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    to give rise to health benefits, and I don't know what the answer to that question is, I

    mean, some people have argued that awareness, which we will talk about later, is maybe

    a key point that something about those disparate mind-body practices, what many of themshare in common is that harnessing of one's attentional faculties. And some sort of

    systematic training of awareness in some way, or bringing awareness to the very capacity

    to be aware, which we all ordinarily don't do as human beings, so whether that might be acommon feature that links them together. And I think you know we could take a lot of

    time to go over what the research says about these mind-body practices, but certainly

    there's a now large body of evidence across a lot of different practices and mind-bodytherapies that indicates that they offer many, many health benefits. And I think that

    what's interesting is that despite that, and you and I have talked about this, that that

    evidence base has been slow to be incorporated into medicine, and I think that the reasons

    for that are very complicated, but it's a curious thing because I think just in our ownexperience we know that, our own direct experience tells us that what is happening in our

    interior experience is impacting what is happening in the body. If we feel anxious, you

    know, our stomach starts rumbling, I like to use that as a simple example that what we

    call the mind and the body are maybe two different aspects of the same phenomenon, andmaybe not separate at all.

    MS: Well, I do want to come back to that because I think that really speaks to some of

    your own practice and the notion of a unitive, non-dual consciousness. But before we gothere, let's stay kind of in the research and say, Yes, obviously there are many different

    kinds of mind-body interventions, a wide range of these, and overall when we look at the

    field, it's very clear that the whole area of mind-body medicine has gained momentumand really is an intervention that's offered in most medical centers in the country now,

    that's quite an interesting phenomenon when you think about Jon Kabat-Zinn's influence

    or Herb Benson, and how much they've impacted in terms of the practice of health care.

    And yet, I mean, your work is revealing that it's not really as widespread as it mightseem, and when people feel like well, the paradigm has shifted and that's like common

    sense now, that's not exactly what you've found in terms of the research you did with

    physicians and medical students. So maybe you could tell us a little more about what youdid find and how willing people are to acknowledge the data, to use the data, to bring it

    into their practices, and if they're not willing, why not?

    JA: Well, I think if you look in general at all the literature linking psychological, if you

    will, or psychosocial factors in health, and that's the literature that's been being built forseveral decades now, and the reality is that while most medical schools will say that, if

    you ask them, Do you teach a bio-psycho-social approach, you know, one that recognizes

    the importance of psychosocial factors in health, not merely biological and genetic andmolecular biologic factors, they would, the medical schools would have to say that they

    do, because they know that that's politically correct [laughs], if you will, to say that, Sure

    we recognize the importance of these factors. But the reality is that if you actually look atthe curriculum, the amount of attention that's given if you look at bio-psycho-social to

    say how much curriculum attention is given to the psycho-social, it's probably, you know,

    it's very, very small, maybe one percent, maybe a little more than that. But the bottomline is that they'll say, and I hate to say lip service, but there's a certain amount of lip

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    service that's being paid to those domains of human experience and their impact on

    health; and I think it's challenging in medical training because your medical students are

    overwhelmed with the curriculum as it is, and in terms of trying to learn all that they canlearn about how the physical body works and how cells function and the types of things

    that influence cellular function and give rise to pathology and disease. And so there's a lot

    to learn, and in my interviews with people in my survey research, one of the things thatI've found was that they say, Yes, it's important to learn these other things about the

    psychological factors and social factors and their influence on health, but where is that

    going to go in the curriculum, how are we going to fit that in, we're already overwhelmedwith trying to keep up with the knowledge base in the more biologic and genetic and

    molecular areas. So that's a real challenge I think, and there's some people who said to me

    that, and I think a lot of it does hinge on the curriculum, ultimately what are they learning

    in medical schools. And I think that what a number of people told me is that their verytraditional medical training still involves a heavy emphasis in the first couple of years on

    basic science, and that most of the people that I spoke with in survey interviews said they

    felt that most of what they learned there was forgotten very quickly; they certainly don't

    remember much of any of it now [laughs]. And my sense is that it's probably important toget some exposure to basic science, but it's probably an overemphasis and an

    underemphasis on these other factors that are clearly, you know, if we just look at humanbehavior, how much human behavior is one of the leading causes of preventable disease

    in this country, and yet so little attention is given that. And of course the question is why

    is that, and I think that there's a lot of reasons for it; I think that there's certainly in the

    practice of medicine there's just the constraints of the structure of how medicine is set up,and that, say with managed care, that physicians have less and less time with patients, and

    of course what's going to get squeezed out, but what's considered to be less vital to know,

    and so talking with patients about what's happening in their lives and the stresses thatthey're under, and how those stresses might be influencing their physical health; if you

    have ten minutes with a patient that may not get covered when you have what you

    consider to be more vital things to deal with in that office visit. So there's sort of astructural constraint, and then I think there's really a paradigm barrier that probably has

    something to do with kind of our being enamored with a sort of a materialistic view and a

    reductionistic view of human health and well-being; and I think that the whole geneticrevolution is probably beating that in many ways, and some notion that we hold that, you

    know, eventually we'll be able to figure out the genetic causes of everything [laughs], and

    in the process overlooked these other dimensions of human beings that simply can't be

    reduced to genetics, as hard as we may try.

