Dukkha Nyanas and the Nocebo Effect

Jason , modified 10 Years ago at 2/9/13 5:32 AM
Created 10 Years ago at 2/9/13 5:32 AM

Dukkha Nyanas and the Nocebo Effect

Posts: 342 Join Date: 8/9/11 Recent Posts
Have you heard about the nocebo effect?

While an inert sugar pill (placebo) can make you feel better, warnings of fictional side-effects (nocebo) can make you feel those too. This is a common problem in pharmaceutical trials and a 1980s study found that heart patients were far more likely to suffer side-effects from their blood-thinning medication if they had first been warned of the medication's side-effects. This poses an ethical quandary: should doctors warn patients about side-effects if doing so makes them more likely to arise?


Well, yes, they should. But they don't need to scare people, and they can offer plenty of reassurance (placebo) to counterbalance the effect.

It seems to me that this has implications for the way we talk about the dark night. Firstly, just calling it the dark night conveys doom and gloom, besides referencing a belief system that includes an immortal soul and eternal damnation. When you consider placebo research, and how much very subtle things can effect significant clinical phenomena, this terminology could be detrimental. (In fact, it's killing you! You can't breathe Aaagh!!!! Jk.) If we call it what it is, dhukka nyanas, it would invite discussion of the meaning of dukkha. That in itself would lead to some skill and insight to help advance beyond them. Dhukka is a nuanced, flexible term. You can't really use it without understanding a little about how fear/misery/disgust arise as mental fabrications. This already has some reassurance in it. The term dark night, on the other hand, has a tone of finality and doesn't really teach you anything other than that you're screwed! You were born bad, you pooped your pants, and now you're going to pay!

My take is that the real danger is chronic yogi syndrome. If you're practicing well, you are on your way through and beyond dukkha forever. If you're not practicing well, then you are bound to be afflicted with dukkha forever. So rejoice, sheeples! Jk.

I've yet to come across any dire warnings from traditional sources. From the Buddha on down, they just say, this way freedom lies. If our practice is really *causing* so much misery, perhaps we're doing it wrong? But I suspect it's just that we live in a litigious society and are addicted to disclaimers and warnings. (BTW: lightning bolt + WARNING + Dark Night = nocebo effect. Maybe some pretty clouds and a drawing by Jane Rainbow wouldn't be so bad afterall?)

(There's a funny caveat to the nocebo story. Turns out, only 8% of all clinical trials report the ingredients of their placebos. It's common practice for them to use active ingredients that mimic known side effects of the med being tested, so the side-effects don't show up as much in the final results. So, even if you do experience adverse reactions, you're likely to be told you're imagining it anyway. Bizarre.)
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Joshua, the solitary, modified 10 Years ago at 2/9/13 6:56 AM
Created 10 Years ago at 2/9/13 6:49 AM

RE: Dukkha Nyanas and the Nocebo Effect

Posts: 86 Join Date: 9/28/12 Recent Posts
I've yet to come across any dire warnings from traditional sources. From the Buddha on down, they just say, this way freedom lies. If our practice is really *causing* so much misery, perhaps we're doing it wrong? But I suspect it's just that we live in a litigious society and are addicted to disclaimers and warnings. (BTW: lightning bolt + WARNING + Dark Night = nocebo effect. Maybe some pretty clouds and a drawing by Jane Rainbow wouldn't be so bad afterall?)


Agree with you completely. I think it's highly related to American culture, where people care a lot for their social image of 'happiness'. So if a person intuitively discovers uncomfortable truths, it could be more dramatic to a person's life there than in other countries. Almost a complete opposite to the USA's sick relationship with joy and success is somewhere like Sweden, where something like a Dark Night experience would be validated and respected, look at Ingmar Bergman.

I guess the Buddha thought it was a given that deconstructing your reality for a better one would include uncomfortable moments.
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Eric B, modified 10 Years ago at 2/9/13 10:38 AM
Created 10 Years ago at 2/9/13 10:38 AM

RE: Dukkha Nyanas and the Nocebo Effect

Posts: 187 Join Date: 8/24/09 Recent Posts
There have been various discussions here about the hazards of "scripting". I'd previously concluded that I'd fallen prey to this myself on a couple of occasions.
Jason , modified 10 Years ago at 2/9/13 2:36 PM
Created 10 Years ago at 2/9/13 2:36 PM

RE: Dukkha Nyanas and the Nocebo Effect

Posts: 342 Join Date: 8/9/11 Recent Posts
Eric B:
There have been various discussions here about the hazards of "scripting". I'd previously concluded that I'd fallen prey to this myself on a couple of occasions.


