Mindfulness-Based Compassionate Living: A New Training Programme to Deepen Mindfulness With Heartfulness.Erik van den Brink and Frits Koster (2015) New York, NY Routledge. 258 pp.


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East is East and West is West, and never the twain shall meet. —Rudyard Kipling (1889)Mindfulness-Based Compassionate Living by Erik van den Brink and Frits Koster, published by Routledge, is a thin volume of great wisdom on mindfulness and how it can be used to enhance one’s compassion for oneself. According to the authors, mindfulness involves learning to be more aware of life as it unfolds moment by moment, even if these moments bring us difficulty, pain, or suffering. Compassion requires both sensitivity to our own and other’s suffering and the courage to deal with it. Erik van den Brink is a Dutch psychiatrist trained in the United Kingdom who has extensive experience in mindfulness-based and compassion-focused approaches to mental health. Frits Koster is a Vipassana meditation teacher and studied Buddhist psychology for 6 years as a monk in Southeast Asia. The authors are well placed to write this book and their understanding and self-compassion are evident on every page. The layout is attractive, and the references are extensive and highly relevant.As a psychiatrist brought up in the East, who received his training in psychiatry in the West, I have personally experienced the dismissive attitude of the Western sciences to the concepts that are described in this book. I remember reading an article in the New York Times a few years ago that described the opposition by neuroscientists to an invitation to the Dalai Lama to give the keynote address at their convention. To offer a balanced review, I invited my colleague Dr Robert Barris, who teaches alternative medicine to medical students and residents in my program, to join in this exercise.We wondered why the concept of mindfulness has been gaining ground lately in medicine, and the answer is easy. The training of physicians in the United States is a long drawn-out process that requires great dedication, hard work, and self-sacrifice. As we know, having empathy is a prerequisite for any successful clinical encounter. However, an extensive survey among US physicians showed that approximately 40% of respondents experience symptoms of burnout, which is considerably more than the general population. This exhaustion results both in job dissatisfaction and poor quality of care and makes the physician more prone to making medical errors. Many studies also show a significant empathic decline during medical school and in residency. Another large American study showed that more than half of medical students met the criteria for burnout, which was associated with more unprofessional conduct and fewer professional altruistic values. Is our education system failing our students? On the other hand, participation in teaching mindfulness programs has shown a remarkable positive impact on participant’s quality of life, their stress tolerance levels, and their capacity for self-compassion. Double-blind control research among therapists in training shows that they help not only themselves but also their clients by meditating regularly. Therefore, is teaching the caregivers skills in self-care through mindfulness training much overdue?The book consists of 3 parts. Part 1, “Approaches to Suffering,” has 6 chapters that introduce the reader to the theoretical concepts. This chapter is an elegant effort to appreciate both Western scientific and Eastern Buddhist approaches to wellness and personal growth. The 2 differing systems are compared and contrasted with the use of the foundational axioms of Buddhist psychology: The Four Noble Truths. Western science and medicine use an external methodology wherein objective measures and quantifiable cause and effect data can be utilized in devising treatment strategies.

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