(Nurses learn a practical procedure in the classroom circa 1950 – Google)
Recent posts on meditation and again on mysticism have provided a scaffold on which to arrange my thoughts about both, and appraise them a little. In Meditation 4 I had something to say about possible alternatives to sitting meditation, including a practice I favour: “Standing Like A Tree”, a kind of yoga.
I shall now briefly address the issue of “introverted attention” and “extroverted attention”, as these terms seem to apply to, and perhaps differentiate, two rather different meditation practices, two different methods of meditating, perhaps subserving two different purposes and leading to two different outcomes.
“Introverted attention” or the “inward way” usually occurs within a religious or doctrinal context, the method set out in teachings or texts, follows tradition, and involves a specific decision or a set of decisions, and a commitment to continuing practice.
Methodologically, the meditator goes to a quiet place, adopts a cross sitting legged position, eyes closed or half-closed, and focusses attention on some chosen sense object, usually the breath or some component of breath, such as the sensations at the nostrils. The starting-out object (and the possible result) is separation from sensuality, the quieting of discursive thought, some tranquillity, and perhaps an experience of pleasure and zest.
“Introverted attention” has as its purpose (if it is deemed to have any purpose) as the ultimate attainment of “contentless experience” – a state of consciousness totally devoid of sensory input, memory, discursive thought, feeling, emotion etc. A committed practitioner may attain by increments to a state of ‘contentless experience’ by moving through an ascending scale of states, each of which contains less content than the preceding one. Perhaps modesty forbids that meditators lay claim to attainment of any position on the notional scale, I don’t know. But I do wonder how any such attainment would ‘spin off’ into action that impacted the world, and how we could recognise it, and learn from it.
“Extroverted attention”, again as I understand it, means “going outward” and may be called the “outward way”. In contrast to the “inward way” it involves much less methodological consistency, and may “grow like Topsy” out of the routine activities of everyday life and workaday situations, without a specific decision to practice, or any purpose beyond the utilitarian, such as learning a skill necessary to do a job.
Later on in this article I’ve included some nursing notes that – to my mind – conduce incidentally to “extroverted attention”; but I don’t think that they were intended to develop extroverted attention beyond their prosaic remit, and don’t exist within a recognisable religious or philosophical context. I’m not making any special claim for them, but they may interest and intrigue you, as they do me.
Unlike the techniques of “introverted attention”, the “extroverted attention”practitioner (for want of a word to describe everywoman/everyman at large) has her eyes open, and is open to all her senses and all her immediate experience, including her orientation in space and time, her posture, her movements, and the physical presence of proximate objects and life-forms. The lens of her experience is widely open, and takes in ‘the big picture’, while able to discriminate detail as well, notice change, and to act appropriately to it.
Paradoxically perhaps, she is relatively free from discursive thought, although she may have internalised a series of mental cues and prompts that operate at a level just below the horizon of conscious awareness, and are accessible as thoughts by a small act of intention, like a voluntary blink.
In “extroverted attention” her personal boundary seems to expand, and to become more and more permeable and blurred, so that the subject-object distinctions lose their valency. It is, perhaps, in this way that the pianist’s fingers become one with the keys, the seamstress’s fingers with her needle and threads, the surgeon’s with her scalpel and the organ it incises; the jockey with his horse.
Because the aperture of attention is limitless, so the idea of an aperture between observer and observed is (as if) meaningless. The distinction between carer and cared-for is also lost, as is the notion of compassion as something that flows from one vessel to another, as if from an unidirectional nozzle. Compassion can’t be contrived, but it can be apprehended as a stream of meaning in which both ‘carer’ and ‘cared-for’ are immersed, and in which their reciprocal agency is engaged ‘as one’.
