Acupuncture Points

Acupuncture is a method of Oriental Medicine treatment that inserts needles into acupuncture points to alter our physiological functioning. There are hundreds of acupuncture points that influence the flow of energy, or Qi, in the body. Most of the classical acupuncture points exist along meridians that channel the energy up and down the surface of the body and to deeper levels where they connect with the internal organs and other meridians.

What are Acupuncture Points?

Scientists have conducted studies and determined that acupuncture points are areas of low impedance on the surface of the skin, meaning that these spots are able to conduct electricity more easily than other surrounding areas. This discovery has led some to believe that Qi is a form of bioelectricity of the body, and that meridians are pathways of bioelectric circuits. Acupuncture points tend to be located in depressions and grooves between muscles and other tissues, which allow the Qi of a meridian to be easily accessed. While acupuncture charts and location descriptions provide a guide, palpation is commonly used to find the exact location of acupuncture points on each individual. When acupuncture points are needled, a propagation sensation is often felt by the patient along the pathway of the acupuncture point’s meridian.

The Nei Jing, or Inner Classic, described 160 acupuncture points on the body. Additional acupuncture points were recorded in later texts to include the major 365 acupuncture points in modern use. The classical texts gave general descriptions of the location of acupuncture points, while today we have detailed anatomical charts of their locations. However, because of the dynamic nature of the body and the meridians, the acupuncture points used in a treatment are the points which are most responsive at the time of treatment. A well-trained acupuncturist will palpate the body to find the exact location of each acupuncture point during the treatment, finding areas of depression, tenderness, or other surface changes.

Recently, there is an international movement to standardize the location of all major acupuncture points on the body so that clinical trials and other research can be conducted more efficiently. Each of the acupuncture points has a unique Chinese name which indicates some feature of that point, such as a function or the location of the acupuncture point. In the Western world, we have secondary names for each acupuncture point corresponding to their sequence along their associated meridian. For example, the first acupuncture point of the Lung meridian is named Zhong Fu, but we also refer to it numerically as Lung 1.

Categories of Acupuncture Points

The most important acupuncture points of the Regular meridians are divided into various categories to create the systems of point selection. It is common to find these important acupuncture points located on the limbs of the body, mainly from the elbows to the fingers and the knees to the toes. It is said that in distal areas of the limbs, the Qi is most accessible and has the greatest influence on the body.

The first major category of acupuncture points is the Shu-Transporting points. The Shu-Transporting points are five non-sequential acupuncture points starting at the tips of the fingers and toes on each meridian. Each of these acupuncture points has a special function identified by these labels: Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea. These five acupuncture points on each Regular meridian are also associated with the five elements of Oriental Medicine: Wood, Fire, Earth, Metal, and Water (see the table below). The Jing-Well points are located at the very ends of the fingers and toes; they are used for channel excess conditions and mental illness. The Ying-Spring points are the 2nd points from the ends of the fingers or toes; these acupuncture points are used to treat fevers and other excessive heat conditions. The Shu-Stream points are the third points from the ends of the fingers and toes; they are used for painful obstruction along their meridian and to strengthen their corresponding organ on Yin meridians. The Jing-River points are usually on the forearm or lower leg; these acupuncture points treat cough and voice changes. Finally, the He-Sea points are located around the elbow and knee; they treat vomiting, diarrhea, and Yang organ disease.

Yin Organs		Well	Spring	Stream	River	Sea	Element
		Wood	Fire	Earth	Metal	Water
Greater Yin	Lung (Lu)	11	10	9	8	5	Metal
	Spleen (Sp)	1	2	3	5	9	Earth
Lesser Yin	Heart (Ht)	9	8	7	4	3	Fire
	Kidney (Kd)	1	2	3	7	10	Water
Absolute Yin	Pericardium (Pc)	9	8	7	5	3	Fire
	Liver (Liv)	1	2	3	4	8	Wood

Yang Organs		Well	Spring	Stream	River	Sea	Element
		Metal	Water	Wood	Fire	Earth
Bright Yang	Large Intestine (LI)	1	2	3	5	11	Metal
	Stomach (St)	45	44	43	41	36	Earth
Greater Yang	Small Intestine (SI)	1	2	3	5	8	Fire
	Urinary Bladder (UB)	67	66	65	60	40	Water
Lesser Yang	Triple Heater (TH)	1	2	3	6	10	Fire
	Gall Bladder (GB)	44	43	41	38	34	Wood

Yuan-Source points are acupuncture points on the meridian where the original Qi of the body comes to the surface. This is the third acupuncture point from the extremity on the channel for Yin meridians (same as the Shu-Stream points mentioned above), and mainly used to strengthen the Yin organ. It is commonly the fourth acupuncture point from the extremity on a Yang Meridian, where the point works to expel disease from the Yang organ.

Xi-Cleft points are acupuncture points on the meridian, usually the midway along a limb, where the Qi and Blood plunge deeper into the body. These acupuncture points are mostly indicated for acute painful conditions of a meridian or organ.

Luo-Connecting points are acupuncture points on the meridian where a branch splits from the meridian to connect with its Yin-Yang paired meridian. For example, at Lung 7 on the wrist the Lung meridian branches to connect with the Large Intestine meridian. Luo-Connecting points can be used to treat disease that involves both of the paired organs or meridians.

