Interpersonal aspects of meditative traditions

Author: Jyotsna Agrawal*, Poonam Bir Kaur Sahota** *Assistant Professor (corresponding author), ** M.Phil Scholar, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore Contact details of corresponding author: Postal address: Department of Clinical Psychology, NIMHANS, Bengaluru, 560029 Email id: [email protected]

Biographical sketch

Dr. Jyotsna Agrawal is currently an Assistant Professor in the Positive Psychology unit, Department of Clinical Psychology, at National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, from where she had earlier completed her M.Phil and Ph.D. She is also the faculty in-charge of VIPRA (Vedic Indian Psychology Research and Application) division in the department, under which she has set up two clinics Sattva and Swasthya. Prior to NIMHANS she has served as a faculty at Indian Institute of Technology Patna, as a Research Officer at Community Empowerment Lab Lucknow and as a Senior Officer at Tata Motors Ltd. Jamshedpur. She was awarded Fogarty postdoctoral fellowship at Washington University School of Medicine at St. Louis, USA and postdoctoral fellowship at S-VYASA University Bangalore. Her research interests include positive psychology, preventive and promotive approaches towards public mental health, psychotherapy, Indian psychology and yoga. She has several publications in the field and is also supervising M.Phil and Doctoral level research in this area.

Ms. Poonam Bir Kaur Sahota, is completing her M.Phil degree in Clinical Psychology at Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore. She has done her M.A. in Psychology from Delhi University. She has deep interest in Indian psychology and has been part of many workshops on Yoga and Indian Psychology. She has done a one-month short term course on Vedanta and Life, from Bharatiya Vidya Bhavan, New Delhi.

Key words: , interpersonal, , loving kindness Introduction/ Background

Meditative traditions

Meditation is considered as ‘a means or technique to control the mind’ (Rao and Paranjpe 2016). It is ‘deep exploration of mind towards a profound alteration of our being’ (Goleman and Davidson, 2017). In last few decades much attention has been given to meditation, which is considered to be a family of self-regulation practices directed at training of attention and awareness for bringing mental processes under greater voluntary control (Walsh and Shapiro, 2006, p. 228). This stream of research has empirically supported various beneficial effects of meditation in improving health and well-being (Brand, Holsboer-Trachsler, Naranjo, and Schmidt 2012; Davidson and McEwen 2012; Kaliman et al. 2014; Ospina et al. 2007; Sedlmeier et al. 2012).

There are various types of and a common way to categorize them has been open awareness versus focused attention types. meditation is considered to be an open awareness type of meditation, where the attention is directed at the mental content or the current feelings or sensorial experiences with a non-judgmental attitude (Hofmann et al. 2011). The other type of meditation is focusing one’s attention on a specific idea, image, sound etc. The focus of attention differs as per the tradition / technique. Such concentrative meditations have its own usefulness in terms of cultivating states of mind, specific skills or attitudes and have been discussed in Yogic-Vedantic traditions, as well as in .

When it comes to application of meditation as a mental health intervention, research has predominantly focused upon the beneficial aspects of mindfulness meditation. Psychotherapy based on mindfulness meditation has empirically demonstrated reduction in negative psychological states, such as stress, anxiety and depression (Hofmann et al. 2011). Further, traditionally literature has focused more on the inner and transcendental experiences associated with these meditative traditions.

However, the meditative traditions with its long and varied streams also include interpersonal aspects, however research in this area trails behind. Only in recent times the exploration of meditation has widened to include other types of meditations. The interpersonal aspects are about relationship between individuals and/or actual or imagined presence of other people. In the meditative tradition, it means focusing attention for cultivating attitudes favorable to other people. Such interpersonal aspects need to be studied, as much as cognitive-affective aspects of meditation. These aspects are useful in the modern world, where majority of meditation practitioners live a life populated with interpersonal joys, interactions, concerns and suffering, which is intimately related to their mental health. Since ancient times in India, there has been an emphasis on the development of qualities called ‘Brahmavihāra’, a term used for loving-kindness (maitri/ mettā), compassion (karuṇā), empathetic/ appreciative joy (muditā) and (upeksha/ upekkhā, or samata). These emotions and attitudes are positive and interpersonal in its focus.

Positive interpersonal aspects: Attitudes and emotions

Attitudes are predispositions towards something and are a combination of thoughts and beliefs (cognitions) and feelings (affect). These attitudes can influence behaviours, on the other hand behaviours can also influence attitudes. Similarly, emotions comprising of subjective experiences, physiological aspects and behavioural reactions (Nairne 2000) can influence attitudes. One broad group of emotions have been categorised as social emotions, such as shame, empathy etc., since these are exclusively associated with social concerns, involve social appraisal and have a social function (Bucks 1999). Another way to categorise emotions are based on positive and negative valence, with positive emotions linked to approach motivation. Cultivation of positive emotions have been found to undo the after effects of negative emotions, while also building cognitive and social resources (Broaden and build theory, Fredrickson 2001). Although no single theory has been proposed to tie a variety of positive interpersonal emotions together, the concept of may easily do so.

Brahmavihara

Sarve bhavantu sukhina (May all be happy) Sarve santu nirāmayāḥ (May all be free from infirmities); Sarve bhadrāṇi paśyantu (May all see good) Maa Kaschid Dukha Mapnuyat. (May none have misery of any sort) Shanthi Shanthi Shanthi. (Om, peace, peace, peace) - Vājasaneya Saṁhitā of Sukla Yajurveda

The term literally means ‘divine abode’ (‘’ + ‘’) or living in a sublime realm with loving-kindness (maitri/ mettā), compassion (karuṇā), empathetic, appreciative joy (muditā) and equanimity (upeksha/ upekkhā, or samata). These are cultivated without limits and discrimination, and thus are also called four immeasureables (apramana) or illimitable (Bodhi 1993).

This practice is considered pre-Buddhist (Hindu) and extra Buddhist (Jain) in its origin, with references present in , Upanishads, , Bhagawad Gita, Yoga Vashistha and Patanjali Yoga . Chandogya Upanishad states matri and ahimsa lead to Brahmaloka. Similarly, ancient figures practicing brahma-vihara are mentioned in Buddhist text (e.g. King Govinda). The practice of Brahmavihara was later assimilated in Buddhism (Wiltshire 1990; Harris 2001; Aronson 1996).