I think there is always a question in the air about which meditation practice is ‘best’, and perhaps that question begs the question “Best for what?”. For me (and please challenge me on this) I might argue that weighing the “inward way” against the “outward way” is like assessing the relative merits of breathing in and breathing out: the answer does rest/doesn’t rest on what’s the purpose of breathing at all……
PRACTICAL NURSING NOTES (circa 1955) – edited extracts
*************
Performing a blanket bath or bed bath is an important nursing duty, not to be shirked by a nurse on grounds of her seniority, or because she may be called to more pressing duties. A senior nurse will remind herself of her duty to teach and supervise her junior in the performance of such duties; she will pride herself in passing on her knowledge, skill and especially her dexterity, her economy of movement, and her powers of observation to another, thus kindling her charge’s enthusiasm for excellence in bedside nursing care; encouraging her devotion to the nursing art; and earning her professional respect.
Aside from its importance in maintaining a level of personal hygiene – vital for health, for self-respect and for dignity, and the prevention of the secondary infections and decubitus ulcers (bedsores) associated with prolonged bed rest – the skilfully administered blanket bath confers a profound feeling of well-being on the patient, and helps him to develop trust and confidence in his nurse. This sense of security is necessary for the confidential exchange of information between patient and nurse, in order that she may build up a picture of his progress, its adequacy in response to his treatment and care, and any hindrances to progress that will need attention by the physician.
***************
Having collected the requisite equipment, lay up a bath-trolley (which should be scrupulously clean) as follows:
Top shelf: enamel bowl, large enamel water jug containing water at 45 degrees Celsius; large receiver or kidney dish containing two body flannels, suitably sized portion of white unperfumed soap, unperfumed talcum powder (the patient’s own talcum powder may be used if he permits its use), surgical spirit in sprinkler bottle, large enamel bowl of coarse tow or brown wool for peri-anal toilet, small receiver or kidney dish containing a nail brush, nail-scissors, a hair brush and comb; small bowl or receiver containing an enamel mug for mouth-wash.
Lower shelf: Enamel bucket for used water; large enamel water jug containing water at 60 degrees Celsius; bedpan and/or urinal and sanitary cover; toilet tissue; bath thermometer; strong paper bag for disposal of used tow or brown wool; two large bath towels and a face towel; change of night attire or gown; change of bed linen (normally one draw sheet, one bed sheet and one pillow case); one flannel bath blanket.
*****************
Check the contents of the trolley carefully before proceeding to the bedside to prepare the patient and the environment for the procedure.
Inform the patient about what you intend to do and so as to ensure his willing cooperation. Close the nearby windows to exclude draughts and screen the bed or close the bed-curtains.
*****************
Carefully assist the patient in the removal of his night-clothing, taking care to preserve his dignity and privacy. The nurse’s movements and gestures will be well-considered, economical, unhurried, firm, gentle; they will inspire confidence and they will reassure; nurse will have full attention for any indication in the patient’s response that her support is the occasion of any alarm, discomfort or his unwillingness to proceed.
******************
When washing the upper limbs, begin with the arm distal to the ministering nurse. Ensure that the proximal arm and chest are covered so as to avoid drips. Wash the exposed arm from the shoulder down its length with a soaped cloth, using long firm strokes from above to the tips of the fingers, giving careful attention to between the fingers, and to skin creases and folds. Note the condition of the nails and cuticles. Rinse the wash-cloth and repeat the washing action to remove all suds, then dry the limb and hand carefully and cover with the flannel blanket to prevent chilling.
********************
At the end of a skilfully-performed blanket bath, it is not unusual for the patient to drop into a peaceful sleep, waking refreshed after a short interval. Nurse will plan her procedure to take this into account, especially if the blanket bath is administered less than hour before a main meal is served.
Hi Peter,
An interesting post. I take it that the nursing notes are intended to get us in touch with the process of doing one thing and then another thing with awareness? That rather reminds me of something Sangharakshita is supposed to have said. When asked whether he was busy, he replied “Busy? Well, I do one thing, then I do the next thing.”
However, there are a few points I want to question here. One very broad one is to flag up the danger of a false dichotomy between the internal and the external. It’s a distinction with some practical usefulness, but I don’t think we should build too much on it, because the dividing line is largely one that we conceptually impose on our experience. Every ‘outward’ thing is also ‘inward’, in the sense that we form a representation of it to practically relate to it, and that representation is the result not just of the impact of a thing-out-there, but also our processes. Similarly, every ‘inward’ thing is a reflection of our ‘outward’ experience.
