when the cloud-like thoughts and emotions fade away, the sky-like nature of our true being is revealed, and, shining from it, our buddha nature—bodhichitta—like the sun. And just as both light and warmth blaze from the sun, wisdom and loving compassion radiate out from the mind’s innermost nature. Grasping at a false self, or ego, has dissolved, and we simply rest, inasmuch as we can, in the nature of mind, this most natural state which is without any reference or concept, hope or fear, yet with a quiet but soaring confidence—the deepest form of well-being imaginable.

One oral instruction from the great masters of the past, for me, resonates this innermost nature of mind. In Tibetan:

Chu  ma  nyok  na  dang

Sem  ma  chö  na  dé

Nothing could be simpler, yet more powerful:

“Water, if unstirred, will become clear—that’s a fact. In just the same way, the very nature of mind is such that if you do not alter, fabricate, or manipulate it with needless thinking, it will, by itself,  find its own natural state of peace and well-being.”

So many have found that even a glimpse of the nature of mind is utterly transforming, nourishing, and purifying. For if disease is due to our losing sight of our true nature, to recognize the nature of our mind must be the ultimate healing.

Padmasambhava, who introduced Buddhism into Tibet in the eighth century,  clarifies this even further:

“Don’t regard illness as a hindrance, or consider it a virtue. Leave your mind unfabricated and free... cutting through the flow of conceptual thoughts... old illnesses will disappear by themselves and you remain unharmed by new ones."


Healing practices generally fall into three different approaches:  prevention; applying antidotes; or transformation. They could be compared, to take an everyday example, to avoiding your enemy, facing him and dealing with him, or turning him into a friend. Today I have touched only on meditation and on training the mind in loving kindness and compassion, but there is a vast range of healing practices, especially within the Vajrayana Buddhist tradition where healing is achieved through transformation. Some of these will be presented during this Congress. They employ every kind of skilful means—visualization, mental imagery, sound, mantra, movement and yoga—and embrace every facet of the human mind—imagination, intellect and emotion. A number of these methods have been used to great effect to help combat illnesses such as cancer and AIDS. 

Finally, the real power and strength of the lineage of Tibetan Buddhism is, I feel, seen most clearly in its great practitioners and masters, whose mere presence is deeply healing in itself.  Our good fortune is that someone such as this is here with us today, in the person of HH the Dalai Lama.

It is largely due to His Holiness, I believe, that Tibetan medicine has endured and thrived in the way that it has. I would like to salute here the Tibetan Medical and Astrological Institute in Dharamsala in India, which was one of the very first Tibetan institutions to have been established by His Holiness in exile.  At the same time, let me also pay tribute to all the other Tibetan physicians and centres of Tibetan Medicine around the world.

To see a major conference like this on Tibetan Medicine, attended by so many eminent doctors, scientists and scholars from all over the globe, gives me enormous pleasure; I applaud it and con-gratulate the organizers with all my heart. It presents us with an exciting opportunity, and I hope that in the wake of this Congress, the dialogue will continue. The holistic approach of Tibetan Medicine, which deals with both mind and body, holds out tremendous promise, but so far we have only skimmed the surface of what it has to offer the world. As we enter the 21st century we can, and should, imagine research of many kinds, for example into how to make these amazing Buddhist healing methods available alongside Tibetan medicine, in the right environment and to patients who would be receptive, and so explore their combined power of healing. And yet, in order for the Tibetan medical tradition to be more effective in serving people’s needs, two things I feel are required:

a greater understanding and communication between Tibetan doctors themselves, and

a greater exchange and collaboration between Tibetan physicians and western doctors and scientists, one which never compromises the integrity of Tibetan Medicine.

For as His Holiness says:

“Tibetan medicine is an integrated system of health care that has served the Tibetan people well for many centuries and which, I believe, can still provide much benefit to humanity at large. The difficulty we face in bringing this about is one of communication, for like other scientific systems, Tibetan medicine must be understood in its own terms, as well as in the context of objective investigation.”