    MS: So part of it is just the structural aspects of time management, and inherent in that is

    a bias toward the physical, and then there's this other issue that you're talking about

    which is just fundamentally a worldview question about what counts, and clearly in our

    culture what we're talking about is the physical aspects of our experience are really theonly things we - we being the dominant culture - consider to be important; and yet that's

    not what gives meaning or purpose or volition in our lives. So you see these paradigmatic

    and structural as well as the educational, so they didn't learn it, so they don't know it, sothey're not comfortable...

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    JA: They don't know the evidence base, most of them. That's the reality, they've never

    been exposed to it. I mean, I read when I was interviewing physicians and medical

    students and residents, I would read them some of the seminal articles that have beenpublished in some of the major medical journals linking psychological factors to health,

    and I would say, Did you ever come across articles like this in your training, and almost

    never. So it's a big case of them not being exposed to the evidence base that's actually outthere. And I think that one aspect that represents a barrier and a challenge to them sort of

    shifting the paradigm of healthcare and medicine is that we are talking about things that

    are less tangible, domains of human experience that are less amenable to measuring andquantifying. And so it makes it more difficult for people to wrap their hands around in the

    same way they might wrap their hands around measuring your cholesterol, or even

    behaviors, like knowing that you smoke, and being able to assess, when that's a simple

    thing to assess, Do you smoke? But telling me, How are you experiencing your life, in amore interior way is harder to get a handle on, more difficult to assess, and so it's

    messier, if you will, less concrete, and less amenable to control as well, and so I think for

    all of those reasons it makes it, makes physicians let's say more inclined to deal with the

    concrete, with the tangible, what they feel they can actually measure and assess and thenbe able to influence in some way.

    MS: Kind of reminds me of the parable of the fisherman who goes out with his net and

    the space in the net is like two inches big, and so he comes back from his fishingexpedition and concludes that all fish are larger than two inches, because that's what his

    instrument would allow him to measure.

    JA: Exactly.

    MS: It seems like there's a similar thing, there's a bias towards kind of what's in front of

    us rather than sort of the deeper inquiry and you know, that's a big fundamental challengein terms of how we should reform and revise the healthcare system. What are strategies

    do you think for beginning to overcome those individual barriers and then let's talk about

    it at a larger institutional level.

    JA: Well, I think that my sort of intuitive sense, and confirmed by my talking to people

    in my research, is that probably direct experience is going to go further than simply

    generating more evidence, more empirical evidence. I always like to tell the story of aformer colleague of ours when I was at the University of Maryland who was an

    immunologist, and we did a lot of research on acupuncture and he was always very

    interested but very skeptical, and yet there were these very compelling randomized

    control trials and meta-analyses and systematic reviews suggesting there's somethinggoing on with this acupuncture at least in the case of some conditions, certainly

    management of pain. And yet he remained very skeptical and he's this brilliant scientist;

    he developed back pain at a certain point and he tried everything and nothing worked andfinally my boss Brian Berman who's also an acupuncturist said, Look, I know you're

    skeptical but why don't you just try acupuncture. And so he did some treatments on this

    immunologist and his back pain went away. And you know that was more convincing

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    than a thousand randomized control trials to show that something, it's very hard to refute

    direct experience [laughs].

    MS: And yet we know that direct experience can be unreliable. So how you weigh theimpulse then to say, on the part of the kind of established medical science practitioner

    who knows how to measure something in a fMRI, you know oftentimes psychologists arequite dismissive of subjective reporting because it's unreliable. How do you find the

    balance between this notion of direct experience and then the kind of reliability thatcomes from the objective epistemology of science?

    JA: Well, I like what Ken Wilbur says about there's narrow empiricism and there's broad

    empiricism; and narrow empiricism tends to include only those things, he would say that

    you can see with, that have simple location, that can be seen with the eyes or with someextension of the eyes essentially. But there's this whole other realm of reality that we all

    experience, right now we are having an experience that's not empirical in the sense of you

    can't see my experience, but I'm having this experience nevertheless; and you can call it

    subjective, but it's still empirical in the sense that it's data. So he encourages us tobroaden our notion of what we say is empirical to include the interiors as part of what

    falls within our realm of what can be observed and studied, you just have to use differenttools, you can't measure them with the same tools. So there's other types of measurement

    and inquiry that are used for gaining knowledge about our interiors.

