CORRESPONDENCE concerned to find out why the GPs felt that two are practising generosity and truthfulness. written communications had made so little The cultivation of these positive counterparts difference to their practice. are probably a more Important focus for those When auditing process, unless all parties who wish to practise . who have a direct Influence on the outcome of As well as on breathing the that process are Included in the audit Buddha taught the 'metta ' or mechanism (GPs In this case), changing development of loving kindness (, performance (improving referral Information) 1985). The cultivation of metta provides an may prove elusive. emotionally positive balance to the meditation Nalk & Lee's article reinforces the need to on breathing. Dr Dwlvedi refers to the famous develop both face to face mulüprofessional analogy with the ocean: Just as the ocean has communication and audit which crosses the one taste the taste of salt so the Buddhist perceived "wall" between primary and teaching has not the taste of renunciation, but secondary care. Using such an approach, rather the taste of vimuttl, which Is release, or there is more chance of Improved clinical freedom (Udana, verse 56, 1985), practice. Renunciation Is an aspect of the Buddhist path, but the purpose Is to find freedom, BURNS.T.. SILVER.T.. FREELING,P., & CRISP.A. (1994) especially freedom from suffering. General practice training for psychiatrists. Psychiatric Bulletin. 18. 286-288. The importance of understanding the positive nature of is threefold. SIMONBALMER,Wakefield Healthcare. White Rose First many Westerners may have a House, West Parade, Wakefield WF1 1LT materialistic, nihilistic conditioning which will tend to lead to a misinterpretation of Buddhism as a nihilistic (and therefore Sir: We agree with Simon Balmer. We forgot to unattractive) religion. Secondly, the say that a general practitioner helped to design meditation on breathing practised on its own the audit. This lapse may be an example of the without also cultivating positive emotions can partly unconscious barriers that Simon lead to adverse psychological effects. In Balmer describes. We do meet and talk fairly particular. It may lead to an exaggeration of often with our GPs. We avoided mentioning the neurotic defences such as Intellectualisation Items we were measuring In the Interests of and reaction formation to dissociate from ego- dystonlc emotions (Epstein & Lelf, 1981). science. More recently we have often suggested Thirdly, In order to gain 'Insight' not only is a letters might be sent to the base, and might concentrated mind required but also one include more Information, but most still arrive flexible and refined through being 'soaked' In after some delay, at the hospital, and some are still highly condensed. Old habits may die emotional positivlty (jhana). The final goal of hard, especially in the face of modem enlightenment Includes wisdom (panna) which pressures. However, Simon Balmer's is conjoined with compassion (karuna) to help reminder to include all parties that affect other sentient beings. outcomes in the audit process Is very well EPSTEIN,M. & LEIF,J. D. (1981) Psychiatric complications of taken. meditation practice. Journal of Transpersonal. Psychology. 13, 137-147. ALANLEE, University Hospital, Nottingham NE7 Metta Sutta. In Sutta-AKpolo. Translation by Saddhatlssa, H. 2UH; and PRAKASH NAIK, Lyndon Resource (1985) London: Curzon. Centre, Hobs Meadow, Solihull, West Midlands Udana. Verses o/Upli/t In The Minor Anthologies of the Pall B928PW Canon, Part n. Translation by Woodward, F.L. (1985) London: Pall Text Society.

Buddhist meditation PARAMABANDHUGROVES, National Addiction Centre, Addiction Sciences Building, 4 Windsor Sir: Dr Dwlvedi gives an Interesting account of Walk, London SES 8AF the relationship between and contemporary psychotherapy (Psychiatric Bulletin, 1994, 18, 503-504). However I think he gives an overly negative impression of Sir: Thank you for asking me to respond to Dr Buddhism. He describes the In Groves' letter. Buddha taught many their negative form for example refraining from techniques of meditation and suited his stealing and lying. In their positive form these teachings to the needs of the Individuals. As

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