The four Brahmavihara / immeasurables

1. Maitri / Metta/ Loving-kindness (Sarve bhavantu sukhina)

The root of the term ‘Mitra’ in Samskrit means to embrace, to contain and hold, and to link together the parts or materials of a whole. Mitra means friend and maitri is the quality of being a friend. It is interesting to note that the earliest mention of this psychological quality may be in the form of Mitra, the Vedic God of truth, dawn and friendship, who abhors violence.

“Mitra is considered to be the Lord of Love, a divine friend, a kindly helper, the most beloved of the Gods as he brings in our reach divine enjoyment and perfect happiness. He creates in us a happy rightness of mind and feeling—sumati, a state of grace, an unhurt abiding-place within, “free from all undelightfulness. Often invoked in company of Varuna, since Mitra cannot fulfil his harmony, except in the wideness and purity of Varuna.” (- Sri Aurobindo, in The Secret of the Vedas).

In later , Metta () is described by as the inner state of being a friend (mittassabhāvo-mettā), having unconditional, sibling like affection and goodwill for others, which is free from lustful attachments. It can be cultivated by developing affectionate connection some commonality and oneness with others, and once present, it results in removal of ill will and hatred. However, one has to be careful not to misunderstand it with selfish love/ lust, which is considered to be a close enemy. Another barrier is having ill-will/ hatred towards others (Aronson 1996). Maitri is the foundation, on which other brahmaviharas are built.

In modern research on loving kindness meditation, various beneficial outcomes have been reported, such as increase in positive emotions, building of personal resources, such as mindfulness, acceptance, purpose in life, self-compassion, social support and enhanced life satisfaction along with decrease in illness symptoms, self-critical perfectionism and depressive symptoms (Fredrickson et al. 2008; May et al. 2012; Shahar et al. 2015).

There have been fewer clinical studies, although the practice of loving kindness meditation was found to be applicable and beneficial in 2 studies, although with small sample sizes, in patients having Schizophrenia Spectrum Disorder with prominent negative symptoms, leading to reduction in negative symptoms, anhedonia, asociality and avolition. Simultaneously, there were improvements in terms of positive emotions, hope, environmental mastery, self-acceptance, satisfaction with life and psychological recovery (Johnson et al. 2009; Johnson et al. 2011). In war veterans with Post-Traumatic Stress Disorder, Kearney and his colleagues (2013) found enhanced self-compassion and mindfulness and lower levels of depression and PTSD symptoms.

2. Karuna/ Compassion (Sarve santu nirāmayāḥ)

Karuna or compassion is the practice of cultivating kindness for others. It is triggered by seeing someone helpless amidst pain and suffering, resulting in a wish to protect them and end their difficulties, while also wishing for their happiness (e.g., maa Kaschid Dukha Mapnuyat). It leads to peaceful and harmless thoughts, avoidance of injury, violence or cruelty. Karuna is not pity, which is colored by egoism. It is also different from loving-kindness which aims to develop unconditional love and kindness while compassion practice focuses on cultivating deep, genuine sympathy for those in misery (Grossman and Van Dam 2011; Hopkins 2001). Although both forms of these meditations which are interpersonal in their approach have an important role in the mindfulness practice (e.g., Bodhi 2005; Kuan 2008; Sanharakshita 2004; Shen-Yen 2001; Suzuki 2011). Empirical research has also indicted that the effects of Mindfulness Based Cognitive Therapy are mediated by self-compassion and mindfulness both (Kuyken et al. 2010). In modern intervention research, a variety of programs have been developed aiming towards compassion for self and others (Gilbert and Procter 2006; Leary et al. 2007). When one generates a desire to heal oneself, while being kind and mindful, it is considered as self-compassion and includes awareness of one’s shared humanity. In a series of studies, Leary and his colleagues (2007) found self-compassion reduces people’s emotional and cognitive reactions to negative events and has a protective effect especially in those with low self-esteem. Those high on self- compassion are also less defensive and able to take personal responsibility in negative events. Gilbert and Procter (2006) developed a self-compassion intervention program (compassionate mind-training) to targets self-criticism and shame by enhancing self- soothing for negative emotions. This program was tested in personality and mood disorders resulting in improvement in anxiety, depression, and self-criticism. On the other hand, in participants diagnosed with paranoid schizophrenia having hostile auditory hallucinations leading to decrease in depression, psychoticism, anxiety, paranoia, Obsessive-Compulsive Disorder and interpersonal sensitivity along with malevolence and persecutory nature of auditory hallucinations decreased and became more reassuring (Mayhew and Gilbert 2008).

Other directed compassion is often conducted jointly with loving kindness meditation and studied. Increased activation of circuitry related to empathy and theory of mind have been found in FMRI studies on combination of compassion and living kindness meditation (Lutz et al. 2008). Another program, cognitive based compassion training (CBCT) was found beneficial for social cognition and empathic accuracy (Mascaro et al. 2013).

3. / Sympathetic Joy or appreciative Joy (Sarve bhadrāṇi paśyantu)

Muditā is the feelings of joy or delight at the happiness or well-being of others. It is triggered by seeing happiness, good fortune, or prosperity of others and leads top removal of envy, jealousy or dislike. Empirical research in past has usually focused on either loving-kindness meditation or compassion meditation, or an integration of these. Zeng and his colleagues (2017) conducted the first study comparing Appreciative Joy Meditation (AJM) and Compassion Based Meditation (CM) and found that both AJM and CM promote pro-socialness and enhance positive other- focused emotion,s but CM group reported increased sadness and decreased happiness, whereas AJM group reported enhanced happiness and suppression of interpersonal negative emotions. Later, Zeng and his colleagues (2018) developed an intervention program Heart of Joy, focusing on appreciative Joy Meditation. They reported it led to higher other-focused emotions (pro- socialness), positive emotions, life satisfaction and lower negative emotions and envy.

