Pema Khandro is a Tibetan Buddhist teacher and humanitarian. She is one of the leading advocates of the tradition of Buddhist Yogis in the world. Her mission is to make in-depth Buddhist education available and accessible to everyone right in their own homes and communities, to open the doorway to the great treasures of Buddhist philosophy, meditation, medicine, art, ritual and poetry to a western audience. Pema Khandro is the spiritual leader of the Community of Buddhist Yogis in North America, she is the founder of Ngakpa International (www.ngakpa.org), the Yogic Medicine Institute, the MahaSiddha Center in BerkeleyCalifornia and Ngakpa House, a charity which supports the education of children and elders in the Himalayas. Pema Khandro is an authorized Lama and lineage holder of the Nyingma and Kagyu lineages and one of few westerners recognized and enthroned as a tulku. She is a teacher of Dzogchen and Vajrayana Buddhism, teachings that emphasize cultivating awareness and presence as the goal of the path. She is certified as Tibetan Naturopath and has led dozens of courses in nutrition, yoga teacher trainings, yoga therapy trainings, meditation trainings and courses in natural medicine for health practitioners from every field. Her work is also academic, as she spends her days studying Tibetan Buddhist history and researching the philosophical tradition, stories, culture and medical practices of the Buddhist Yogis. Pema Khandro specializes in the teachings of Dzogchen, Chod and the Six Yogas; esoteric Buddhist practices for lay people that focus on direct access to cultivating wisdom. Pema Khandro was ordained in the Nyingma tradition and was authorized to pass this non-monastic lineage of ordained Buddhist Yogis, also known as naljorpas and ngakpas on to her students, a task which she has been dedicated to since 1999. Pema Khandro has been featured in Yoga Journal as one of the “young teachers not to miss,” on TV, on numerous radio interviews, and her writing is also featured in the February 2015 issue of Buddhadharma quarterly. Today, Pema Khandro continues to be an advocate of the relevance of non-monastic Buddhist traditions as Buddhism takes shape in North America. She runs a residential center, leads a thriving community, runs a clinic and non-profit organization. She teaches courses regularly, pursues research projects and continues to cultivate a close relationship with her students and friends who work together in Ngakpa Intl and the North American Community of Buddhist Yogis.
Interview by Evelyn Einhaeuser
Where does Tibetan Medicine stem from?
It is one of the oldest medical systems in the world. Tibetan Medicine’s primary influences are Buddhist philosophy and Indian Ayurveda, however, since its earliest period, it has had an international influence which included elements of healing traditions from China, Mongolia, Nepal and more.
How is health and a healthy person defined in Tibetan Medicine and where is it defined?
Tibetan Medicine defines health in holistic terms – it includes not only the body and biological systems, but it also includes ethical practices, nutrition, lifestyle practices, social relationships and it takes into account religious perspectives. Tibetan Medicine is heavily connected with Tibetan Buddhist philosophy, with which it shares its views of conception, birth, death and rebirth, karma and so forth. However, within the tradition’s teachings and clinical applications it also takes into account religious views or lack thereof and how these impact a person’s health. In the Western medical model we are starting to see greater awareness of the body-mind connections. Tibetan Medicine has a highly developed understanding of the body and mind’s interaction and their effect on health. Yet this is not just a matter of internal factors, it includes a person’s lifestyle, relationships and ethics as well. So for Tibetan Medicine, health is not just a physical experience – health is a mental, emotional, spiritual and social well-being.
What are the root causes for sickness according to Tibetan medicine?
Tibetan Medicine considers how the development of disease relies on multiple factors that work together to reinforce illness and imbalance in the body.
The view in Tibetan Medicine is that disease is based on the body’s ecology, the person’s nutrition, their lifestyle, environmental factors.
The body ecology principles of Tibetan medicine look at how three humors, three forces in the body, work together to generate our health. These principles begin with common sense and proceed to something more sophisticated and complex. For example, if one eats too much spicy, salty food then it can trigger inflammatory responses, this is basically provoking the “bile” humor. If someone has too much bile humor this signals a tendency towards inflammation and or the harboring of an infection. It becomes more complex as we begin to consider how some foods which would be classified as bile increasing such as sauerkraut (fermented cabbage) actually kill infection.
As for the impact of environmental factors, for example, we are starting to understand how repeated exposure to toxins in food and the environment can imbalance the gut ecology leading to indigestion.
Mental and emotional factors can lead to the development of disease especially if there is anger, closed-mindedness, grasping at false realities or past traumas. This is something more and more common to consider even in modern medical models.