    MS: So direct experience is part of it and...

    JA: I think it's huge, actually.

    MS: So the idea would be what, in terms of medical school?

    JA: Let's use the example of meditation, okay? So let's say you're a physician or just ahuman being and I could talk to you till I'm blue in the face about what a fantastic thing

    meditation is and here's all the evidence showing all the health benefits and okay, how

    about if we just do some meditation together [laughs] and you have direct experience ofwhat happens when you engage in that practice, in the laboratory of your own direct

    experience. And I think that can become a very potent, if you will, tool for helping people

    to go beyond their preconceptions and their judgments and their conceptual barriers toconsidering the potential value of something when they've actually experienced the value

    directly in their own life. So I think that's probably the most important thing.

    MS: I think that's kind of the essence of the noetic sciences, is that notion of the directexperience and then trying to find a reliable, rigorous way of understanding that, and Ithink about Tibetan Buddhism and how in that system there is a epistemology for

    studying consciousness, but it's based on a subjective methodology that involves

    verification and replication and corroboration and some of the things that we think aboutas essential to the scientific process. How does that translate? I think again about

    Toynbee, and Toynbee said that historians of the twentieth century are going to look back

    at that period and say the biggest thing that happened was Tibetan Buddhism coming to

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    the West because it's this convergence of methodologies or really ontologies of what's

    important. What's real? And for this Tibetan model it's that interiority becomes very real

    and there's ways of understanding and mapping and developing it; and in the Westernworld it's really much more about the objectification of that, and we certainly see that

    today, looking at the front page of Time magazine to National Geographic, Richie

    Davidson's work for example has so captured the collective imagination because in a wayhe is bringing this objective lens to the subjective experiences of these meditators and

    what do you think are the strengths and weaknesses of that kind of tension?

    JA: I think there's great value in, human minds are curious and we seem to be curious by

    nature and trying to understand what we see around us and make sense of it in some way.And so in terms of understanding the interior one way we try to make sense of that is by

    looking at what interior states of consciousness, how they register in very observable

    domains, i.e. the brain and how changes in the brain may give us some clue as to what'sactually shifting in people's interiors. The problem with that is that it may be a function

    of, our current neuroscience tools are still pretty crude, but they actually don't tell us a

    whole lot about what's happening in this state of consciousness. You know, if I ask you toimagine--forget about kind of very rarified states of consciousness that one might realizethrough some contemplative practice--but if I do something simple, like ask you to

    imagine an apple in your mind's eye, most people could do that, create some visual image

    of an apple, and if I looked at your brain under an MRI machine before you did that andthen while you were doing it, something would change; because you were creating that

    visual image it would register, that interior experience of visualization would register in

    the brain in some way. But the fact that something shifted in the brain, what would thatactually tell you about how you experienced the seeing of that visual image? The only

    way I'm really going to know about that experience is if I talked to you about it, if I ask

    you, How did that look? What did that feel like? What was that experience like? Did you

    enjoy that experience? There's so many dimensions of that one little visualizationexample. And then you compare the richness of you telling me about that experience,

    how it made you feel, what was difficult about it, what you enjoyed about it, what you

    learned from it, I mean the list could go on and on; versus what shifted and what part ofyour brain was using glucose when you had a visual image of that apple [laughs]. Do you

    see what I mean? And with our being enamored with the material realm, and that sort of

    constitutes real science, we end up I think missing this whole other dimension of the realrichness, where the human experience is actually happening, you could say. It's also

    happening in the brain, but we're not experiencing this moment as neurons firing in our

    brains, all of us who are listening to this conversation, we're experiencing this as, we'llgive different names to these experiences, bodily sensations and thoughts and insights

    and feelings and states of mind and the whole rich, what we would call our inner

    landscape of what's actually being experienced.

    MS: But there has been a trend now, in a certain sense neuroscience is co-optingconsciousness as something that is an epiphenomenon of the brain, and all things can

    now be reduced to that, and what I'm hearing you say is that that would be very

    misleading to make that kind of conclusion.

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    JA: Even if it is all just the brain, [coughs], excuse me, there's a part of me that says, So

    what? Where does that leave us? What if it is just the brain?

    MS: What do you do with that?

    JA: Yeah, so that's okay; it's just brain, and here we are in this moment having thisexperience. In a way it doesn't change anything, which is kind of interesting. Some

    people feel like, that just sucks the marrow out of life, and the richness out of life and the

    mystery out of life and I don't know if it really does, which is kind of interesting becausewhen we say it's just brain, we don't actually know what that even really means. Because

    even at the level of the material universe, if you start to talk about what the material

    universe is made of, well now you're getting into very mysterious territory of quantum

    phenomena that are essentially potential and how they come into form. I don't understandquantum physics but even the material level is not such a concrete, nice, neat thing that

    we understand [laughs]; it's quite ineffable.