4. Upeksha / Equanimity (Om Shanthi Shanthi Shanthi)

Upeksha, or equanimity indicates towards a mind which is balanced and peaceful, in spite of attraction or repulsion without experiencing the roller coaster ride of elation and depression. In interpersonal context, it is characterized by impartiality and equal-vision, without attachment or aversion to others. It is supposed to be developed by having a perspective about larger laws of nature (karma) and taking an impartial witness stance. Upeksha seems to be complex process and is hardest to cultivate. In the psychological literature, equanimity has been described as including a variety of processes from psychological self-distancing or meta-awareness, accepting, non- judging, non-attachment, patience etc. It may not only result in decreased emotional and physiological reactivity, rumination, depression but also facilitate adaptive self- reflection, by maintaining calm and mental equilibrium even when provoked (Ayduk and Kross 2008; Kross, Ayduk, and Mischel 2005; Kross and Ayduk 2008, Teasdale et al. 2002, Carmody et al. 2009; Desbordes, Gard, Hoge and Holzel 2015).

Taking a stance of an impartial witness to one's experiences is like psychological self-distancing and meta-awareness, which is required for therapeutic change through facilitating self-reflection, decreasing emotional and physiological reactivity and rumination (Ayduk and Kross 2008; Kross, Ayduk, and Mischel 2005; Kross and Ayduk 2008). By treating thoughts as transient and insubstantial mental events, inner space can be created, extinguishing habitual maladaptive behavior responses and allowing choice of an optimal response based on the current situation. Thus, it may promote cognitive flexibility and psychological health (Kashdan and Rottenberg 2010). Another interesting take on equanimity was provided by Hadash, Segev, Tanay and Goldstein (2016). They conceptualized equanimity as an intentional attitude of acceptance of experiences regardless of its hedonic tone, along with reduction of autonomic reactivity. Further it includes decoupling of desire from the hedonic tone of current or anticipated experience. This model includes higher acceptance and capacity to tolerate distress, while there is lower experiential avoidance or thought suppression present. This may lead to decreased anxiety sensitivity and cognitive reactivity to mood (Hadash, Segev, Tanay and Goldstein 2016). The commonest intervention for enhancing equanimity studied is related to mindfulness. In a study, Hadash, Segev, Tanay and Goldstein (2016) found reduction in reactivity to unpleasant hedonic tone just after four sessions, however that did not lead to attitude of acceptance.

However no published study was found with intervention primarily aimed at increasing equanimity. Desbordes, Gard, Hoge and Holzel (2015), have emphasized equanimity need to be studied as an outcome measure in mediation and contemplative research. One stream of work related to this concept would be Samata- jhana meditation, which is similar to the tradition of dharana-dhyana and covers focused meditation.

Practice of Brahmavihara

Patanjali YogaSutra proposes that by deep focus and contemplation () on maitri and related feelings (karuna and mudita), they become stronger.

Maitry-adisu balani (“By performing Samyama on friendliness, etc. comes strength of the quality” - Patanjali Yogasutra Verse 3.24, translation by Taimini 1961)

This specific type of contemplation ‘Samyama’ is a combination of three processes, i.e. fixed attention (dharana) contemplation (dhyana) and concentration () and happens in stages (Patanjali Yoga , III.1-6, explanation by Vyasa and Commentary by Misra, in Woods, 1914).

Further, cultivation of brahmaviharas is also helped by the process of ‘pratipksha ’ where one replaces negative thoughts and feelings to its opposite (whatever one dwells upon in one’s mind), for e.g. anger and hatred by love.

Vitarka-badhane pratipaksa-bhavanam. (“When the mind is disturbed by improper thoughts constant pondering over the opposites, is the remedy” - Patanjali Yogasutra Verse 2.33, translation by Taimini 1961).

The practitioners are supposed to cultivate the mindset of friendship towards those who are happy, compassion towards those in distress, joy towards virtuous and equanimity towards the non- virtuous. Yoga sutra further discusses how such a cultivation of maitri, mudita, karuna, can help overcome various negative emotions like envy, jealousy, anger etc. It can thereby increase Satva and lead to a stable mind fit for deeper meditation. (Patanjali Yoga Sutra, explanation by Vyasa and Commentary by Misra, in Woods, 1914). Maitri-Karuna-muditopeksanam -dukha, -punyapunya-visayanamn bhavanatas - prasadanam (“The mind becomes clarified by cultivating attitudes of friendliness, compassion, gladness and indifference respectively towards happiness, misery, and vice. - Patanjali Yogasutra, Verse 1.33, translation by Taimini 1961).

Interconnection: Finally, it is also important to mention that one needs to develop some sense of interconnection with others, for cultivating brahmavihara. In the vedic tradition the practice of brahmavihara is linked to the idea of an inherent oneness (Tat Tvam Asi). It is beautifully discussed in the Isa Upanishad as ‘He who sees all beings in his own self, And sees his own self in all beings. He does not hate anyone thereafter’ (Yasthu sarvani bhutani aathmany eva anupasyathi; Sarva bhuteshu cha aathmaanam tatho na vijugupsate). Although this advanced state is not easily reachable, one can begin from where one is currently which may be starting the practice from ‘dharana’ stage. As Yogi philosopher Sri Aurobindo says (Commentaries on Isha Upanishad: Part One, pg 35-36), “Although in the initial stages, one needs to understand and sympathize with others, widen one’s love, compassion or fellow-feeling for others and work for others. As one experiences self-realization, they directly perceive essential oneness in multiple forms of the universe.” In the Buddhist tradition this interconnection is associated with the theory of interdependence, where all phenomena are connected. People can begin by contemplating on the common experiences of being a human, shared difficulties and hurdles that everyone faces and the fact that everyone is trying to be happy, though their ideas of it and how to achieve it may differ from ours. This is similar to the yoga-vedantic idea that everyone is trying to experience their real nature of ‘Satchidananda’ (Truth-Consciousness-Bliss) and the life is a bumbling journey towards it.