Back-Shu and Front-Mu points are pairs of acupuncture points on the back and chest of the body that correspond to each internal organ. For Yin organs, the Back-Shu point tonifies and the Front-Mu point regulates the energy of the organ. For Yang organs, the Front-Mu point sedates and the Back-Shu point regulates the energy of the organ.

	Earth				Heaven				Human				Extra
	Lu	LI	St	Sp	Ht	SI	UB	Kd	Pc	TH	GB	Liv	Rn	Du
Yuan-Source	9	4	42	3	7	4	64	3	7	4	40	3
Xi-Cleft	6	7	34	8	6	6	63	5	4	7	36	6
Luo-Connecting	7	6	40	4	5	7	58	4	6	5	37	5	15	1
Front-Mu	Lu1	St25	Rn12	Liv13	Rn14	Rn4	Rn3	GB25	Rn17	Rn5	GB24	Liv14
Back-Shu	UB13	UB25	UB21	UB20	UB15	UB27	UB28	UB23	UB14	UB22	UB19	UB18

Hui-Meeting points are acupuncture points on the body where the energy of specific tissues can be influenced. These tissues include: Yin organs, Yang organs, Qi, Blood, Tendons, Marrow, Bones, and Vessels. For instance if there is a tendon problem in a patient, needling Gall Bladder 34 will help increase the strength of the tendons in the body.

Yin Organs	Yang Organs	Qi	Blood	Tendons	Marrow	Bones	Vessels
Liv13	Rn12	Rn17	UB17	GB34	GB39	UB11	Lu9

Crossing points are acupuncture points on the body where more than one meridian crosses. These acupuncture points are especially useful to alter the Qi flow in more than one meridian by using only a single acupuncture point. Unfortunately, this chart is much too large to list here; however, this information is readily available in acupuncture texts.

Acupuncture Charts

In our discussion so far, we have detailed several major categories of points. However, it is difficult to understand the system of acupuncture without the use of an Acupuncture Chart. An Acupuncture Chart is a diagram of the human body with the acupuncture points and the pathways of the meridians superimposed on the skin. Most of these charts generally show only the external pathways of the 14 major meridians, which include the 12 Primary Meridians and two of the Extraordinary Meridians. In acupuncture textbooks, individual diagrams of a single meridian are able to more clearly show each Regular meridian and its associated Divergent meridian, Luo-Connecting meridian, Sinew and Cutaneous meridians, also including the internal pathways of these meridians. Many different versions of acupuncture charts have been created over the last 2000 years; unfortunately, many of the older versions have been lost.

Point Selection Methods

The methods of selecting acupuncture points for treatment ranges from simple to complex. The most basic approach is to needle local acupuncture points on an area that shows signs of being reactive or tender; these are often called Ashi (That’s It!) acupuncture points. The next level would include selecting points based upon their effect on their connected meridian and organ; these acupuncture points are often distal to their affected area. For example, you can needle the Yuan-Source point of the Lung meridian to tonify the Lung organ for cases of cough, asthma, or other respiratory disorders. A more advanced level includes the use of therapeutic point combinations to strengthen the effect of the treatment. This would include the use of the Yuan-Source point of a meridian and the Luo-Connecting point of its Yin-Yang paired meridian, such as Liver 3 and Gall Bladder 37; this acupuncture point combination is useful for vision degradation.

A more complex method of acupuncture point selection is based on the 5 Element Theory. Pulse diagnosis is used to detect whether the energy of a meridian is in excess or deficiency, Based upon a passage in the NanJing, the Classic of Difficulties, chapter 69, in cases of deficiency tonify the mother; and in cases of excess sedate the son. We need to refer back to the Shu-Transporting Charts above. From these charts, we can identify that each meridian is associated with one of the five elements and each of the Shu-Transporting Points are associated with one of the five elements. An understanding of the Generation cycle of the 5 elements tells us that Earth generates Metal, which generates Water, which generates Wood, which generates Fire, which generates Earth. The cycle repeats to maintain balance and control. As an example, deficiency of the Lung meridian (Metal) would be treated by selecting points on the Lung meridian that generate Metal. Since Earth generates Metal, we needle Lung 9, the Earth point on the Metal Channel. To strengthen our treatment, we also choose to needle the Earth point on the Earth channel, which is Spleen 3. In a case of excess of the Gall Bladder channel (Wood), we would use the son element (Fire). So we needle Gall Bladder 38, the Fire point on the Wood meridian. To assist, we needle Small Intestine 5, the Fire point on the Fire meridian. Since there are two Fire meridians, we also could have chosen Triple Heater 6 as our supporting point.

Many theories and methods of acupuncture point selection have been developed over time, and what we have discussed here are only the most basic methods. This is why the study of classical acupuncture theory is a life long endeavor with clinical experience enhancing the skills of an acupuncturist.

Extra Points

There are hundreds of acupuncture points on meridians that have unique functions and local indications that are used in every treatment. In addition, there are extra points that are not found on the 14 major meridians; these include ear acupuncture points, Korean Hand Therapy points, Scalp acupuncture points, and Master Tung points, to name just a few. In modern times, newer styles of acupuncture have emerged that integrate Western medical knowledge. These systems of acupuncture incorporate the use of nerve motor points, trigger points, and other recent discoveries to enhance the effects and options in acupuncture treatment. With the ability to palpate the body and discovery even more active areas, the real number of acupuncture points is endless; each treatment is truly tailored to meet each individual’s unique condition.