Then, I feel certain, Tibetan medicine will take its rightful place as a universally respected, major system of medicine and healing, and prove itself to have more and more to offer, in a world increasingly beset with diseases and disorders, towards relieving suffering everywhere.

A modified version of this article appeared in Alternative Therapies in Health and Medicine, May 1999, Vol 5. No. 3, pp.70-72. H. H. the Dalai Lama’s paper at the congress: 'The Relevance of Tibetan Medicine Today' appears in the same issue, pp. 67-69.

Reproduced from 'The Future of Buddhism' by Sogyal Rinpoche with kind permission of Rider Books, Ebury Press. option=com_content&view=article&id=247&Itemid=229

Purification of the Body, Mind and Speech

One of the paramount Tibetan Buddhism teachings is the purification of body, mind and speech. Several Tibetan religious rituals symbolize this transformative process. The cleansing of the body, mind and speech can be performed in the initiation and empowerment rituals. As aforementioned in the Tibetan (Varjayana) Buddhism spiritual community, one cannot participate in a Dharma practice of a Tantric deity without receiving initiation and empowerment from his or her spiritual teacher (guru) first. Thus, prior to entering the hall where the initiation is performed, one must first fold one’s palms to form a cup shape to receive the rose water from a precious vessel, put it in one’s mouth and then rinse it. It is a symbolic act as it indicates the purification of one’s mouth, so one’s speech is cleansed. One then uses the leftover rosewater in the palms and spreads it onto one’s forehead and head. This again symbolizes cleansing of one’s body. Upon entering the hall where the initiation ceremony is held, one will then be given the nectar-like water and then drink it. This indicates that now one is receiving the blessings from the guru, the learned masters who preceded the guru, and all the sacred beings such as (deities and protectors). The drinking of the nectar-like water replenishes one’s psychological and physiological well-being. Upon drinking of the nectar from the vessel, one is “symbolically purified of worldly defilements such as ignorance, anger, greed, pride and jealously” (Tibet: Treasures from the Roof of the World, 2003, p. 111). After that, images and statutes of deities will be placed on one’s forehead and on the top of one’s head (charka). Performing this act communicates the meaning that now the divine beings are upon us and we not only receive blessings from them but also visualize ourselves as divine and as holy as the superior beings. The side note of this is that one of the Buddhist teachings, particularly with Tibetan Buddhism and Zen Buddhism traditions, emphasizes that there is no difference between Buddha and all sentient beings. Buddha is you and you are the Buddha. All sentient beings are essentially equal and all of us possess the capacity of becoming Buddha, which literally means the awakened one. Buddha nature lies within one’s own heart. One also visualizes in this very situation and environment, where the initiation/empowerment ritual is performed, that all the divine beings are with us and we are now in their sacred paradise. Visualization of these deities, the holy place and one’s possession of the Buddha nature helps to further strengthen and cleanse one’s mind. One will also chant a specific deity’s mantra, for example, the Compassion Buddha’s mantra, om mani padme hum, to invoke the close connection with this deity and to visualize one’s own embodiment of this divine being. Taken from a communication perspective, one can clearly see that participating in the initiation/ empowerment ritual is a verbal and nonverbal representation of purifying one’s body, mind and speech.

Kalu Rinpoche

Kalu Rinpoche discusses the process of cultivating the loving-kindness and compassion inherent in the enlightened attitude. Rinpoche first explains the basis of engendering relative bodhicitta: we realize that all sentient beings have been our parent at some point, we see the suffering all beings endure, and we have the overwhelming desire to free them from this suffering. Rinpoche then turns attention to one's development of ultimate bodhicitta through recognizing the illusory and dreamlike nature of the "reality" that sentient beings experience in the six realms of Samsara.