The Buddhist tradition has further discussed inimical and favorable conditions for the four brahmaviharas / apramana (). The practice goes from cultivation of these sentiments for an individual to gradually extending it to the whole world, in an object neutral manner, i.e. without any change in the sentiment based on who the target object might be. The stages of practice of these sentiments may go from 1) self; 2) a good friend (i.e., a living person who is close in a non-sexual manner); 3) a neutral person (i.e., a familiar person who does not lead to either positive or negative feelings); 4) a “difficult” person (i.e., someone who is often a trigger for negative feelings); finally the focus is on 5) all the above (self, good friend, neutral person, and difficult person) with attention being equally divided between them; and eventually the practice may end with 6) focus on all sentient beings, all directions and the entire universe. The practice goes from easy to difficult focus of contemplation (Buddharakkhita 1995; The Dalai 2001; Salzberg 1995) Thus being known as the practice cultivated towards all, without any limits or the four immeasurables/ illimitable (Bodhi 1993). Based on one’s mental disposition and needs, one can choose to meditate on either of these qualities.

The empirical studies have mostly been done on cultivation of loving-kindness and compassion using either only meditation, or a mix of didactic teaching, group discussions, meditation practice and homework assignments to incorporate these concepts into daily life. The practice may begin with cultivating a particular feeling and then extending it to increasing number of people. It may also include discussion and reflection on helpful factors and barriers in developing the four brahmaviharas. To take an example of loving kindness, one may generate this feeling for oneself initially and then towards a loved one or some for whom it comes naturally (or vice-versa), then it may be extended to someone neutral, before imagining someone who comes across as difficult or challenging and continuing this feeling for that person too. Finally, the practice may end with extending this feeling towards everyone.

When it comes to compassion, Negi (2013) has developed cognitive compassion training based on ‘’ tradition of Buddhism which reverses harmful thoughts, emotions and behaviours into those beneficial to self and others and is also similar to ‘pratipaksha bhavana’ of Yoga tradition. A protocol for developing compassion by Ozwa-de-Silva and Dodson-Lavelle (2011) includes 8 modules starting with development of attention and stability of mind and insight into the nature of mental experience. It then goes on to cultivate self-compassion, equanimity, appreciation and gratitude for others, affection and empathy and finally ending with aspirational and active compassion. Another intervention known as compassion focused therapy was developed by Gilbert (2009) by drawing from developmental, evolutionary social and Buddhist psychology. It begins by formulating negative self-beliefs and thoughts (e.g. shame, low self-worth) as originating from early life experiences impacting threat-protection system. Then it aims to cultivate 6 attributes (care for well-being, sensitivity, sympathy, distress tolerance, empathy, non- judgement) as components of self-compassion. The specific interventions focus on compassionate attention from therapist while identifying the strength of client and helping them notice their positive qualities, compassionate and balanced reasoning based on dialectical behavioural therapy and cognitive behavioural therapy. It includes compassionate imagery by exploring their ideas of compassion and help generate these feelings for self and compassionate behavior while facing frightening activities by use of warmth, compassion and gentleness. It also involves compassionate feelings for self and others and from others and compassionate sensations in the body (e.g. sensations of warmth, kindness and support). The entire therapy aims helping client feel safe in therapy, replace self- criticism with kindness and develop affect regulation.

Zeng and his colleagues in 2018 have specially developed a program on appreciative joy (Heart of Joy), which again included meditation practice, didactic teaching and group discussions. It had 4 weekly group sessions, of 90 minutes duration each, with meditation to be also practiced at home. The program starts with breathing meditation and practice of appreciative joy for friends, then for self and continues for strangers and finally for difficult targets. Johansson and his colleagues (2015) included all 4 brahmaviharas into an advanced mindfulness module, which was offered to participants as an 8 month program having monthly meetings of 2.5 hour duration. It ended with an all-day retreat on four immeasurables and included insight dialogue training. The 8 sessions covered introduction to the curriculum, along with brief meditations (on sensations, breathing, walking, metta, appreciative joy, mountain and balance, remembering and visualizing), didactic teaching on mindfulness, friendliness, acceptance, appreciative joy, peace, equanimity etc. along with noticing pleasant and unpleasant experiences (in body and mind) and increasing awareness of one’s choice in it. It moves from self to others, to dialogue training for developing mindfulness in communication and relationships. The program ends with letter-writing to self as a reminder of insights. Group-dialogue and reflections are part of every session.

Another module based on Yoga-Vedanta tradition was developed and successfully tested with caregivers in Indian context by the authors (Sahota and Agrawal 2020).

Supportive practices: and Sila

The term brahmavihara originally was associated with not only the foundational practice of maitri but also ahimsa or non-violence (ahimsa and maitri leading to Brahmaloka, Chandogya Upanishad). In the entire contemplative-meditative tradition there is an emphasis on ethical living. In Yoga Patanjali Yoga Sutras the other-directed practices of Yama (Sutra 2.30-2.31) are the 1st step, which along with make the base on which higher order (antarang) practices of ‘Astanga Yoga’ (eightfold path) are built. They focus on harmonizing outer aspects of our nature (bahiranga). Yama are yogic ethics and considered to be the basic universal rules of (right living) and social conduct. These are considered as maha-vrata, take precedence over all other vrata and their perfection leads to unfolding of highest potential in humans (, Sutra 2.35- 2.39). There are 5 yamas, including ahimsa/ non-violence which again is considered to be the root of all other yamas. Ahimsa is described as not wishing harm to any creature in thought, word or deed. The other four yamas are, (truthfulness) described as doing what we say and saying what we do (pleasant, beneficial and kind truth); Asteya (non-stealing) or not taking what rightfully belongs to others and not even harboring such desires; Aparigraha (non-coveting, non- possessiveness) which emphasizes material simplicity and custodianship of resources (not acting as the owners). Behind the other yama of Brahmacharya (continence, control of sexual energy) is avoiding misidentification with non-self which may impel someone to seek fulfillment at sensual level (Taimini 1961; Bryant 2009).