    MS: That's so true; Hans Peter Drr was with us for a workshop and he was talking abouthow, as a quantum physicist he was the director of the Max Planck Institute in Germany,

    and he said that physicists are forever trying to find the elementary particles of matter,

    and they would go deeper and deeper and smaller and smaller and ultimately, within the

    framework of this quantum model it isn't about an elementary particle. It's about therelationship of the parts, so it becomes a very different sort of model that's from the

    Newtonian kind of view of billiard balls to something that is fundamentally about

    relationship even at the core level of matter. I appreciate what you said though very muchabout this kind of dilemma in a certain sense of consciousness; and Dave Chalmers talks

    about the hard problem and the easy problem, the easy problem is really documenting

    that the brain has certain qualities and characteristics, but the hard problem is really

    understanding subjectivity and that self-reflection and intention and volition.

    JA: Well, what's interesting about, as it relates to my own interest in consciousness and

    awareness and the training that I do and the writing that I do about awareness, is that in a

    certain way everything that we've talked about, and does it ultimately reside in the brain,and what's the relationship between mind and body and what is the mind and the body, I

    meanthere's all this wonderful stuff to speculate about and wonder about and try to

    discover, and that's part of what fuels scientific inquiry, but in a certain way what's sofascinating is the most difficult to grasp by science, namely consciousness, we could say

    that that's the one thing that's not at all speculative, the fact that there's consciousness

    here, the fact that awareness is happening in this moment. In a sense it's the only thing, in

    my own direct experience, it's the only thing that's really certain, is that we're aware. Andeverything else is interesting speculation, but beyond that I don't go much further than to

    say that it's ultimately speculation.

    MS: It's that "I think, therefore I am."

    JA: It might be, "I am, therefore I think."

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    MS: [laughs] Very nice.

    JA: Because I am, the fact that there is this sense of knowing that you know you exist,

    there's this knowing of that that's not dependent on thinking, this fact that you exist.

    MS: [laughs] So moving beyond philosophy, one of the issues that comes up when wethink about mind-body medicine and the whole system of healthcare today is really the

    alleviation of human suffering, and so we can get into debates about different

    philosophical positions and so on, but ultimately it translates to some bottom line issuesabout people's experiences of pain and discomfort and the kinds of things that, in

    Buddhism it's their major focus. So I wonder in terms of your research now, if...

    JA: Well actually it relates very much to what I was just saying about that's there's this

    certainty of being aware, and then there's this speculation about, let's just say what thatawareness is, not to mention all the other things we wonder about, who we are and what

    the meaning of life is, and what's brain and what's mind; I say it's the stories we tell about

    our experience. And what's interesting, as it relates to the alleviation of human sufferingis that in a way suffering, as I have come to understand it, is always tied in with some

    story about our experience, some interpretation of our experience. And that's ultimately

    part of what contemplative practices do is to help to reveal the ways in which we are

    constantly telling stories about our experience. And sometimes they're nice stories thatmake us feel good, but a lot of times they're stories that create suffering. And what's

    interesting is that, I make this distinction, I use this a lot in my work, a lot of my work

    right now is focused on addiction, and we draw this distinction. It comes out of some ofthe contemplative traditions, it's between the little mind and the big mind. The little mind

    is the mind that tells stories about what's happening, it's commenting on our experience,

    it's evaluating our experience, it's judging our experience, and in its most primitive form

    it's either liking what's happening or not liking it in some way; and it's probably true ofour experience right now, like there's some part of us that's got some little running

    dialogue about this conversation, and do we like this conversation, do we like the

    direction it's going, we have maybe some judgments about it, we think, Wow, this isreally exciting, or God, this is the most boring thing I've ever heard, and When are we

    going to get to something more interesting, and so the little mind is just kind of going

    Yak, yak, yak about our experience, sort of monitoring it and talking about it. And thenthere's this other dimension of awareness, what I call the big mind, which doesn't have

    any opinions about the experience; and in a sense it's, in the mindfulness field one of the

    ways they, even Jon Kabat-Zinn traditionally defined mindfulness, it's non-judgmentalawareness. And really what that's pointing to in my own perception of this is it's pointing

    to this dimension of awareness or consciousness that is simply not evaluating this

    moment, but is aware of the moment, and it's also aware of evaluation that we might, thatthe little mind, if you will, might be generating about this moment.

    MS: So how do you bring that in to the addiction, or another project I know you have an

    interest in is this conscious parenting and working with pregnant moms around

    mindfulness.

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    JA: Well, with addiction the theory that we're testing is, we've been looking mostly at

    relapse prevention. A lot of treatments for addiction are pretty successful but despite

    however successful they are, people end up relapsing, and a lot of research suggests that,we all probably know this from personal experience too, we don't need research to tell us

    that we tend to revert to a habit like an addiction as a way of managing the stress, right?