II      The Unhealthy State of People‘s Bodies and Minds Today

In this era, science and technology have been very well developed and the material conditions of much of the world are also in a good state. Yet it is common to see that people are not satisfied, still considering that current innovation is inadequate and economic development is not fast enough, and many more other unsatisfying thoughts. However, compared with the living standards of the 19th and 20th centuries, it is obvious that our present situation has improved significantly. Yet, strangely, even while material development has improved significantly, people’s hearts have grown pale and barren. This paradox suggests that the underlying assumption that material wellbeing alone can bring about happiness is a mistaken view. We should, therefore, seek an alternative: spiritual development. In my opinion, the inclination toward spiritual development will actually bring far more satisfaction and benefits than the satisfaction and benefits that material things can bring, for, generally speaking, it remains with you always. For example, if you give a person one hundred thousand Yuan, or even one million Yuan, should he not treasure it, the money will soon be squandered. On the other hand, if you teach him some very useful knowledge and philosophy, this can bring immense benefits to his whole life, and nobody can rob or steal it from him.

In the present age, people living in big cities tend to seek happiness through material things. Peace of mind and mental calm are often neglected. If we investigate the cause of this phenomenon, we will find that it is due to problems in education. From the moment we first go to school, many teachers only emphasize the importance of earning money, and many parents are also only concerned about our scores in exams. Furthermore, from an early age, they encourage us to cultivate the desire for fame and teach us to be selfish. With this kind of environment, what will the results be when we grow up? It should be evident to everyone. Through observing our own happiness and suffering, as well as observing the various situations of people in different occupations, we can uncover some of the truths behind these situations. It should be evident to us that material wellbeing alone fails to bring the happiness we aspire to have.

In the 21st century, compared with twenty years ago, we have made unprecedented progress toward securing our basic necessities of life. However, as we see, while material things can provide some benefits for us, they also can be a source of anxiety. Due to the effect of various stresses of keeping up with a modern lifestyle, most people are burned out. According to the 2009 “White paper on China’s urban white-collar health,” in Beijing, Shanghai, and more than ten other major cities, 76% of white-collar workers suffer from various ongoing health problems, known as “sub-health conditions,” nearly 60% of respondents were found to be burned out, and less than 3% of all of those surveyed could actually be considered “healthy.” The survey also shows that their stress originates from four primary areas: buying a house and having a mortgage, their parents’ health, their children’s education, and relationships and marriage. These are like four huge mountains pressing down on them heavily until they cannot cope, and, as a result, they are not able to enjoy any comfort, joy, or happiness.

For that reason, I feel sorry for children. As they grow up they have to endure greater stress. Not long ago, in my home town, when a group of sixth-grade primary school students graduated, they became very excited and said: “We no longer need to queue up; we can now move on to higher schools.” I smiled at them and joked gently: “The more you grow and the further you progress, the more you will feel the pressure ahead.” Indeed, as an adult, although you do not need to study books like when you were in school, and do not need to line up, the fierce competition in society means that the stress you are under is much greater than before.

In March 2010, Xiao Kang Magazine joined forces with Tsinghua University and surveyed the health of China’s civil servants and white-collar urban population groups. The outcome of the survey showed that more than 88% of people think they are in or close to a “burned out” state, suffering from depression, feeling agitated, and lacking a sense of happiness and satisfaction. This suggests that even though outwardly many people may appear to be leading entirely meaningful and comfortable lives, when they subject their lives to investigation, they actually find that they are plagued with mental and emotional suffering, are miserable and exhausted.

As we can see, at the moment, most people living in cities are mentally and physically unhealthy. The reasons for this are, first, overwork; second, strong desire; and third, an unhealthy lifestyle. With these trends, there are now more and more people suffering from mental illness. According to one figure, one out of every six people suffers from some form of mental illness, and two hundred thousand people commit suicide in China every year because of this illness. This data is really quite worrying.

III   How Buddhists Maintain a Healthy Body and Mind

1.  The importance of faith

Of course, medical treatment is one of the important remedies to these problems; however, as I said before, in my view, spiritual development provides long lasting effects compared to other solutions. Although one can survive without a faith or belief, it is still better to have one. In fact, to treat these psychological problems, it is important to have some kind of faith or belief. The University of Toronto Medical School has found in its research that those who have firm faith and beliefs have less stress, are able to socialise actively, have a healthy diet, and are thus psychologically and physically healthier. In contrast, those who have no faith or belief have poorer health.