Similar codes have been discussed in Buddhism and . In the eight-fold path of Buddhism, sila are the prescribed moral path for monks and lay person alike although it differs in numbers for both (5 for lay people and 10 for monks). The common 5 include non-violence, truthfulness, continence, non-stealing and abstinence from intoxication (Bodhi, 2010). In all these above mentioned traditions, these ethical practices were often given more importance and even first priority than the advanced practices.

Benefits of Brahmavihara

When one reviews the beneficial effects of cultivating Brahmavihara, it is noted that since these practices are predominantly interpersonal in nature, not only these enhances positive emotions, life satisfaction and decreases negative emotions, but also have beneficial effect with respect change in attitude towards self and others and cultivation of positive social emotions, such as empathy, kindness etc. Research has shown even one aspect of Brahmavihara meditation can lead to increase in a variety of desirable outcomes such as positive emotions, life satisfaction, self-awareness, self- acceptance, compassion for self and others, empathy, perspective taking, emotional concern and altruistic actions. It further leads to embracing rather than denying the suffering, and decreased self-criticism, distress, depression, anxiety and perception of relative lack along with envy (Fredrickson et el. 2008; Leppman 2011; Boellinghaus, Jones and Hutton 2013; Zeng et. al. 2018). In the Indian context, Smrithi, Agrawal and Kapani (2017) had found that the peer-group nomination ratio in a college going sample was positively correlated with brahmaviharas and non-attachment (anasakti).

In clinical situation, these modules have been found to be effective in reducing symptoms of post- traumatic stress disorder in veterans (Kearney et al. 2013) and for reducing negative symptoms in schizophrenia (Johnson et al. 2011). Further, it has been studied in professionals engaged in mental health care, such as using loving-kindness meditation for fostering well-being and cultivating compassion and self-care in in trainee psychotherapist (Boellinghaus, Jones and Hutton 2013) and loving-kindness meditation for enhancing cognitive and affective empathy and decreasing personal distress in student counselors (Leppman 2011). In a sample of family care-givers of people having mental illness, a yoga-vedanta based brahmavihara module was found to be beneficial in reducing psychological distress (Sahota and Agrawal 2020).

Clinical experiences from psychotherapy practice

The first author has clinical experience of using loving kindness meditation in own therapy practice and in few where she was the supervisor. The Case I was that of a young married woman who presented with the history of marital conflict and extra marital affair along with depression in the context of Borderline Personality Disorder and childhood sexual abuse. The loving kindness meditation was tentatively introduced when the mindfulness based dialectical behavior therapy (DBT) and couple’s therapy had stalled due to intense emotion dysregulation. Since the client had negative self-image initially loving kindness was mainly focused on self. As she started feeling better, loving kindness was expanded to others and gradually therapy was continued based on initial plan leading to achieving the goals of in-patient therapy and successful termination later. Another case (Case II) was that of a middle-aged married woman, with significant emotional dysregulation, interpersonal difficulties and high-risk behavior in context of depression, drug- abuse and Borderline Personality Disorder and cardiac illness. In this case the loving kindness meditation was introduced after the successful completion of DBT based therapy. Although the client had improved, she reported feeling dry inside and joyless inside. Thereafter loving-kindness meditation was introduced resulting in significant improvement in terms of feeling happy and improved relationship with her family.

Clients diagnosed with emotionally unstable personality disorder have a pattern of hostility, antagonism, negative affect and negative self-image, which often comes with attachment injuries. This may also lead to difficulties in psychotherapy practice since the relationship between therapist and client is tested repeatedly. DBT based CBT with a component of mindfulness is usually the treatment of choice. Based on clinical experiences it may be hypothesized that one important aspect of this maitri/ loving-kindness practice could be creating ‘an unhurt abiding-place within’ which may overcome such deep sense of hurt along with cultivating a ‘happy rightness of mind and feeling’ (As earlier mentioned by Sri Aurobindo about Mitra). This may make it easier for rest of the therapy to progress.

First-person experiences: Method triangulation or use of multiple research methods exploring same variable has been emphasized for deeper understanding of a variable. This includes using first-person research frequently discussed in the field of contemplative-meditative tradition, Indian psychology and consciousness research. The first author had intensely practiced loving-kindness meditation during a transition phase and also maintained a diary and blog. Later analysis of this data suggested initial difficulty in the process, but with intention and exploration the practice becomes easier. The practice further resulted in a state of mind which was more open, gentle and kind. Although as the intensity of practice lowers, even the benefits start fading, however memory (smriti) does last, becoming an important moor for future practice. The second author has also conducted research in this area and in the process found while each of these Brahmaviharas were an every-day feeling, embodying them constantly is difficult.

Challenges and issues

One of the major challenge in application of brahmavihara based intervention lack of training of mental health professionals, who then cannot use it successfully in their work. Further, the engagement with this practice has been reported to be emotionally challenging by trainee therapists, in spite of various benefits on self, others and clients (Boellinghaus, Jones and Hutton 2013). However, that might be true with any other meditation practice like mindfulness. Further there is limited research in this area and it is still a developing field. Even the studies which are available have small sample size, high dropout rate, poorly controlled design, and inadequate assessment methods.

Solutions and recommendations

More work is required in this area, both in terms of research and training and application. One of the context for application of brahmavihara practice might be modern work place, which is interpersonal in its context and people from different backgrounds, abilities and skills come together for common goal. With such diversities, the workplace interpersonal context can become a fertile ground for development of jealousy, hatred, unhealthy competitiveness etc. and at times sabotaging of the organizational goal (Sarawasti 2013). However for an organization to succeed, it is important to give attention to employees’ well-being. With the advent of Positive Psychology, there is empirical evidence to suggest that the positive experiences and positivity in individuals lead to a profitable organization. To counter the negative feelings and interactions, Brahmaviharas meditations may be introduced for enhancing employee well-being and better interpersonal relationships, along with lowering their anxiety, depression, psychological distress, envy etc. In fact, one study found that ethical decision making was associated with loving kindness, compassion, sympathetic joy and equanimity (Jayawardena-Willis, Pio and McGhee, 2019).