    So if it's food or if it's alcohol or if it's cigarettes, one of the things that's powerful aboutingesting the various substances is that they change our consciousness. That's why we do

    them, is we don't like the state of consciousness we're in and we want it to be different;

    and that could either be the stress that we want to medicate, let's say, if we're depressedso we'll drink to manage our depression; or it might be boredom, and we don't feel like

    the moment is quite enough, quite exciting enough so we want to pump up the moment in

    some way so we'll use some substance to enhance the moment. In any case they both

    come out of this sense that something about the present moment is not enough. And sowhat we're teaching people to do in our training, in our studies with meditation, is when

    some state of mind arises that would ordinarily lead somebody to use or return to using a

    substance to manage that state or change that state, we're presenting a radical idea and I

    think it's very radical for most of us, and that is what if this state of mind that you're indoesn't have to be changed actually? That just runs up against people's sort of conditioned

    habit and tendency which is to try and feel better, it's a deep human yearning. But whatwe say is, the paradox is that the way to feel better is to not try to change the state that

    you're in, because what ends up happening is if you can enter into a different relationship

    with, or as I like to say, discover a place within you, an awareness, this big mind that I

    was speaking about is already in a different relationship with experience, it's notstruggling with your state, even if the state is agitated or upset or distressed; that there's

    something that's not struggling with that experience, that's at peace with it even if the

    state is not peaceful. And of course if we take any state, even a distressing state and wediscover what it's like to not fight against that state, well then the experience of being

    agitated stops becoming a source of suffering in a sense, because we're not struggling

    with it anymore, we're not resisting it, we're not fighting against it. And so the theorywe're testing in our research is that once somebody starts to discover that they can relate

    to their distress in a different way, they don't actually have to manage it or change their

    state, but they can actually allow it or accept it, then they're going to be less likely intheory to turn to some you know, conditioned habit or substance use to manage their

    distress. Does that make sense?

    MS: And also it's a way to kind of begin to reframe the pathology of all of our activity to

    allow us, in the Living Deeply work and the transformation study that we did what wefound was very similar to what you just said, that transformation isn't really about any

    fundamental change in who you are, it's actually coming to a more authentic appreciation

    for exactly who you are, but in the process just a shift in perspective about the Who is the

    me that's having that experience. So from your own perspective, I know that the non-dualphilosophy is very important for you, so what are your own perspectives on meditation

    and how to do it and how it's valuable to us in our lives?

    JA: Well I think that in my own life, I mentioned at the outset of our talking together thatI got interested in this stuff when I was about 19, and I spent about the next 20 years

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    trying very hard to find inner peace through meditation; and I didn't quite know how hard

    I was trying, but I was very disciplined and doing lots of meditation practices and going

    on retreats and funny enough, I only saw this through a particular experience where I wasstriving really to get to a particular state which I thought was a higher state or a more

    enlightened state or a more God-realized state or a more whole state, pick your favorite

    term, and what I didn't realize until that process sort of unwound itself in a way was thatthat's a guaranteed way to keep a state of, an experience of peace away is by trying to

    find it, trying to seek after it, because of course the seeking for it is it's own kind of

    agitation, the looking for it, looking for it, where is it, where is it. So in the case ofmeditation what's happened for me in my approach to doing it in my own life and

    teaching it to other people is helping people to discover that rather than something that

    one sort of develops, really awareness is already present, obviously as I was saying

    earlier it's the most certain thing about our experiences, that we're aware, so actually youdon't have to do a practice to be aware; you already are aware. And so I introduce

    meditation and the qualities that one is cultivating as part of meditation practice, let's say

    something like acceptance of our experience and not something, we hear "Become less

    judging of your experience," we hear that as a prescription and we hear from all thevarious religious traditions and spiritual traditions we hear various prescriptions. Become

    more forgiving, become more loving, become more compassionate, become less judging,right? And really what I think happened in the evolution of spiritual tradition and practice

    is that people heard what were essentially descriptions of what we fundamentally are as

    prescriptions for what to become. Then we engage in various practices to try to become

    more loving, become more forgiving, but actually if you look into, and I teach this in ourstudies in fact, if you look into the nature of ordinary awareness, what's aware and awake

    in this moment right now, and you actually begin to explore, in a sense you almost let

    awareness explore itself, if you even ask the question, if you turn awareness back onitself, let awareness be aware of awareness, and then you ask the question, What are the

    qualities of ordinary awareness? What's very interesting is that you begin to see that all

    those spiritual prescriptions are in fact describing the very qualities of ordinaryawareness, that it's open by nature, it's not placing conditions on what it's open to, it's not

    judging, it has no biases, it has no opinions, it's not grasping, it's not pushing experience

    away. So it's very, very interesting to see that could it be that it's not so much, againdeveloping these qualities as it is discovering that these qualities are already present, as

    the most natural thing about us, is our own ordinary awareness.