For that reason I disagree that ‘inward’ meditation is anything to do with seeking ‘contentless experience’. Dhyana, that I wrote about in the previous meditation blog, is not ‘contentless’. Representations of the world are still present even in the most refined states of meditation, but they have considerably less emotional impact than usual in motivating us to desire, hatred or anxiety. The process of moving into the higher dhyanas is not one of losing content, but of content becoming more subtle and closer to a solid centre of integrated experience. One might say that content becomes more integrated.
One can link this misunderstanding to the widespread misunderstanding (which you pick up on here) that meditation is about blanking out one’s thoughts. I think this confuses a process of integration with one of elimination, and they are very different. Meditation absorbs thoughts, quietens them and brings them into harmony with the rest of our experience over a period of time. It does not remove them, but rather improves them. That’s why it becomes much easier to think more clearly after meditation, not less.
As to how ‘inward’ meditation can impact the world, I see no problem with that. Our representations of the world become more integrated, so the practical judgements we make under the influence of the temporary integration that meditation can produce will be ones that address conditions better. To take your nursing example, any judgements made by the nurse about how to respond to a patient, a colleague, or a physical situation will be more objective, taking more into account what’s actually going on rather than a deluded projection of what is the case. This is not easily measurable, but none the less practical in a long-term fashion.
On the other hand, the outward activities of your nurse might well not be judged in a very integrated way without some degree of inward integration (whether or not that has been produced by ‘inward’ meditation). Everyday concentration is not enough, given that such concentration can be forced and alienated, repressing other processes. A nurse without some degree of such integration might make poor judgement which adversely affect patients, including being less effective in the emotional relationships he/she develops with them.
Hi Peter and Robert,
I can see that inward and outward ways of meditating are very inter- changeable, they cannot exist without each other, just as cognitive and emotional experiences combine. Would our personalities determine which method has the most sway? If introverted we tend to look into ourselves in a different way to the way an extrovert would act? This may not be a relevant question, I am simply putting my thoughts into print. Seeing rather than idly looking when ‘standing like a tree’ is different in a subtle way, we become more aware as we see what is happening around us, if anything is happening or, all may be still and calm. While trying to solve a problem I’m having with a painting for example, I sit, eyes closed, allowing the workings of imagination to surface, my old thoughts do not empty- out but space is made for new ones to arise.
Peter, I was reminded of the eighteen months I spent as a student nurse, we nurses considered that we had a vocation, we know that much in nursing involves performing unpleasant duties, all part of the job of caring. I remember tests for laying trolleys, from bathing a patient, as your article describes, to preparing instruments for a surgical proceedure. Times have changed, pressure to complete work quickly on the ward was not an issue then, there is little time now for getting to know patients well.
Thanks Robert for your very helpful comments. I feel that you have very thoroughly miggled my blog and miggled me, and I appreciate that, it’s what I need, and why I’m a member of the society.
About the false dichotomy of inward-outward, I agree with you. If I hadn’t rather rushed the blog, I might have done a better job of getting my thoughts down on paper, but habits of mind prevailed because I’d put myself under pressure to perform. Just as every in-breath contains within it the ‘seeds’ of an out-breath and vice-versa (as a result of intracellular metabolism and its effect on humoral gases), so introverted attention and extroverted attention (and experience) inter-penetrate. The yin-yang symbol comes to mind. I think yin-yang predates modern understanding of physiological processes, but it certainly expresses it.
Although the dichotomy is indeed a false one, the assumed superiority of inward meditation seems to me to be very prevalent. My own disinclination to regular or consistent sitting meditation aside, I still hold that the ‘outward way’ is not inferior, and certainly not less likely to ‘deliver’ the “solid centre of integrated experience” you describe.