Another area might be couple’s and family therapy where it is common for clients to come up with negative emotions such as anger, hatred, sadness etc. since not only the practice enhances positive emotions but also undoes the effect of negative emotions (Fredrickson et el. 2008). This may further be extended to group-based conflict-resolutions work in the community. Brahmavihara based intervention may also be successfully used on a regular and scaled up manner to enhance self-care and protect professional and non-professional care givers from burn-out, in the field of health and especially mental health. Due to the demands of caregiving brief interventions may be most useful.

Discussion

It is important to note here that the Indian spiritual tradition goes a long way and has had a rich field with various psychological models and insights. Although there are various concepts and techniques available which may be successfully used for psychotherapy in modern times, the efforts in this direction has been few. While yoga has been included in mental health interventions, however the focus is predominantly asana and pranayama (Forfylow 2011; Vorkapic and Range 2014). The psychological concepts are either ignored or studied in a decontextual, diluted or even distorted manner (Cornelissen 2001). Thus, it is important to understand these concepts, the associated assumptions and practices and also include them for one’s own growth as a therapist (Agrawal and Cornelissen 2019).

The interpersonal aspect of meditative traditions is one such area of study. Interpersonal focus in contemplative traditions also makes them a moral system against the criticism of being a self- centered system with sole focus of ‘self’ liberation. Thus, we see that the practice of bhrahmaviharas is also associated with ethical practices (Yama in Yoga and Sila in Buddhism). The practice has potential to improve personal, interpersonal and universal well-being, however one needs to understand the assumption of interconnected universe behind. If utilized as a standalone practice it may remain limited in its ability to transform our lives. Although there is some research in the field, majority of it has focused on loving kindness and compassion-based meditation. Equanimity especially has been ignored or reduced in its meaning to mere psychological distancing and not as an entire practice in itself to experience highest wisdom and liberation (Sthitaprajna).

Future research directions

Thus, it may be concluded that although the field is still developing, the research on all four aspects are especially lagging behind. However, the preliminary results indicate a lot of potential of this practice especially for developing, maintaining and enhancing personal and interpersonal well- being. Based on the previous research and author’s experiences, it may be suggested that the future research may focus on:

1. Studying it in non-clinical population, especially in educational and organizational context. If proven effective, these practices may be scaled up for supporting people to flourish at home, in school/colleges and at work place, both in terms of intra-individual (emotional) and interpersonal areas. Brahmaviharas meditations may be introduced in the organizational setting, for employee well-being and better interpersonal relationships along with lowering of anxiety, depression, psychological distress, envy etc. 2. More studies need to be done in the clinical population, which may then be used for theory building, longitudinal research and interventions in different population. Although the first author has noticed the benefits of this practice in emotionally unstable personality disorder, however no empirical study has been found. Difficulties with empathy and intimacy, along with that of self-image and self-direction are common patterns in personality disorders (DSM 5- alternate version) and the traits of hostility, antagonism, manipulativeness, negative affect are common, especially in cluster B (BPD, NPD, ASPD). This may be an area worth studying. 3. Another area of potential research may be that of marital and family conflict and inclusion of these practices in couple’s and family therapy. 4. Intervention research may be conducted in professional and non-professional care givers in the field of health, especially mental health to reduce burn out and enhance resilience building practices. 5. Neuro-psychology related variables may also be explored with interpersonal aspects of meditation, as it has been done with other types of meditation. 6. Research has mostly focused on limited practices (loving-kindness and compassion) and needs to be expanded to all four of them along with supportive practices such as non- violence. Further yoga-vedanta based module needs to be further studied empirically. 7. Although Patanjali in his Yogasutra, have suggested brahmavihara or four bhavana for the purpose of overcoming a variety of difficulties, including dullness of mind, doubt, procrastination, distractibility etc. and making mind better prepared for deeper meditation. However, research has not been conducted on these effects and may be a worthwhile pursuit. 8. Triangulation of method needs to be utilized, with if possible more first-person research by the therapist-researcher, which in turn may enhance their own well-being.

Conclusion

It may be concluded that the interpersonal aspects of meditative traditions are an important component and have rich insights of offer and needs to be given more attention. The limited research indicates a variety of benefits. However, the research and application need to be further expanded to a variety of traditions, concepts, techniques and population. Interpersonal aspects of meditations have potential for both promotive mental health programs and building treatment- oriented psychotherapy. Further it may be also be helpful for a researcher and a clinician by becoming a practitioner themselves.

Acknowledgement: Ms. Smrithi, Ms. Priya and Ms. Fasli, PhD Scholars at the Department of Clinical Psychology, NIMHANS, Bengaluru.

References

Aurobindo, Sri, and Aurobindo. Isha upanishad. Publishing House, 1951.

Aurobindo, Sri. Secret of the Veda. Sri Aurobindo Ashram Press, 1999.

Agrawal J. and Cornelissen, M. (2019). Yoga and positive mental health. (Manuscript in press).

Aronson, Harvey B. Love and sympathy in Theravāda Buddhism. Motilal Banarsidass Publ., 1996.

Ayduk, Özlem, and Ethan Kross. Enhancing the pace of recovery: Self-distanced analysis of negative experiences reduces blood pressure reactivity. Psychological science 19, no. 3 (2008): 229-231.

Bodhi, . A comprehensive manual of abhidhamma: The abhidhammattha sangaha of âcariya . Kandy: Buddhist Publication Society (1993).

Bodhi, Bhikkhu. In the Buddha's words: An anthology of discourses from the Pali Canon. Simon and Schuster, 2005.

Bodhi, Bhikkhu. The : The way to the end of suffering. Buddhist Publication Society, 2010.

Boellinghaus, Inga, Fergal W. Jones, and Jane Hutton. Cultivating self-care and compassion in psychological therapists in training: The experience of practicing loving-kindness meditation. Training and Education in Professional Psychology 7, no. 4 (2013): 267.

Brand, Serge, Edith Holsboer-Trachsler, José Raúl Naranjo, and Stefan Schmidt. Influence of mindfulness practice on cortisol and sleep in long-term and short-term meditators. Neuropsychobiology 65, no. 3 (2012): 109-118. Buck, Ross. The biological affects: A typology. Psychological review 106, no. 2 (1999): 301.