    MS: That's beautiful, thank you. I think we should probably open the phone lines,

    because I'm sure people would like to be chatting with you. So Angela, you want to takeit away?

    SIA: I can do that, yes. This has been a great discussion, thank you. So we are now going

    to open all of the lines for Q & A, and we ask that you please mute your own phones by

    pressing *6 when I count to three, if you have a question for John or Marilyn, you canpress *6 again to un-mute your phone; please say your name, where you're calling from,

    ask your question, and then please remember to re-mute your phone again after your

    question. That way we won't hear all the background noise. So get ready to mute yourphones, one, two, three... All right, it sounds like everyone is re-muted.

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    MS: Okay, good. So who out there would like to raise the first question or broach the

    first conversation with John Astin?

    Q: I have a question.

    MS: Okay, great.

    Q: This is Dale in Portland.

    MS: So we have two people, let's start with Dale in Portland, and then there's a woman's

    voice in there that just spoke up, we'll take you second, okay? So Dale, go ahead.

    Q: Okay. Hi Marilyn, I was with you at Ashland, and I'd like to ask, have you envisioned

    the role of ritual in a treatment process; shamans use ritual, AA has kind of a ritual thatthey say this framework seems to hold in it the human potential. Would treatment centers

    develop rituals that would enhance the treatment process, and what might that be in your

    imagination?

    MS: So, John, you want to pick that up?

    JA: Well, I think that we could say that, in a sense everything that we're doing is our

    ritual, right? That's what we do, that's our ritual, that's the way we are in relationship to

    other people, that's the way we behave with other people, the way we treat other people;

    in a sense I would almost say, what is not a ritual? I know that what you're speakingabout is maybe more ancient traditions and rituals and do they hold value in the way we

    do healthcare and the way we treat patients. I would say probably that may be the case, I

    don't think it's been something that's been studied very much, but I guess that I would ask

    you what is sort of underneath the question for you, what's your own sense, have you hadsome experience with rituals of one kind or another as you understand them that have

    somehow been, have done something for you, have transformed you in some way thatmakes you be interested in that?

    Q: Well, for instance just AA has a simple process, and they have definite limits and the

    process seems to guide people in a helpful way. So I was thinking if there were a way to

    do intakes or ways of preparing people for, say, physical treatments, that might be a quietsession, it might be saying certain things or watching a video that would enhance just

    their sense of presence and well-being. I don't know, I'm wondering if there are some

    ways we could create an experience, as people enter into treatment, that would enhance

    the treatment process.

    JA: That's a great question. I think it's pretty unexplored in terms of, if you say even

    using some kind of centering technique or quieting technique or meditative kind of

    technique before, you can imagine as a simple example, if you're a physician and everytime the patient walks in you say, You know, before we start dialoguing about what's

    going on with you, why don't we just sit in silence for a couple of ( ). You can imagine

    how that might alter the whole tone, shape, that dialogue will then come out of their

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    dialoguing together. I think you're right, those kinds of things are very simple things you

    can do to kind of set a certain tone as part of the whole healing ritual, absolutely.

    MS: And you can also think about the placebo, and the expectancy effect and how youcan really prime people to have either a state of discomfort or a state of comfort. And so

    much of it is our anticipation of that so if you can find ways to either minimize orenhance, depending on what the goal is, a certain kind of experience, I could imagine that

    that would be very beneficial. Thank you Dale. And there was a woman who was on thephone who started to ask a question, and I didn't get your name, but go ahead and jump

    in.

    Q: My name's Lorraine, out of El Dorado Hills, California.

    MS: Hi there.

    Q: Hi. I'm a registered nurse, and I've worked in acute care settings, trauma ER's, ICU,

    and I don't any longer; and I wonder have you ever thought much about the barrier inmedicine of the false ego, the lack of mindfulness and spiritualness in how people are

    treated, the patients and doctors toward nurses, nurses toward nurses, et cetera. As I'vegotten older I've realized that thoughts are real things, and one day I think we'll discover

    that the negativity of the thoughts in these centers--ICU, et cetera--are actually harmful to

    patients.

    JA: Is that part of what led you to get out of being in medicine?

    Q: Yes, I felt like my own health was being impacted, because there's too much

    negativity and falseness going on just in the treatment of these very ill people, and a lot of

    negativity, and it's very, very negative, there's nothing healing about it.

    JA: What was your sense, since you were in those environments as a practitioner, did youhave a feeling of what was giving rise to that kind of negativity, what was at the root of

    that?