Why and how, I ask, should attention that is not practiced in deliberate solitude, that is not withdrawn inwards and away from the world, that neither requires an unnaturally prolonged stillness nor disallows expressive engagement with the material universe, its embodied beings and their affairs…..why should that form of attention be any less productive of integration than sitting on a cushion with eyes closed preoccupied with sensations in the nose?
There is a more urgent question (for me) that runs in tandem with that one. Why do people who practise inward meditation believe themselves to be more integrated than those who don’t? I’m not referring here specifically to you, Robert, and me, Peter. My references for this question are the whole gamut of my experience of others across a huge and diverse front. I can’t properly judge or even guess at how solid is the central core of integrated experience in anyone, but I have to say that I see nothing in my experience of Buddhists I know, who claim to meditate regularly, that distinguishes them in any way from John and Jill Ordinary.
On the other hand, from my lifelong experience of working as a nurse alongside other nurses, mainly women, I believe that most of them are deeply grounded, lacking in bias or prejudice, emotionally intelligent, reflexively inclined to cooperate with others rather than to compete, and generally selfless. I do believe that these markers of integration are very much the product of their nursing work, and a response to its mystic dimension.
Nurses tend not to talk much about their work, and resist conceptual frameworks that have been developed to give it written expression or professional kudos. There is seamless property to nursing work, and this can be missed by those who see it as a series of disconnected and discontinuous episodes of ‘doing’ or ‘thinking’ or ‘attending’ or whatever. This seamless-ness is apparent in the doing of nursing, which can’t readily be captured in narrative accounts (although its spirit can be felt in some accounts, like the one I offered in my blog).
I think what I’m saying here (in a roundbout way) is that I think sitting meditation is a male or masculine paradigm of integration: cerebral, solitary, aloof, self-directed in its primary purposes. It ignores and/or seems unwilling to acknowledge the potency and vividness of alternative routes to self-discovery and work in the suffering world, and unready to hear or credit alternative womanly accounts of an “outward way”.
I hope this doesn’t come across as ad hominem, Robert, because it isn’t inspired by distaste for your work, or for you, both of which I admire hugely. Again, I think I’m making a not-very-articulate plea for a more inclusive and accessible account of the middle way. In a recent discussion we spoke of the need to speak to the young woman in the nail-parlour and to the part-time bicycle courier (this is not to caricature or diminish either). Are either of us or any of us doing this? Are we using the language or drawing on the experience of the wider world?
I think I’ve said enough, and will retire!
I’ll respond to you and your comments later, Norma, and thanks for writing.
Hi Norma
When I wrote the Meditation 6 article I was mindful of your own nursing experience and did wonder what you’d make of it. Times have indeed changed and pressures have increased but, because there is an increased imperative to developing powerful extroverted attention in these new circumstances I’m not persuaded that today’s nurses are less capable than those of yesteryear of adapting to change; it’s perhaps a sexist generalisation, but I firmly believe based on my own experience that most women do possess a special faculty for ‘making do’, and a better apprehension of the “bigger picture” than most men can conceive of.
That the Health Service has not collapsed under the weight of a burden of fragmentation and at clueless efforts at reorganising the bits back together is largely a tribute to the collective capacity of its women workers to hold it together; or so I’m disposed to believe!
When standing like a tree myself, I’ve begun sometimes to have an inkling of non-duality, so that the “me” observing the world like looking out of a slit in a post-box made of flesh begins to slip or fall away, and that distinction between “me in here” and “it out there” wobbles: hard to describe but full of wonder and awe. I had the same experience in Africa shortly after arriving there 45 years ago – everything just fell away suddenly, except an awareness of emptiness. It was triggered by my lying in bed, listening to drumming coming from a distant township, so alien and strange…….I’ve read somewhere that’s it’s described as “world collapse”, that’s what I experienced it as.