Buddharakkhita, . Mettā: The Philosophy and Practice of Universal Love. Dharma Net International (1995).

Carmody, James, Ruth A. Baer, Emily LB Lykins, and Nicholas Olendzki. An empirical study of the mechanisms of mindfulness in a mindfulness‐based stress reduction program. Journal of clinical psychology 65, no. 6 (2009): 613-626.

Cornelissen, Matthijs. Consciousness and its Transformation: Papers Presented at the Second International Conference on Integral Psychology. (2001).

Davidson, Richard J., and Bruce S. McEwen. Social influences on neuroplasticity: stress and interventions to promote well-being. Nature neuroscience 15, no. 5 (2012): 689-695.

Desbordes, Gaëlle, Tim Gard, Elizabeth A. Hoge, Britta K. Hölzel, Catherine Kerr, Sara W. Lazar, Andrew Olendzki, and David R. Vago. Moving beyond mindfulness: defining equanimity as an outcome measure in meditation and contemplative research. Mindfulness 6, no. 2 (2015): 356-372.

Forfylow, Andrea L. Integrating Yoga with Psychotherapy: A Complementary Treatment for Anxiety and Depression. Canadian Journal of Counselling and Psychotherapy 45, no. 2 (2011): 132-150.

Fredrickson, Barbara L., Michael A. Cohn, Kimberly A. Coffey, Jolynn Pek, and Sandra M. Finkel. Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of personality and social psychology 95, no. 5 (2008): 1045.

Fredrickson, Barbara L. The role of positive emotions in positive psychology: The broaden-and- build theory of positive emotions. American psychologist 56, no. 3 (2001): 218.

Gilbert, Paul. Introducing compassion-focused therapy. Advances in psychiatric treatment 15, no. 3 (2009): 199-208. Gilbert, Paul, and Sue Procter. Compassionate mind training for people with high shame and self‐ criticism: Overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy: An International Journal of Theory and Practice 13, no. 6 (2006): 353-379.

Goleman, Daniel, and Richard Davidson. The science of meditation: How to change your brain, mind and body. Penguin UK, 2017.

Grossman, Paul, and Nicholas T. Van Dam. Mindfulness, by any other name…: trials and tribulations of in western psychology and science. Contemporary Buddhism 12, no. 1 (2011): 219-239.

Hadash, Yuval, Natalie Segev, Galia Tanay, Pavel Goldstein, and Amit Bernstein. The decoupling model of equanimity: theory, measurement, and test in a mindfulness intervention. Mindfulness 7, no. 5 (2016): 1214-1226.

Harris, I. 2001. Attitudes to nature. In Buddhism edited by P. Harvey. Continuum, London. Pg. 247.

Hofmann, Stefan G., Paul Grossman, and Devon E. Hinton. Loving-kindness and compassion meditation: Potential for psychological interventions. Clinical psychology review 31, no. 7 (2011): 1126-1132.

Hopkins, J. Cultivating compassion. Broadway Books, 2001.

Jayawardena-Willis, Thushini S., Edwina Pio, and Peter McGhee. "The Divine States (brahmaviharas) in Managerial Ethical Decision-Making in Organisations in Sri Lanka: An Interpretative Phenomenological Analysis." Journal of Business Ethics (2019): 1-21.

Johansson, Birgitta, Helena Bjuhr, and Lars Rönnbäck. Evaluation of an advanced mindfulness program following a mindfulness-based stress reduction program for participants suffering from mental fatigue after acquired brain injury. Mindfulness 6, no. 2 (2015): 227-233.

Johnson, David P., David L. Penn, Barbara L. Fredrickson, Ann M. Kring, Piper S. Meyer, Lahnna I. Catalino, and Mary Brantley. A pilot study of loving-kindness meditation for the negative symptoms of schizophrenia. Schizophrenia research 129, no. 2-3 (2011): 137-140. Johnson, David P., David L. Penn, Barbara L. Fredrickson, Piper S. Meyer, Ann M. Kring, and Mary Brantley. Loving‐kindness meditation to enhance recovery from negative symptoms of schizophrenia. Journal of clinical psychology 65, no. 5 (2009): 499-509.

Kaliman, Perla, Maria Jesus Alvarez-Lopez, Marta Cosín-Tomás, Melissa A. Rosenkranz, Antoine Lutz, and Richard J. Davidson. Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators. Psychoneuroendocrinology 40 (2014): 96-107.

Kashdan, Todd B., and Jonathan Rottenberg. Psychological flexibility as a fundamental aspect of health. Clinical psychology review 30, no. 7 (2010): 865-878.

Kearney, David J., Carol A. Malte, Carolyn McManus, Michelle E. Martinez, Ben Felleman, and Tracy L. Simpson. Loving‐kindness meditation for posttraumatic stress disorder: A pilot study. Journal of Traumatic Stress 26, no. 4 (2013): 426-434.

Khalsa, Manjit K., Julie M. Greiner‐Ferris, Stefan G. Hofmann, and Sat Bir S. Khalsa. Yoga‐ enhanced cognitive behavioural therapy (Y‐CBT) for anxiety management: a pilot study. Clinical psychology and psychotherapy 22, no. 4 (2015): 364-371.

Kross, Ethan, Ozlem Ayduk, and Walter Mischel. When asking “why” does not hurt distinguishing rumination from reflective processing of negative emotions. Psychological science 16, no. 9 (2005): 709-715.

Kuan, Tse-fu. Mindfulness in : New approaches through psychology and textual analysis of Pali, Chinese, and sources. Routledge, 2008.

Kuyken, Willem, Ed Watkins, Emily Holden, Kat White, Rod S. Taylor, Sarah Byford, Alison Evans, Sholto Radford, John D. Teasdale, and Tim Dalgleish. How does mindfulness-based cognitive therapy work?. Behaviour research and therapy 48, no. 11 (2010): 1105-1112.

Lama, Dalai. An open heart: Practising compassion in everyday life. Hachette UK, 2002.