    Q: Yeah, I do. I think it's in the schooling, it's in the competitiveness, it's insecurity that

    people have. There's so much to know, and I think it creates an insecurity, and I think thatpeople have developed this false ego of trying to protect themselves from one another,

    from what they don't know, from what they think they don't know, that creates a very

    negative atmosphere.

    JA: I think you're right in many ways about that, and I think one of my observations, I'veseen it working directly with medical residents, that it's actually not okay to not know.

    Q: Right.

    JA: And what we do, all of us as human beings, is, I think in a lot of ways our

    dysfunctional behavior comes out of this discomfort we have with uncertainty, and with

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    not knowing, and so we make things up; literally we make them up and we make them up

    in the form of belief systems and ideologies, and one way it can manifest is negativity as

    a way of regaining a feeling of power and control in a situation that we know actually isfundamentally out of control, and not very knowable.

    Q: That's it, thinking power and control in situations where you aren't going to get it, youknow? They've all have been heading down a slippery slope for many years and they

    come in to you, and they're getting ready to die, and there's a lot of stress.

    JA: Right, and it's very interesting, I think it's both a question for medicine, but you know

    maybe it's a question that's much bigger than just medicine and has to do with how do

    human beings deal with not knowing, with being uncertain about, what's interesting, I

    talked about my work with mindfulness and it's a very, very interesting thing to thinkabout that we don't, we can't actually predict what's coming in the next moment let alone

    the next week or the next few months or the next few years. And so in the face of not

    really being able to know what's going to unfold in the next moment, are we okay with

    not knowing that? Or are we struggling against that, and fighting against the reality thatit's actually not fully controllable at all.

    Q: Right.

    JA: It's interesting. I've looked at that a lot in my own life and I've seen it in people that Iwork with, and it's interesting too, I was describing these two minds, if you will, there's

    that mind that's trying to understand which is a very natural thing, is also trying to get a

    foothold of certainty and security and yet there's this other part of us that's actually very

    comfortable with not knowing, it's fine with not knowing.

    Q: Right, yeah.

    JA: And can we gain more familiarity with that part of us that acknowledges the not

    knowing and in a way really almost rejoices in the fact that it's not knowable, it's

    mysterious, and most people aren't familiar with that but they can learn to become morefamiliar with it.

    Q: I agree. Just hearing it helps.

    JA: Yeah, well thank you for your question. That's a great observation.

    Q: Thank you.

    Q: I have a question.

    MS: Thank you. Go ahead. And who is this?

    Q: My name is Jeff, I'm in New Jersey.

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    JA: Hi Jeff.

    MS: Great, Jeff.

    Q: Hi. I was fascinated with your discussion of you know, self awareness, the big self.

    And I guess my question is when you start becoming self-realized, and this relates to theway this was billed on the website, not a lot of questions, technical questions on

    healthcare and mind-body interaction, but on structured versus unstructured meditation.

    JA: Right.

    Q: You know, I've done a lot of reading in a lot of different areas, and Eckhart Tolle andjust acceptance of the present moment and just even, you know he defined consciousness

    as the absence of thought without loss of consciousness, so there's perceiving; in other

    words, you're becoming aware of the big self, you're a perceiver for the self that's

    functioning through you, living your life, and I think that's what you were getting at

    before. And I was wondering if you could relate those different meditation techniques,whether structured or unstructured, to how to more greatly embody that unconditioned,

    nonjudgmental awareness also referred to by Jon Kabat-Zinn, into everyday reality soyou become more and more an embodied sage rather than something you have to

    consciously bring in, and you know, something that kind of takes over your life so you

    become the enlightened sage instead of a person that's still...

    JA: Right...

    MS: John, before you answer that call, a question. Could I ask that everyone please

    remember to re-mute your phone if you've already asked a question; press *6, we're

    hearing a lot of background noise, thank you.

    Q: Yes, and before I get on and you answer that, or before I get off rather, I have aresponse to the gentleman that talked about ritual. There's been a lot of experiments over

    the years since the 70's using psychedelic drugs in psychiatric settings with people about

    to die and bringing them into that more unconditioned awareness, using music and other

    rituals to try in this setting, and it helped these individuals tremendously, so I think there'sa lot of research going on in that area, but it's more in connection with, you know, with

    entheogenic substances more than through meditation.