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Acupuncture Styles

There are many different styles of Acupuncture that are practiced today. While Acupuncture originated in China approximately 3,000 years ago, the practice spread over the Asian continent and developed its own regional adaptations. Each of these Acupuncture styles differs in their theory and practice. While they mostly share the same fundamentals of Oriental Medicine, their interpretation of classical texts, such as the Yellow Emperor’s Classic of Internal Medicine (Huang Di Nei Jing), can alter their diagnosis and treatment techniques.

Several modern styles of acupuncture have been developed, incorporating Western medical knowledge, to form hybrid systems of acupuncture. These modern systems of Acupuncture commonly focus on biomedical explanations of how acupuncture works and distill many of the more esoteric aspects of practice.

While all of the classical styles of acupuncture are in agreement on the pathways of the Acupuncture meridians, the exact location of the Acupuncture points does vary. Each style may utilize the acupuncture points with different therapeutic goals in mind, and include a variety of extra points that many not exist in other styles of Acupuncture. Styles can also vary in the needle size, insertion depth and needling technique. Summaries of each major style and high-lights of their differences are shown below.

Chinese Acupuncture

Chinese Acupuncture is one of several treatment modalities within Traditional Chinese Medicine (TCM). In the 1950’s with the rise of Communism, Chairman Mao instituted the formulized development of Traditional Chinese Medicine from the knowledge of the remaining traditional doctors in China. TCM was modernized into a curriculum which included western medicine and was integrated into the hospital care system. This style of acupuncture is taught in most US Acupuncture schools and has a large amount of research from China supporting its methodology. It is the most common form of Acupuncture practiced today.

Some acupuncturists identify more with Classical Chinese Medicine (CCM) verse Traditional Chinese Medicine (TCM), the former is based more on interpretation of classical Chinese medical texts over modern research. The creation of TCM removed many of the more esoteric concepts of Chinese Medicine to focus on methods that could more easily be taught in an institutional settings verse the traditional method of long-term apprenticeships.

Chinese style acupuncture utilizes thicker acupuncture needles compared to other styles, and tends to focus on the “de qi”, or getting Qi, sensation to achieve a clinic result. Some patients may find Chinese style more aggressive in treatment then other styles of acupuncture.

Japanese Acupuncture

Japanese Acupuncture is best known for its use of thinner needles and shallower insertions. It developed approximately 1,500 years ago when the influence of China spread to Japan. The thinner needles were adapted to better suit the more subtle nature of the Japanese culture. In fact, many Japanese-style acupuncturists perform only contact needling, which does not even puncture the surface of the skin.

This “softer” style is very suitable for children who often have fear of needles. Japanese acupuncturists also place less emphasis on the needle sensation as an indication of clinical effectiveness.

There are many styles of Japanese acupuncture practiced in Japan; however in the United States, Meridian Therapy and Kiiko Matsumoto style are the most common. Meridian Therapy focuses on diagnosis via the pulse and meridian palpation, and then uses subtle needle techniques to balance the meridians. Kiiko Matsumoto style of acupuncture utilizes body palpation, especially of the abdomen, to treat the disharmonies that are felt in the body.

Due to the fact that acupuncture spread to Japan long before the Communist revolution in China, Japanese acupuncture has also retained much of the spiritual aspects of the original medicine. Acupuncture is still very popular in Japan today and functions as alternative and complementary care.

Five Element Acupuncture

Five Element Acupuncture is based upon one of the foundational concept of Oriental Medicine: the five elements. The system was made popular in the Western world thought the teaching of the late Professor J. R. Worsley. While this concept of the five elements exists in all classical forms of acupuncture, Five Element acupuncturists focus more on the energetic, spiritual, and emotional components of the Classical Chinese Medicine that were stripped from TCM.

Each patient is diagnosed with a causative factor of one of the five elements: Fire, Earth, Metal, Water and Wood. Various energetic blocks are resolved through acupuncture treatment before a constitutional treatment is performed. Five Element Acupuncturists generally use thinner needles with more subtle stimulation than TCM practitioners.

Auricular Acupuncture

Auricular acupuncture is a microsystem or micromeridian style of acupuncture treatment that maps the entire body onto the ear. Smaller needles, magnets, pellets, and seeds are used to stimulate ear points in order to induce a physiological response. Auricular acupuncture, or ear acupuncture, is commonly used in combination with whole body acupuncture to treat addiction, pain, and stress.

The National Acupuncture Detoxification Association (NADA) Treatment Protocol uses five specific ear acupuncture points on each ear for addiction treatment, and has been very successful in large-scale substance abuse programs worldwide. Auricular acupuncture also works well in Community Acupuncture clinics, where large groups of patients receive acupuncture together, in one single room, at a lower cost than when administered privately.

While this style of Acupuncture originated in China, much of the modern research in Auricular therapy was inspired from the work of French Dr. Paul Nogier. Dr. Nogier’s efforts spread throughout Europe and even back to China. Modern research from both Europe and Asia has formed the system of Auricular acupuncture given today.