Leary, Mark R., Eleanor B. Tate, Claire E. Adams, Ashley Batts Allen, and Jessica Hancock. Self- compassion and reactions to unpleasant self-relevant events: the implications of treating oneself kindly. Journal of personality and social psychology 92, no. 5 (2007): 887. Leppma, Monica. The effect of loving-kindness meditation on empathy, perceived social support, and problem-solving appraisal in counseling students.(2011).

Lutz, Antoine, Julie Brefczynski-Lewis, Tom Johnstone, and Richard J. Davidson. Regulation of the neural circuitry of emotion by compassion meditation: effects of meditative expertise. PloS one 3, no. 3 (2008).

Mascaro, Jennifer S., James K. Rilling, Lobsang Tenzin Negi, and Charles L. Raison. Compassion meditation enhances empathic accuracy and related neural activity. Social cognitive and affective neuroscience 8, no. 1 (2013): 48-55.

May, Christopher J., Jared R. Weyker, Stephanie K. Spengel, Lisa J. Finkler, and Scott E. Hendrix. Tracking longitudinal changes in affect and mindfulness caused by concentration and loving-kindness meditation with hierarchical linear modeling. Mindfulness 5, no. 3 (2014): 249- 258.

Mayhew, Sophie L., and Paul Gilbert. Compassionate mind training with people who hear malevolent voices: A case series report. Clinical Psychology and Psychotherapy: An International Journal of Theory and Practice 15, no. 2 (2008): 113-138.

Negi, L. T. Emory compassion meditation protocol: cognitively-based compassion training manual. Atlanta: Emory University (2013).

Ospina, Maria B. Meditation practices for health: state of the research. No. 155. Diane Publishing, 2008.

Ozawa-de Silva, Brendan, and Brooke Dodson-Lavelle. An education of heart and mind: Practical and theoretical issues in teaching cognitive-based compassion training to children. Practical Matters 4, no. 4 (2011): 1-28.

Rao, K. Ramakrishna, and Anand C. Paranjpe. Psychology in the Indian tradition. Springer India, 2016.

Sahota, Poonam B.K. and Jyotsna Agrawal. 2020. Development of a Brahmaviharas based intervention for improving well-being and reducing distress of primary care-givers in psychiatric disorders. (Unpublished M.Phil Dissertation).

Salzberg, Sharon. Lovingkindness: The revolutionary art of happiness. Publications, 1995.

Sanharakshita. Living with kindness: The Buddha’s teaching on metta. Windhorse publications, 2004.

Saraswati, Swami Satyananda. Meditations from the Tantras. Prakash Publiciations, 2013.

Sedlmeier, Peter, Juliane Eberth, Marcus Schwarz, Doreen Zimmermann, Frederik Haarig, Sonia Jaeger, and Sonja Kunze. The psychological effects of meditation: a meta-analysis. Psychological bulletin 138, no. 6 (2012): 1139.

Shahar, Ben, Ohad Szepsenwol, Sigal Zilcha‐Mano, Netalee Haim, Orly Zamir, Simi Levi‐ Yeshuvi, and Nava Levit‐Binnun. A wait‐list randomized controlled trial of loving‐kindness meditation programme for self‐criticism. Clinical psychology and psychotherapy 22, no. 4 (2015): 346-356.

Shih, Sheng-yen, and Dan Stevenson. Hoofprint of the Ox: Principles of the Chan Buddhist Path as Taught by a Modern Chinese Master. Oxford University Press, USA, 2001.

Smrithi, M., Jyostna Agrawal, and Aruna R. Kapanee. 2017. Association of and Brahmaviharas with Psychological Distress and Wisdom among college going youth (Unpublished M.Phil Dissertation).

Suzuki, Shunryū. mind, beginner’s mind. Shambhala, 2011.

Taimni, Iqbal Kishen. The science of yoga. Quest Books, 1961.

Teasdale, John D., Richard G. Moore, Hazel Hayhurst, Marie Pope, Susan Williams, and Zindel V. Segal. Metacognitive awareness and prevention of relapse in depression: empirical evidence. Journal of consulting and clinical psychology 70, no. 2 (2002): 275. Vorkapic, Camila Ferreira, and Bernard Rangé. Reducing the symptomatology of panic disorder: the effects of a yoga program alone and in combination with cognitive-behavioral therapy. Frontiers in psychiatry 5 (2014): 177.

Walsh, Roger, and Shauna L. Shapiro. The meeting of meditative disciplines and Western psychology: a mutually enriching dialogue. American psychologist 61, no. 3 (2006): 227.

Wiltshire, Martin G. Ascetic figures before and in early Buddhism: the emergence of Gautama as the Buddha. Vol. 30. Walter de Gruyter, 2013.

Wojciszke, Bogdan, Andrea E. Abele, and Wiesław Baryla. Two dimensions of interpersonal attitudes: Liking depends on communion, respect depends on agency. European Journal of Social Psychology 39, no. 6 (2009): 973-990.

Woods, James H. The Yoga-system of Patañjali: Or, The Ancient Hindu Doctrine of Concentration of Mind, Embracing the Mnemonic Rules, Called Yoga-sūtras, of Patañjali, and the Comment, Called Yoga-bhāshya, Attributed to Veda-Vyāsa, and the Explanation, Called Tattva-vāicāradī, of Vāchaspati-Miçra. Vol. 17. Harvard University Press, 1914.

Zeng, Xianglong, Cleo PK Chiu, Rong Wang, Tian PS Oei, and Freedom YK Leung. The effect of loving-kindness meditation on positive emotions: a meta-analytic review. Frontiers in psychology 6 (2015): 1693.

Zeng, Xianglong, Vivian YL Chan, Xiaoliu Liu, Tian PS Oei, and Freedom YK Leung. "The four immeasurables meditations: differential effects of appreciative joy and compassion meditations on emotions." Mindfulness 8, no. 4 (2017): 949-959.

Zeng, Xianglong, Rong Wang, Tian PS Oei, and Freedom YK Leung. "Heart of joy: A randomized controlled trail evaluating the effect of an appreciative joy meditation training on subjective well- being and attitudes." Mindfulness 10, no. 3 (2019): 506-515.