The psychologist Carl Jung also noted that the increase of psychological disorders in the modern population is closely related to the decline of religious beliefs. He wrote, in Modern Man in Search of a Soul, that in this era where science is so highly developed, humans are psychologically unhealthy and so need a religion or faith. He saw that of all the religions, Buddhism has the most profound method to heal the unhealthy mind. Including meditation, prayer, chanting sutras, reciting mantras, and other practices, these are recognized as the most effective methods for healing psychological problems and so are being adopted by psychotherapy.

Therefore, for today, our discussion will focus on using Buddhism to ease and cure the present sufferings of human beings. Without this, even if you have wealth, fame, and a successful career, physical exhaustion still increases every day, and the mind keeps filling with anxieties, discontentment, and dissatisfaction. In this context, wealth has no significant value.

Some of you here have always followed and believed in Buddhism; some of you may believe in it but still have doubts about it; some of you are engaged in technological careers, and not only do you not have any faith or belief, you even refute all the views or doctrines of those that have faith and belief. Amongst the above, the last group of people must observe and analyze using their wisdom. Otherwise, if you don’t understand the effects of faith and religion, and proceed solely on the basis of the presupposition to refute other people’s views, this cannot be considered a scientific or rational way for ascertaining things.

We should know that, if we have faith and religion, even in times of great difficulties and hardship, we will still have something we can rely on and in which we can take refuge. I recall that at 10:00am on February 22nd, 2002, former U.S. President George W. Bush came to Tsinghua University. At that time, I was in Xiamen translating White Lotus: The Legend of Shakyamuni Buddha. When I switched on the TV, I happened to see the news. Although eight years have passed, I can still remember many things that he talked about. In one of his speeches, he said: “This may interest you—95 per cent of Americans say they believe in God, and I’m one of them…. Faith points to a moral law beyond man’s law, and calls us to duties higher than material gain. Freedom of religion is not something to be feared, it’s to be welcomed….” Although the religion that he talked about was Christianity, whether Christianity, Islam, or Buddhism, it is still better to have a religion than not have one. If you have faith and belief, you will live your life with discipline. Otherwise, if you don’t believe in life after death, you will not observe the law of karma and will therefore not refrain from any harmful activities. The case is just as it says in the Nirvana Sutra: “Not knowing that there will be a next life, you will create negative karma.”

Look at what unbridled testosterone managed to accomplish in the first Iraq War. You had these penis-like missiles, gazillions of them per minute, penetrating the cradle of civilization, the womb of the world, and that image was being pumped into our collective unconscious by satellite as it was happening. That was part of our humanity being destroyed.

I am fixed on the idea that if we lose the Tibetans, we lose the model they carry for us in a way that no one else is carrying it at the moment. Imagine a planet without the possibility of peace and nonviolence. And let’s not forget the place we live; our home is also the Great Mother.

We dedicate this issue of Inquiring Mind to the people of Tibet, Burma, Iraq, Afghanistan and Darfur— and to the multitudes of others throughout the world suffering from violence. May the fruits of our practice of the Dharma and the teachings of nonviolence be passed along for the benefit of this generation and generations to come.

“Because violence can only breed more violence and suffering, our struggle must remain nonviolent and free of hatred. We are trying to end the suffering of our people, not to inflict suffering upon others. . . . I pray for all of us, oppressor and friend, that together we succeed in building a better world through human understanding and love, and that in doing so we may reduce the pain and suffering of all sentient beings.”

—His Holiness the Dalai Lama, from his Nobel Prize acceptance speech, 

December 1989

“If we take revenge upon our enemy,  then it creates a kind  of vicious cycle. If we  retaliate, the other person is not going to accept that— he or she is going to retaliate against us, and then we will do the same, so it will go on. . . . The result will be that both sides suffer. . . . So anger or hatred is like a fisherman’s hook. It is very important for us to ensure that we are not caught by this hook.” 

—His Holiness the Dalai Lama, from The Art of Happiness

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