Korean Hand Therapy Acupuncture

Korean Hand Therapy (KHT), also known as Koryo Hand Therapy is an acupuncture method invented by Dr. Tae Woo Yoo in 1971. In KHT, the hands are considered a microsystem of the entire body including its meridians, allowing diagnosis and treatment of conditions anywhere in the body by using just the hands. KHT is a very popular form of pediatric acupuncture, highly suitable for children because the needles are so fine and insertions are shallow and gentle. Practitioners also can use magnets, pellets or low-frequency electromagnetic stimulation to achieve results.

Scalp Acupuncture

Scalp Acupuncture, or Zhu's Scalp Acupuncture, is a specialized system of acupuncture for treatment of neurological disorders, including spinal cord injury (SCI) and multiple sclerosis (MS), by needling the scalp. Scalp Acupuncture is especially useful in post-stroke conditions to improve motor and sensory functions. Treatment works best when given as soon as possible after a stroke, ideally within 6 months of the cerebrovascular incident.

Scalp Acupuncture has its own unique treatment zones, apart from Traditional Chinese Acupuncture points. Patients can receive treatment in almost any position, which is ideal for those confined to a hospital bed or wheelchair. The needles used in scalp acupuncture are shorter and thinner than regular needles, and the techniques include rapid manipulation the needles. Scalp Acupuncture is commonly combined with physical and mental exercises called "dao-yin tu-na" to expedite the therapeutic results.

Tung Style Acupuncture

Tung Style Acupuncture is a unique system of acupuncture developed by the late Master Tung Ching Chang in Taiwan. Master Tung became famous due to his ability to achieve rapid results with few needles. While many of the points used by Master Tung were on acupuncture meridians, they were not the standard points used by most acupuncturists.

In Tung style acupuncture, distal points on the limbs are needled that can balance the Qi of the entire body. This technique is achieved though an imaging of the entire body onto the limbs, ear, and scalp. Acupuncture points on the chest and back were also used with bleeding techniques for specific conditions. Tung Style Acupuncture is growing in popularity and is considered highly-effective; however, finding a properly-trained practitioner can be difficult due to the limited transmission of knowledge from close teacher – student lines. Master Tung’s system of acupuncture is also referred to as Master Tong acupuncture or Tung’s Orthodox Acupuncture.

Electro-Acupuncture

Electro-acupuncture is the application of a pulsating electrical current to acupuncture needles as a means of stimulating the acupuncture points. Electo- or Electronic Acupuncture was developed in China as an extension of hand manipulation of acupuncture needles around 1934.

The benefits of using electro-stimulation in conjunction with acupuncture include:

• Electo-acupuncture substitutes for prolonged hand manipulation, assuring that the proper the amount of stimulation is delivered. Extended hand manipulation can lead to the practitioner pausing due to fatigue.
• Electro-acupuncture can produce a stronger level of stimulation, if desired, without causing tissue damage associated with twirling and lifting and thrusting the needle. Strong stimulation may be needed for difficult cases of neuralgia or paralysis.
• It is easier to control the frequency of the stimulus and the amount of stimulus than with hand manipulation of the needles.

More classical style acupuncturists shy away from electo-stimulation since they do not feel the machine can replace the energetic connection and adaptation of technique provided by an experienced practitioner.

Balance Method Acupuncture

Balance Method Acupuncture is best known for its ability to relieve pain instantly. While the style is taught by Dr. Richard Tan, much of the theoretical knowledge came from the work of Dr. Chao Chen and Master Tung. Dr. Tan has synthesized and improved on his predecessors’ work by further expanding the system and creating methods to easily train other acupuncturists. The method uses distal points on the limbs to image the entire body for balancing of the meridians. Much of the theory is based upon the Yi Jing (I Ching or Book of Changes). In addition to its success at treating pain conditions, Balance Method acupuncture is also effective in treating other health problems with equally impressive results.

Laser Acupuncture

Laser Acupuncture is the use of a low-level laser to treat acupuncture points. Currently, Laser acupuncture is considered an investigational therapy by the FDA. However, there is growing interest in the use of lasers due as some suggest they are as effective as acupuncture needles and pain-free.

Buddhist Meditation

The Techniques of Meditation  

The seventh step of the Noble Eightfold Path is termed right mindfulness, also called the four foundations of mindfulness and Satipatthana. The three terms are synonymous and encompass not only the most important aspects of Theravada meditation but also one of the most unique and important features of all Buddhism. A full explanation of mindfulness or Satipatthana is given in the Satipatthana Sutta, which appears twice in the Pali canon. The Buddha begins the discourse as follows:

 This is the only way, monks, for the purification of beings, for the overcoming of sorrow and lamentation, for the destruction of suffering and grief, for reaching the right path, for the attainment of Nibbana, namely the Four Foundations of Mindfulness.[11]

This same message he repeated frequently:

 Those for whom you have sympathy, O monks, those who deem it fit to listen to you — friends and companions, kinsmen and relatives — they should be encouraged, introduced to and established in the four foundations of mindfulness.[12]

And again:

 There are three taints (asava or cankers), O monks: the taint of sensuality, the taint of desire for renewed existence, and the taint of ignorance. For eliminating these three taints, O monks, the four foundations of mindfulness should be cultivated.[13]

This same emphasis has persisted even to the present era in some sections of the Buddhist world, as described by the Venerable Nyanasatta Thera:

 The great importance of the Discourse on Mindfulness (i.e., the Satipatthana Sutta) has never been lost to the Buddhists of the Theravada tradition. In Ceylon, even when the knowledge and practice of the Dhamma was at its lowest ebb through centuries of foreign domination, the Sinhala Buddhists never forgot the Satipatthana Sutta. Memorizing the Sutta has been an unfailing practice among the Buddhists, and even today in Ceylon there are large numbers who can recite the Sutta from memory. It is a common sight to see on full-moon days devotees who are observing the eight precepts, engaged in community recital of the Sutta. Buddhists are intent on hearing this Discourse even in the last moments of their lives; and at the bed-side of a dying Buddhist either monks or laymen recite this venerated text.[14]

Thus it seems a paradox that most Western texts on Buddhism merely list right mindfulness as one of the steps of the Eightfold Path and say little more except to redefine it by such terms as "right contemplation" and "right reflection." The reason is probably twofold. First, Satipatthana cannot be as concisely explained as the other seven steps; for it is not a single step but includes instead several distinct meditation exercises. Second, to be properly understood the Satipatthana Sutta must be examined from a psychological and psychiatric viewpoint. Most scholars of comparative religion are accustomed to approaching their studies from religious, ethical, or philosophical frames of reference, but none of these orientations apply here. If this sutta alone was to be filed on the shelves of a public library, it would most aptly be placed adjacent to the archives of eclectic psychiatry and would have little in common with the classic writings of religion and philosophy. Even psychology would not be an appropriate title, for the sutta is not concerned with any theoretical or conceptual interpretation of the mind. It deals only with the empirical facts of conscious experience and prescribes the techniques for mental development. It is, therefore, not surprising that many Occidentals who have scanned the pages of the Satipatthana Sutta have judged it confusing, meaningless, and sometimes morbid.

In addition to the two occurrences of the Satipatthana Sutta, condensed versions of the same teaching appear several times in the Sutta Pitaka.

The four parts of the four foundations of mindfulness are: contemplation of the body, contemplation of feelings, contemplation of mind, and contemplation of mental objects. The body contemplation is itself divided into six parts — breathing, postures, clear comprehension of action, repulsiveness, material elements, and the cemetery meditations.

Mindfulness of Breathing  

The initial endeavor in Buddhist meditation is to calm and quiet the mind so that it is fully alert but has temporarily diminished the quantity of daydreaming, planning, reminiscing, and all other forms of verbal and visual thinking. This goal can only be approached gradually, and therefore the beginner should start his practice by focusing his attention on some quiet, readily available, rhythmic process. Respiratory movements are ideal for this purpose. Thus the first exercise of the sutta begins:

 Herein, monks, a monk having gone to the forest, to the foot of a tree, or to an empty place, sits down cross-legged, keeps his body erect and his mindfulness alert. Just mindful he breathes in and mindful he breathes out. Breathing in a long breath, he knows "I breathe in a long breath"; breathing out a long breath, he knows "I breathe out a long breath"; breathing in a short breath, he knows "I breathe in a short breath"; breathing out a short breath, he knows "I breathe out a short breath." "Conscious of the whole (breath-) body, I shall breathe in," thus he trains himself. "Conscious of the whole (breath-) body, I shall breathe out," thus he trains himself. "Calming the bodily function (of breathing), I shall breathe in," thus he trains himself. "Calming the bodily function (of breathing), I shall breathe out," thus he trains himself. As a skillful turner or his apprentice, making a long turn, knows "I am making a long turn," or making a short turn, knows "I am making a short turn," just so the monk breathing in a long breath, knows "I breathe in a long breath"; breathing out a long breath, he knows "I breathe out a long breath."...

The practitioner endeavors to keep his mind focused only on the act of breathing itself and not to think about breathing as a subject of intellectual contemplation. In other words, one attempts to give full attention to the reality of immediate experience and not become involved in speculations or contemplations about reality.

The theory is quite simple but the practice most difficult. In a typical case, at the beginning of his meditation the novice directs his attention solely to the process of breathing. Then after a few seconds, he inadvertently begins to think, "So far I am doing all right. My mind hasn't strayed from its subject." But at this very moment he has strayed from his subject. For now he is not concentrating but thinking about concentrating. If he does not catch himself (and he probably will not), the stream of consciousness will proceed something as follows: "My mind hasn't strayed from its subject. I'm doing better than yesterday. I wonder why? Maybe it's because I've finished all of my letter writing. I wonder if Marvin will answer the letter I sent him? He hasn't... Oh, Oh! I've gotten off the subject. I'd better get back to it. But I'm not really back; I'm just thinking about it. I wonder how long it will take me..." And so on it goes, day after day, week after week until the practitioner begins to wonder if he is not seeking the impossible. Yet the fact remains that many thousands living today have achieved this degree of concentration. With little short of amazement, the Western novice reads the Venerable Nyanaponika Thera's remarks concerning Burmese Satipatthana training: "Three to four hours of continuous mindfulness, i.e., without unnoticed breaks, are regarded as the minimum for a beginner undergoing a course of strict practice."[15]

The most widely practiced form of the breathing meditation is focusing attention at the nostrils where one feels the faint pressure of the ebb and flow of the breath. This technique is not mentioned in any of the recorded teachings of the Buddha or his disciples but has been popular at least since the time of Buddhaghosa in the fifth century A.D. In the words of Buddhaghosa:

 This is the simile of the gate-keeper: just as a gate-keeper does not examine people inside and outside the town, asking "Who are you? Where have you come from? Where are you going? What have you got in your hand?" — for those people are not his concern — , but does examine each man as he arrives at the gate, so too, the incoming breaths that have gone inside and the outgoing breaths that have gone outside are not this monk's concern, but they are his concern each time they arrive at the (nostril) gate itself.[16]

And again, in the simile of the saw, the woodcutter's attention is focused only at the point of contact between the saw and the wood:

 As the saw's teeth, so the in-breaths and out-breaths. As the man's mindfulness, established by the saw's teeth where they touch the tree trunk, without his giving attention to the saw's teeth as they approach and recede, though they are not unknown to him as they do so, and so he manifests effort, carries out a task and achieves an effect, so too the bhikkhu sits, having established mindfulness at the nose tip or on the upper lip, without giving attention to the in-breaths and out-breaths as they approach and recede, though they are not unknown to him as they do so, and he manifests effort, carries out a task and achieves an effect.[17]

Modifications of the breathing meditation can be applied to suit individual requirements. In the early stages of practice many persons find that mentally counting the breaths enhances concentration. In these instances one is advised not to count less than five or more than ten. Upon reaching ten the counting starts over. By going beyond ten, the counting rather than the breathing is likely to become the subject of one's attention:

 Herein, this clansman who is a beginner should first give attention to this meditation subject by counting. And when counting, he should not stop short of five or go beyond ten or make any break in the series. By stopping short of five his thoughts get excited in the cramped space, like a herd of cattle shut in a cramped pen. By going beyond ten his thoughts take the number (rather than the breaths) for their support.[18]

But how long is he to go on counting? Until, without counting, mindfulness remains settled on the in-breaths and out-breaths as its object. For counting is simply a device for settling mindfulness on the in-breaths and out-breaths as object by cutting off the external dissipation of applied thoughts.[19]

In the initial stages of practice one merely observes the process of breathing without attempting to change its rate or depth. Later, as concentration is achieved, the breathing is gradually and deliberately slowed in order to further quiet the mind. There is, however, no attempt to stop respiration as in certain yogic practices:

 When his gross in-breaths and out-breaths have ceased, his consciousness occurs with the sign of the subtle in-breaths and out-breaths as its object. And when that has ceased, it goes on occurring with the successively subtler signs as its object. How? Suppose a man struck a bronze bell with a big iron bar and at once a loud sound arose, his consciousness would occur with the gross sound as its object; then, when the gross sound had ceased, it would occur afterwards with the sign of the subtle sound as its object; and when that had ceased, it would go on occurring with the sign of the successively subtler sound as its object.[20]

It was a Burmese meditation teacher, Venerable U Narada (Mingun Sayadaw), who in the early part of this century, stressed the application of mindfulness of breathing as a means of cultivating direct awareness. It was he who gave the first strong impetus to the revival of Satipatthana meditation in contemporary Burma. He passed away in 1955 at the age of 87 and is said by many to have realized Nibbana.

A variation of the breathing meditation was developed by another Burmese monk, the Venerable Mahasi Sayadaw, who was a pupil of the Venerable U Narada. His technique involves focusing attention upon the respiratory movements of the abdomen instead of the sensation at the nostrils. This system has become popular in several parts of southern Asia. A revived interest in meditation has developed in that section of the world, especially in Burma, where numerous training centers have been established, and thousands of monks and lay people have received instruction.[21]

During meditation, when the practitioner finds that his mind has strayed from its subject, there should be no attempt to suppress or forcibly remove the extraneous thoughts. Rather he should briefly take mental note of them and objectively label them with some appropriate term. This may be done by thinking to himself "planning," "remembering," "imagining," etc., as the case may be. Then he should return to his original meditation subject. However, if after several tries the unwanted thoughts persist, he should temporarily take the thoughts themselves as the meditation subject. In so doing their intensity will diminish, and he can then return to his original subject. This same technique can be used for distracting noises. It can also be used for feelings of anger or frustration, which may develop as the result of unwanted thoughts or distractions. In these instances the meditator should think to himself "noise," or "irritation."[22]

As the mind becomes quiet and verbal thinking begins to diminish, other stimuli come into awareness. Among these are sensations, such as itches and minor pains, which are always present but go unnoticed because attention is directed elsewhere. The same may occur with emotions such as worry or fear, and these we shall discuss in detail later. Pictures or visual scenes may arise and are often so vivid as to be termed visions or hallucinations. They often have the appearance of dreams or distant memories and differ from thoughts in that the meditator usually finds himself a passive spectator not knowing when such scenes will arise or what forms they will take. The meditator should first attempt to ignore these sensations, feelings, and pictures. This failing, he should label them "itching," "fear," "picture," etc., and lastly make them his meditation subject until they diminish.[23]

To be successful, meditation should not be an unpleasant experience. Strain and tension should be minimized. Therefore, if the practitioner finds himself becoming tense, irritable, or fatigued during meditation, he may wish to terminate the practice until he acquires a better state of mind.

Mindfulness of Postures and of Actions  

Following mindfulness of breathing, the next exercise prescribed in the Satipatthana Sutta is the development of the same clear awareness towards one's daily actions. Thus the Buddha continues:

 And further, monks, a monk knows when he is going "I am going"; he knows when he is standing "I am standing"; he knows when he is sitting "I am sitting"; he knows when he is lying down "I am lying down"; or just as his body is disposed so he knows it.