Tibetan Medicine also accounts for an additional factor in disease - spiritual causes of disease such as past life karma or ethical misconduct. So for example, harming others not only hurts others, it is bad for the health of the person who causes the harm. This is not difficult to conceive of, we can see how it is impossible to be angry at another person without experiencing the toxic effects of the anger ourselves.
What are the similarities to other traditional healing modalities like Ayurveda and Yoga and what are the distinct differences?
Both Tibetan Medicine and Ayurveda are based on the system of the three humors. One is bile, a metabolic function in the body, another is phlegm, an immune and structural function, and the other is wind, a circulatory function. These are akin to what is known as Vata, Pitta and Kapha in Ayurveda. However, Tibetan Medicine also is intertwined with Buddhist philosophy about the person and their purpose in life, whereas Ayurveda features elements of Indian Samkhya philosophy. Both Ayurveda and Tibetan Medicine include Yoga practices such as meditation, breathing and visualization. Some of these practices are similar and others are different.
In what ways are astrology, meditation and mantra involved in Tibetan medicine?
These elements vary based on who the Tibetan Medicine practitioner is and what their specialities are. One example of mantra and meditation in Tibetan Medicine is in the practice of Moxabustion, where points of the body are heated in order to stimulate circulation, stimulate removal of toxins and restore the nervous system functioning of particular areas of the body. During this practice a mantra is done to the Medicine Buddha and it is done to pray for the liberation of any microorganisms such as bacteria or virus that might be killed during the healing process. This is a way of bringing an attitude of compassion and benevolence to one’s healing process. This is there instead of having an aggressive attitude of trying to “kill disease” which could solifidify the habit of anger and the concept that we are separate from others. On the contrary, the well-fare of these beings is considered and the patient and doctor establish a compassionate relationship with them.
As for astrology, certain practices are done on certain days. For example, during the dark moon, eclipses and equinoxes when the body’s lymphatic and energetic systems are affected by changes in astrological context, moxabustion or surgerys may be avoided. This seems remote for persons who are only familiar with Western medical models. However Western scientists understand how the oceans tides are affected by lunar cycles, so too, our bodies, which are mostly water, are also affected by planetary forces. These are not seen as deterministic or fatalistic forces, however they are influences. These influences can be understood and dealt with skillfully.
What is the medicine tree?
The medicine tree is a teaching tool in Tibetan Medicine. It summarizes the primary principles of Tibetan Medicine, including the humors, etiology of disease, pathology, diagnostic practices, treatments, therapies and so on. It portrays all these principles visually so that students of Tibetan Medicine can memorize them and conceptualize the relationship between these principles.
What is the Buddha Medicine Practice?
The Medicine Buddha practice is a Buddhist meditation which cultivates compassion, altruism and the capacity to heal. It uses visualization and mantra to train the individual in attitudes that are necessary for healing to take place. It also involves visualization where one is visualizing one’s own body and mind being healed. But this healing doesn’t stop with the individual, the meditation concludes with extending the visualization towards all beings.
It is an important practice for overcoming the mental factors which promote disease such as ignorance, grasping and hatred.
We can see how the Medicine Buddha practice addresses a spiritual, psychological and social component of healing. It can help the patient overcome unconscious psychological blocks to healing through working with symbolic ritual and contemplative exercises. Not only does the patient practice the Medicine Buddha meditation, but the doctor does as well. In traditional Tibetan Medicine, the compassion and clarity of presence and ethics of the doctor are considered important factors in whether or not the patient can achieve maximum benefit from the treatments.
What is the Blue Buddha and why is he blue?
The Medicine Buddha is depicted as having a blue “lapis-lazuli” colored body. Lapis Lazuli is considered a precious healing stone.
How do paintings play a role in Tibetan medicine and how did paintings facilitate learning?
It is fascinating to look through the Tibetan Medicine illustrations such as those of the Blue Beryl of Sangye Gyamtso who was an influential figure in the tradition. These include illustrations of Tibetan herbs, stones, gems, foods and plants, diseases and diagnostics, anatomy, therapeutic practices and more.
What is tantra and how important is it for Tibetan Medicine?
Tibetan Medicine and Tibetan Tantra are heavily connected. There are some differences. However, Tibetan Buddhism is primarily “tantric” Buddhism, which means the system of Buddhist philosophy and practice which emphasizes compassion and mental-psychological transformation. Tibetan Medicine is also based on a text known as the “gyu-shi” (Tibetan: rGyu-bzhi), which is the four medical tantras. This is the main text which is studied in Tibetan Medicine though there is also an oral tradition so that each teacher carries practices and knowledge handed down to him by his teacher, which was passed down from the previous teacher in a lineage. There are also institutional traditions of learning Tibetan Medicine in colleges such as the famous Tibetan Medical College in Lhasa, central Tibet, founded in the twentieth century.