I enjoy periods of quiet sitting myself. My family sometimes find me sitting quietly, and say “Oh, sorry, didn’t want to disturb you meditating” or “Were you meditating?”. When I visit the Brahma Kumaris from time to time they have an hourly reminder throughout the day (0600-2200) to meditate for two minutes on the hour, and I find that is quite beautiful, rather like the beads on a rosary or mala, one gets ready almost instinctively for it, and it weaves itself into all activities, just stopping and being still for a while. I haven’t been able to find a means to prompting myself hourly, or I would love to use it. But I do sit quietly wherever and whenever I have to wait somewhere, and love doing so, almost always with eyes relaxed and unfocussed rather than shut.
Hi Peter,
Thank you for your lovely reply. I agree wholeheartedly with you that our NHS would soon crumble without the dedication of its staff, including nurses. When hospitalised in 2011, I was impressed by the kindness shown to me on the ward and although rushed off their feet, nurses managed to help the healing process with their calm approach.
I live alone and make time to sit quietly without interruption, I enjoy cooking for visiting family as I did yesterday, but today it’s back to being alone but not lonely.
Peter: I’m looking at the items listed on the Practice page of this site and wondering: Which (if any) of these practices meet your criteria for ‘the Outward way’? I’m guessing that none of the items listed under ‘meditation’ do so. In other words, you charge that there’s an Inward bias assumed in the definition of ‘meditation’ there. Yes?
The examples you give in this blog post remind me somewhat of mindfulness, as it’s practiced off of the cushion in everyday activities, according to the model that Thich Nhat Hahn has popularized. But given how meditation and other silent and solitary acts, like washing the dishes by hand, are central to that model, I’m guessing that you have some other criteria in mind for ‘outward’ or ‘extroverted attention.’
In any case, I speak as a natural introvert, who’s usually more comfortable in quiet and uncrowded spaces, either alone or in small groups of familiar faces. Although I feel obliged to challenge myself on occasion with greater exposure to new situations and social activity (not even I crave total isolation), I tend to think that mainstream Western culture is already biased towards extroverts (think domineering businessmen and brash entertainers, who are especially celebrated here in the US). Against that noisy and excited backdrop, the counterweight of a silent and solitary contemplative (if only on a part-time basis) seems to restore a welcome balance.
Thanks Jason for your perceptive analysis and comment on my offering. I’m not very good at making a coherent argument, so all comments help me to re-order my thoughts a little.
You use of the word extroverted seems to be rather different from mine. I use it to mean “outward looking”, rather than brash or domineering, and maybe there’s some slight confusion over two words that sound the same when spoken but are spelled differently (at least in English English as distinct from the American variant).
I’m referring to your use of the word “extravert” for which well-known synonyms are ‘socially confident, outgoing, social, genial, cordial, affable, friendly, people-oriented, lively, exuberant, uninhibited, unreserved, demonstrative’. I’ve used “extrovert” on the other hand to describe (in my understanding) a person concerned primarily with the physical and social environment (and one conversely one concerned less with the inner and more personal environment). By the nature of their work, nurses have extroverted attention, although they may be of introverted disposition or personality type, preferring solitary pursuits in their personal lives away from work etc. The two modes of being aren’t mutually exclusive, and may be complementary as Robert also allows.
Admittedly the two words are often used as if they were interchangeable, and indeed they may well be. But in my article I used extrovert to mean someone whose attention was directed primarily (but not exclusively) to the physical and social environment; and who directed her attention in such a way as to bring about an state of altered consciousness that – in an adept practitioner – was comparable to, and no less transformative than, that produced by sitting meditation.
In Robert’s further response, he says that he is able to recognise in other ‘introverted’ meditators a special state of being that he knows from his own experience is the product of regular and progressive meditation (and I have every reason to believe him). I think that I have a similar specialised appreciation of the enhanced extroverted attention and experience of adept practitioners (of nursing, for example), and – although I have way of comparing these states – I think I have grounds for judging these two different states as equal in producing core integration, though certainly susceptible to closer scrutiny than my meagre expertise allows.