And further, monks, a monk, in going forward and back, applies clear comprehension; in looking straight on and looking away, he applies clear comprehension; in bending and in stretching, he applies clear comprehension; in wearing robes and carrying the bowl, he applies clear comprehension; in eating, drinking, chewing and savoring, he applies clear comprehension; in attending to the calls of nature, he applies clear comprehension; in walking, in standing, in sitting, in falling asleep, in walking, in speaking and in keeping silence, he applies clear comprehension.

Here we note a similarity between early Buddhism and Zen. Or as the Zen master would say: "In walking, just walk. In sitting, just sit. Above all, don't wobble."

Usually while dressing, eating, working, etc., we act on habit and give little attention to our physical actions. Our minds are preoccupied with a variety of other concerns. In Satipatthana, however, the practitioner devotes himself entirely to the situation at hand. Persons interested in meditation are often heard to complain, "But I don't have time to meditate." However, the form of mindfulness we are now discussing can be practiced at all times and in all situations regardless of one's occupation or social and religious commitments.

As with breathing meditation, the primary intent of this discipline is to prepare one's mind for advanced stages of psychological development. However, a valuable by-product is that it can greatly increase one's proficiency at physical skills. In Japan, Zen practitioners have utilized it to achieve mastery in swordsmanship, archery, and judo. The Buddha himself is quoted: "Mindfulness, I declare, O monks, is helpful everywhere."[24] And again:

 Whosoever, monks, has cultivated and regularly practiced mindfulness of the body, to whatever state realizable by direct knowledge he may bend his mind for reaching it by direct knowledge, he will then acquire proficiency in that very field.[25]

For one engaged in strict monastic training, mindfulness of actions becomes a more formalized practice. Breathing and walking meditations often are alternated for periods of about thirty minutes each. In walking the monk paces slowly along a level stretch of ground and directs his attention fully to the movement of each foot, thinking: "lift" — "forward" — "down" — "lift" — "forward" — "down." This alternation of breathing and walking practice may last sixteen hours each day for a period of six or more weeks.

Buddhist Meditation

GOALS AND PREPARATIONS

The Goals of Meditation  

Before discussing the techniques of meditation, it is important that we first define its goals. That is, why does one meditate? What does one hope to achieve?

The ultimate goals of meditation are the ultimate goals of Buddhism, i.e., realization of Nibbana and the abolition of dukkha or suffering. Nibbana, however, is beyond the realm of conceptualization and all other forms of normal human experience. Therefore, we have no certainty that it exists until we ourselves have progressed to realizing it as a direct experience transcending logic and sense perception. Nibbana can thus be defined as that which is experienced when one has achieved ultimate moral and psychological maturation. Little more can be said.

Therefore the Buddha said relatively little about Nibbana and instead directed most of his teachings towards two lesser goals which are empirical realities of readily demonstrable worth. These were, first, the increase, enhancement, and cultivation of positive feelings such as love, compassion, equanimity, mental purity, and the happiness found in bringing happiness to others. Secondly, he advocated the relinquishment and renunciation of greed, hatred, delusion, conceit, agitation, and other negative, unwholesome states.

As we gain in experience and self-understanding, and as we acquire full appreciation for the nature and quality of our own feelings, we find that the positive feelings (love, compassion, etc.) are satisfying, meaningful, and wholesome experiences in and of themselves. That is, they have their own inherent worth and intrinsic value independent of any world view or religious dogma. Conversely, greed, hatred, lust, etc., are agitating, discomforting experiences (i.e., dukkha) which when present preclude a full realization of the happiness born of love and equanimity. Thus the realization of positive feelings and relinquishment of negative feelings are the major goals and motivations of meditation.

While Nibbana and an end of suffering are the primary goals of meditation and the realization of positive feelings is a secondary goal, there are also several tertiary goals which must be achieved before the higher ones can be fully realized. These are non-attachment, insight, and concentration.

Non-attachment is freedom from craving and freedom from infatuation for sensual experience. It is not a state of chronic apathy nor a denial of sense perception existence. Rather it is psychological liberation from our "enslaving passions and our addictions to sensual and emotional pleasures." Thus non-attachment is akin to freedom, equanimity, and serenity.

Insight is a word with two meanings both of which are sought in Buddhist meditation. In its classical Buddhist usage insight (vipassana) means full awareness of the three characteristics of existence, i.e., impermanence, suffering (dukkha), and impersonality. Otherwise stated, this means full realization of the fact that all things in the universe are temporary and changing; the human psyche is no exception and thus is not an immortal soul; and as a consequence suffering is always inevitable, for no state of mind, pleasant or unpleasant, can endure forever. The word "awareness" is italicized here to distinguish it from mere conceptual knowledge, which is usually insufficient to have lasting effect upon one's feelings and values.

In its psychiatric usage insight means gaining awareness of those feelings, motives, and values which have previously been unconscious. Repressed feelings of guilt, fear, lust, and hatred may lurk in the hidden recesses of our minds and unconsciously shape our lives until such time as they are brought into awareness. And unless they are brought into awareness, we cannot effectively deal with them. In Buddhism this version of insight is included under the heading of mindfulness and will be discussed later.