That is an interesting topic that is more detailed than can be covered in this interview, but there are Tibetan Medicine traditions rooted in local healing traditions and lineages and there is also institutional Tibetan Medicine. These are two different contexts.
Can you share one sacred teaching of Tibetan medicine that can help people with their daily wellbeing?
Its very important not to eat late in order to allow the digestive system and metabolic system to cleanse and detoxify at night. If a person eats late then they will be tired int the morning and more likely acculumate undigested material which will create blockages and lead to infections in the body. Of course, this is just a general statement because there are some situations such as hypoglycemia or cleansing where some continuous intake of blood sugar or protein might be beneficial.
What is the Lha body and how can it be lost?
This concept has to do with the person’s life force. Tibetan Medicine understands that there are factors that are beyond physiological factors yet heavily influence them and this is one of them. It can be lost through traumatic events or if the body becomes sufficiently debilated.
What are the symptoms of a lost Lha and how can it be brought back?
Some main symptoms of a lost Lha is anxiety, depression and illnesses which will not respond to treatment. The Lha is brought back through spiritual remedies, in this case the Tibetan Medicine practitioner will refer the person to a Tibetan Buddhist Lama (clergy person) to do ritual remedies and give advice for religious and ethical practices.
How important is the breath in Tibetan medicine?
Breathing practices are incorporated in Tibetan medicine but it depends on the individual case. The general attitude is that healing is not a “one size fits all” process.
What role does spirit or soul play in Tibetan medicine?
Buddhists have a different idea than the Western concept of soul – and this idea shows up in Tibetan Medicine – it is the notion that the person is a stream of consciousness. It is different than a soul because it is not static and fixed, but instead it is dynamic and instantaneous. It can be burdened by patterns which encumber the individual and show up repeatedly, these are known as karmic imprints. It can also be freed of those patterns.
Is prayer a part of Tibetan Medicine and of medicine making?
Mantras and rituals are used in Tibetan Medicine making.
How important is ancestry and past life in Tibetan Medicine and how can we access our karmic blueprints?
Tibetan Medicine understands that there are karmic factors which cause disease. This is why ethical and religious practices are considered an important part of a person’s healing process. However, if there are karmic elements this is not something a Tibetan Medicine physician would treat – that is something in the hands of the individual. Every person is responsible for making and unmaking their own karma.
Are emotional disturbances like anger or hatred perceived as sicknesses and if so, what can people do against them?
Anger and hatred are considered factors that cause disease. They disturb the body-mind system and provoke its systems. This is why, mantra, meditation and ethical practices may be part of a person’s health cultivation. The general concept is that a person must cultivate compassion and virtues such as patience in order to achieve healing and greater health.
How much of the ancient knowledge got lost and why do you think that many of ancient healing methodologies face so much adversary even though they represent forces of light/ the divine?
Bodies of knowledge are always changing and growing. This is impermanance. Change is the one thing that is certain. It is important that new knowledge comes forward, since we have new toxins –such as practices that will address the thousands of chemical pesticides being invented and put into our foods, such as practices that will address the issues such as genetically modified foods and so on. Lineages of medicine are powerful in this way because they include both the previous traditional knowledge contained in scriptures but also the things that experts added to that and adapted to that throughout time.
Natural medicine is a powerful force in the global economy. Because of this, the pharmaceutical industry’s influence over legislation imposes limits to its exposure and practice. However, education is very difficult suppress, especially these days with the internet. Consumers vote with with their wallets too – and they are using natural healing modalities.
How much is sickness part of the spiritual journey?
This depends on the individual. Every person has to choose how they will understand their own body, their own health and their diseases. Illness, aging and death present profound opportunities to clarify what is important in life, to raise questions about who we really are and what we will do with our time and resources. So our physical life lends itself to spiritual questions.
I heard that the Buddha referred to himself more as a healer than a god, and saw his teachings more as remedies than gospels. Is this correct?
The Buddha’s words and deeds were recorded hundreds of years after his life so it is impossible to say what exactly he said or to decisively know what he thought. However, Buddhism’s traditional accounts frame the Buddha’s teachings as a medical paradigm – that the Buddha saw the sickness of human beings (their suffering) and investigated its cure, which where the teachings that became known as Buddhism.
How can one become a Tibetan medicine doctor?
Training in Tibetan medicine happens in two ways. One can train with a Tibetan doctor directly, also known as Amchi, and receive both oral tradition and also study of the four medical tantras, or one may also train in a Tibetan Medical college. This latter is becoming the more common route, but there is local knowledge that is only held in local culture that institutions do not necessarily hold so both the local and institutional influences on the Tibetan Medical education are very important for the future of the system.