    JA: And in relationship to your question about how to sort of let this kind of

    unconditioned, nonjudging awareness sort of take more hold of a life, and be what'smoving the life rather than something else, I think that, for me it's, and why my own

    relationship to meditation and the way I introduce it to people to shift it, is that I think

    that the practices sort of emphasize technique and making effort and trying to cultivate,sustain, and maintain a certain kind of awareness can, I mean they're very powerful

    practices but what they tend to reinforce in my experience is they reinforce the meditator,

    they reinforce the one, and somebody was mentioning earlier about kind of the ego mind,and that's what they tend to reinforce, is the notion of I, as a sort of separate individual,

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    have this power to create, sustain, and embody this awareness, and really I think it misses

    a really fundamental thing, which is that, and the traditions speak about this, and that is

    that if you look into awareness and the nature of awareness, we're not fundamentallyanything but that awareness, we're not separate from it. There's not someone who is

    aware, there's just awareness, and that really these kind of more direct path sort of

    approaches to meditation, it's much more about seeing that it's this kind of integration orthis embodiment that we're talking about. First of all, it can only happen in this moment,

    because this moment is the only moment we're ever alive, and it's happening now, that

    this awareness is present. And in a certain way it's the simplicity of this sometimes kindof takes people aback, but the simplicity is that maybe there isn't much to do about that

    other than see that the reality, this awareness that has an unconditional relationship to

    experience, it's not judging it, it's open to it, and that maybe the work, if there's any work

    to do, is simply to allow oneself to keep surrendering in a sense, back into that awareness.It's already present, and that we're really not fundamentally separate from it. Does that

    make sense?

    Q: It makes sense. But you know that there's a definite difference in the sense when youfeel yourself sort of as the eye of God, the eyes of the world, the eye that's perceiving theforce in itself, and you're consciously conscious of it, as you said, awareness becomes

    aware of itself, whereas when you're, you know, discombobulated with a problem and

    you go into a suffering mode and you have to bring yourself, you have to consciously sayto yourself, at least I do, Well, this is God too, it's happening in this moment, it's all part

    of the flow that I'm part of, and there's a little bit of an exercise that has to be done to

    kind of reunite you with that flow, and even though you're never technically apart from it,I understand what you're saying, you're never apart from it because you can't be.

    JA: Right.

    Q: You know, nothing could function without that ever-present awareness. But my sense

    is that the sage, like Ramana Maharshi or Sargagada Maharaj and people who have

    attained those things in this moment can never kind of lose their center.

    JA: Right. Although we don't really know that, do we? We don't really know that, in a

    way it's speculation as to what someone else may have achieved. And what we really

    know is that there's awareness here, and there's a way in which it's, what if it were somuch more simple than we, I am continually astounded by the way we make the

    simplicity of awareness into something more complex. I don't deny what you're saying,

    about the experience that happens when there's a contraction, and one goes into a kind of

    suffering, one gets caught up in the stories of the mind and of course it happens, butwhat's interesting is that if you look from the perspective of awareness, remember how I

    was saying that awareness has no opinions, or judgments; so let's say that suddenly one is

    wrapped up in some judgment, it's like, from the perspective of what's just registeringthat, what's just awake to that, aware of that, that judgment isn't actually turned into a

    problem that you have to do something about. I say this to people when I'm teaching

    meditation that it's very interesting that we, in a lot meditation traditions thought is sort ofturned into a problem, the thinking mind is the problem, right?

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    Q: (...) said if the thinking mind doesn't dominate your consciousness, you're not going to

    get swept away by it, it's no problem. But I guess that leaves the final issue which was the

    subject of the discussion tonight, and it's what Eckhart Tolle talks about, do we just (...)sit back and (...) don't do anything about our spiritual development or do we take a

    structured amount of time every day and you know, devote ourselves to (...)

    unconditional awareness...

    JA: Sorry there was some distortion there.

    MS: Yeah, we're getting a lot of...

    JA: It was a little difficult to hear you, but...

    MS: The cell phones and speaker phones are probably still on.

    JA: I think I got the gist of what you were saying and I think that maybe there's no

    formula for that, that's a very individual, if you feel drawn to making some kind of effortto be more in touch with this, then that's what you'll do. And at moments it may dawn

    that no effort is required to be, any more than any effort is required to be aware, that

    there's a sense that it's quite effortless. And there may be times when some effort may be

    engaged in to see that, and to know that and to rediscover that moment by moment.

    MS: And to be reminded, I guess, huh? Well, John, thank you so much, I think we're out

    of time, and this was very stimulating, and I think very inspiring for people and I very

    much appreciate that.

    JA: My pleasure.

    MS: Thank you for taking your time, and for all the brilliant work you're doing in theworld and all the ways in which you really are helping to alleviate the kind of suffering

    that we've been talking about, so thank you. And Angela, do you want to take it away?

    SIA: Yes, I will. Thank you both, it was a really wonderful discussion!

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    Member Comments:

    Definition of Awareness

    Submitted by Nancy ER on April 2, 2008 - 8:40am.

    Thank you, John so very much. I just finished reading the transcript (I was unable toactually listen at the time) and I am impressed. I really liked the way you sort of divided

    up the whole aspect of awareness, conciousness. Big Mind, Little Mind. That put it all in

    persepctive so to speak. Being so very new to this whole aspect of life, spirituality and

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