Concentration involves the ability to keep one's attention firmly fixed on a given subject for protracted periods of time, thus overcoming the mind's usual discursive habit of flitting from subject to subject. As we shall see, concentration is one of the earliest goals of Buddhist meditation.

Preparations  

The initial endeavor in Buddhist meditation is to quiet the mind and enhance detachment and objectivity. For only when the mind has stilled its perpetual ruminating and has momentarily abandoned its fascination for sensory experience can it readily become aware of the unconscious feelings and motivations which shape our thoughts, speech, and behavior. Furthermore, only with detached objectivity and its ensuing insights can we readily confront and renounce unwholesome feelings. On the other hand, we do not achieve complete calmness and detachment so long as we harbor unwholesome feelings and unconscious emotional conflicts. Thus the process is reciprocal: the more we quiet the mind, the more we gain insight and relinquishment of undesirable feelings. The more we relinquish such feelings and resolve emotional conflicts, the more we quiet the mind and approach perfect calmness, detachment, and objectivity.

The obscuring of unconscious feelings by preoccupation with thoughts and actions is demonstrated in a variety of neurotic symptoms. Most characteristic are obsessive compulsive reactions; these occur in persons who are desperately trying to repress overpowering impulses of fear, anger, lust, or guilt. In order to achieve this repression they divert nearly all their attention to some repetitious mental or physical activity, which is conducted in a compulsive, ritualistic manner. If prevented from performing their defensive rituals, they often become acutely anxious and even panic as their unconscious feelings begin to come into awareness. Less severe examples of the same defensive phenomena are seen in persons who are chronically anxious and are continuously focusing their worries on minor concerns of exaggerated importance such as unpaid bills, social commitments, and alleged physical ills. They, too, rarely relax and are forever busy with petty chores.

These neurotic symptoms are strikingly similar to an increasingly common way of life in Western society. Our ever-expanding populations with their accompanying advertising, mass entertainment, socializing, industrialization, and emphasis upon success, sensuality, and popularity have produced an environment in which we are forever bombarded with an increasing number of sensory and emotional stimuli. The opportunities for solitude and introspection have diminished to the point that now solitude is often viewed as either depressing or abnormal. This is not to assert that the majority of our citizens are involved in a frantic endeavor to escape from their inner selves. Such is no doubt the case with many, but there still remains a sizeable percentage of people who are involved in the same frenzy only because they have conformed to the social norm and have been lured into a habitual fascination for television, jazz, sports, and the countless other forms of readily-available entertainment. Such persons are not necessarily precluded from relative happiness and emotional well-being.

The point to be made, however, is that the conditions of modern living are such as to pose several obstacles to successful meditation. These are threefold: psychological, material, and social. These same obstacles are present to a lesser degree in traditionally Buddhist cultures and must be considered before discussing meditation itself.

Preparations  

The initial endeavor in Buddhist meditation is to quiet the mind and enhance detachment and objectivity. For only when the mind has stilled its perpetual ruminating and has momentarily abandoned its fascination for sensory experience can it readily become aware of the unconscious feelings and motivations which shape our thoughts, speech, and behavior. Furthermore, only with detached objectivity and its ensuing insights can we readily confront and renounce unwholesome feelings. On the other hand, we do not achieve complete calmness and detachment so long as we harbor unwholesome feelings and unconscious emotional conflicts. Thus the process is reciprocal: the more we quiet the mind, the more we gain insight and relinquishment of undesirable feelings. The more we relinquish such feelings and resolve emotional conflicts, the more we quiet the mind and approach perfect calmness, detachment, and objectivity.

The obscuring of unconscious feelings by preoccupation with thoughts and actions is demonstrated in a variety of neurotic symptoms. Most characteristic are obsessive compulsive reactions; these occur in persons who are desperately trying to repress overpowering impulses of fear, anger, lust, or guilt. In order to achieve this repression they divert nearly all their attention to some repetitious mental or physical activity, which is conducted in a compulsive, ritualistic manner. If prevented from performing their defensive rituals, they often become acutely anxious and even panic as their unconscious feelings begin to come into awareness. Less severe examples of the same defensive phenomena are seen in persons who are chronically anxious and are continuously focusing their worries on minor concerns of exaggerated importance such as unpaid bills, social commitments, and alleged physical ills. They, too, rarely relax and are forever busy with petty chores.

These neurotic symptoms are strikingly similar to an increasingly common way of life in Western society. Our ever-expanding populations with their accompanying advertising, mass entertainment, socializing, industrialization, and emphasis upon success, sensuality, and popularity have produced an environment in which we are forever bombarded with an increasing number of sensory and emotional stimuli. The opportunities for solitude and introspection have diminished to the point that now solitude is often viewed as either depressing or abnormal. This is not to assert that the majority of our citizens are involved in a frantic endeavor to escape from their inner selves. Such is no doubt the case with many, but there still remains a sizeable percentage of people who are involved in the same frenzy only because they have conformed to the social norm and have been lured into a habitual fascination for television, jazz, sports, and the countless other forms of readily-available entertainment. Such persons are not necessarily precluded from relative happiness and emotional well-being.

The point to be made, however, is that the conditions of modern living are such as to pose several obstacles to successful meditation. These are threefold: psychological, material, and social. These same obstacles are present to a lesser degree in traditionally Buddhist cultures and must be considered before discussing meditation itself.