Just as an aside, I’ve been struck throughout my mental health career of the enormous affinity that people with severe or profound learning disability (mental handicap) have with each other, even those who have extremely limited communication capability, and sometimes other incapacities like blindness or deafness. They very often seem able to communicate with each other wordlessly, as if by some telepathic means, and can seek each other out across considerable distances; distances that exclude the possibility of hearing each other or seeing each other. This is a well-recognised phenomenon that defies explanation. Like many other phenomena observed by women (nurses), it has never (as far as I know) been researched or written about.
Thanks again for your welcome contribution to this discussion, it’s nice to be in touch with you!
Hi Peter,
You ask why inward meditation should be more effective at integrating than outward. In theory I agree with you that it isn’t, but in practice I think it is much harder to integrate (in any of the three ways) without some degree of inwardness. The issue isn’t at root one of inward or outward at all, but of centredness and mental and physical awareness. On the whole, ‘outward’ experience tends to consist of objects that are part of goals and plans represented by our left hemispheres. One could bring more or less of a wider awareness into one’s relationships with those goals and plans, as you suggest in your example of nursing, but it’s just very much harder to do so in the more profound ways represented by states like dhyana. The ability to reach those more profound states does make a difference to how deeply one is able to integrate desires.
I take your point that the value of meditation is incremental – it’s just about developing more centred and aware states from wherever one starts. Being more aware whilst doing outward activities seems more accessible and easier for people to engage with, but actually I’m not sure that it necessarily is. You might compare it with paddling in relation to swimming. Paddling seems like partial swimming because you’re partially in the water, but it doesn’t give you an experience of swimming at all. If you were looking for the benefits of swimming (e.g. fitness, muscle toning etc) you wouldn’t get any of those to speak of by paddling.
The reason why people who practise inward meditation think they are more integrated than those who do not might just be because, on average (despite asymmetries and outliers), they are. But we can only conclude that on the basis of experience, and if your experience tells you differently then fair enough. Meditation is not the only way of becoming more integrated, but it does help, because it is about the most direct way available of engaging with the integration of our experience itself, rather than objects that form part of potentially obsessive plans or stories. My experience is generally that people who meditate do tend to stand out. I have had a number of experiences of meeting people who meditated in a context where this would not otherwise be obvious, having an inexplicable intuition that this was the case, and then having this sense confirmed when I talked to them. That doesn’t mean that less direct methods, like the ones you attribute to nursing practice, might not also have a strong integrative effect over time – but probably not quite the same sort or degree of effect.
The bigger point, for me, is that meditation tends to focus on integration of desire. There are others whose integration of meaning or of belief seem far more impressive. Meditation can have a strong effect, but that effect may not endure or produce a lasting impression unless it is supported by integration in other areas. There is a tendency for intellectuals to neglect more practical and creative ways of working, for practical types to neglect the intellect, and for creative artistic types to neglect both. Meditation is only one way of approaching all this, but that doesn’t mean that it’s not the most direct and effective way of doing what it’s best at doing.
Hi Peter
When I was in my 20’s, and a bit of a hippie, I really got into yoga on a six month trip to India. I spent a month on a yoga ashram there. I loved the physicality of it but the meditation sessions that were an optional extra every day left me cold. This was because the focus of the meditation being taught seemed to be about trying to become one with Atman and disassociating oneself from all things sensual and “worldly”. This really did not resonate with me at all and for another 20 years or so that was my understanding of what meditation was about.
It was only about 3 years ago or so , after coming into contact with some books on mindfulness and non-dogmatic Buddhist meditation, that I came to understand that meditation doesn’t have to be about trying to detach oneself from experience but rather engage with it. This awoke a lot of curiosity in me and for better or worse I’ve been meditating on a regular basis ever since.
Like Robert or Thich Nhat Hahn I don’t see meditating as something separate from the other activities in my life or as some end in itself. On the contrary, when I sit (or occasionally stand like a tree) I’m trying to find balance and a greater awareness under what I see as sort of lab conditions which I hope then can help me to be more balanced and aware in my life in general and enable me to address conditions more appropriately. It’s just one of a set of practices that I feel may have contributed to me developing spiritually (to a degree) over the last three years.