Yes, it seemed more original in the middle of the night when I couldn't sleep. There is an important difference though with nocebo, which is that it can induce real physiological changes. So, not only do you perceive things as worse than they are, they really are worse.
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every3rdthought , modified 10 Years ago at 2/9/13 5:01 PM
Created 10 Years ago at 2/9/13 5:01 PM

RE: Dukkha Nyanas and the Nocebo Effect

Posts: 5 Join Date: 10/11/12 Recent Posts
The heavyweight canonical source for "dukkha nanas" (both their existence, and the terminology of progressive Knowledges) is the Visuddhimagga and Vimuttimagga where they first get described, and in fairly serious terms - Knowledge of Fear for example is described using the simile of a woman with three sons who had seen the first two executed, and is now awaiting the execution of the third. Of course, not everyone thinks these should be considered definitive sources for what happens in meditation.

It seems like, as far as the DN experience, it's very much a case of YMMV, but some people experience very intense DNs and of these, some will have expected that (if they knew about the Progress of Insight maps), but others won't. I'm not sure whether you wanted to conclude that we shouldn't talk about dukkha nanas/dark night at all, in order to avoid a nocebo effect, or that we should call it 'dukkha nanas' and not 'dark night'? - but from my perspective, the danger of someone hitting a DN style experience without knowing that it was possible or what it is, is much more serious than the possibility that talking about DN stages has a nocebo effect. For that reason, if I personally knew someone starting insight practice I would always warn them about this possibility.
Jason , modified 10 Years ago at 2/9/13 5:49 PM
Created 10 Years ago at 2/9/13 5:49 PM

RE: Dukkha Nyanas and the Nocebo Effect

Posts: 342 Join Date: 8/9/11 Recent Posts
... every3rdthought ...:
I'm not sure whether you wanted to conclude that we shouldn't talk about dukkha nanas/dark night at all, in order to avoid a nocebo effect, or that we should call it 'dukkha nanas' and not 'dark night'?


It seems like I was discussing the terminology.
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N A, modified 10 Years ago at 2/9/13 11:03 PM
Created 10 Years ago at 2/9/13 11:03 PM

RE: Dukkha Nyanas and the Nocebo Effect

Posts: 157 Join Date: 7/10/11 Recent Posts
It seems that what actually happens more often in practice is people getting depressed for whatever reason, and then thinking they are experiencing the dukkha ├▒anas.
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Avi Craimer, modified 9 Years ago at 11/15/13 9:53 AM
Created 9 Years ago at 11/14/13 11:47 PM

RE: Dukkha Nyanas and the Nocebo Effect

Posts: 114 Join Date: 10/29/13 Recent Posts
Hey,

Four years ago, I experienced very intense dark night symptoms on a meditation retreat doing vipassana meditation. I had never heard of the dark night of the soul, the teachers on the retreat didn't tell me anything, they seemed as surprised and shocked by what as I was going through as I was. I had to leave the retreat early, and I continued to suffer from intermittent terror, misery, and disgust for the next two and a half years. Because I lacked the maps, I had no idea what was happening to me, and this made everything many times worse.

I only discovered Daniel's work a month ago, and it was absolutely shocking to me how closely it fit my completely unscripted experiences. In the years between the onset of dark night stages and discovering Daniel's work, I've looked at numerous other models of the dark night including the Grof's work, stuff on Kundalini awakenings, St John, and so on. None of them were as helpful as Daniel's model. It does seem that not everybody experiences the same intensity of challenging experiences, but I have met several other people whose lives have been completely torn apart because of dark night stuff triggered on silent meditation retreats. Often the teachers don't offer any guidance because they either don't know the maps, or else don't want to share them openly. This can literally be crazy making for some people, and in my view, Daniel's efforts to get this info out to the public is of profound service.

Avi
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Simon T, modified 9 Years ago at 11/15/13 11:52 AM
Created 9 Years ago at 11/15/13 11:52 AM

RE: Dukkha Nyanas and the Nocebo Effect

Posts: 383 Join Date: 9/13/11 Recent Posts
The reason I believe we shouldn't worry too much about scripting is that you can't script yourself forever, or if you do, you are just too good at self-delusion to ever make any progress, with or without map. Eventually, the false diagnosis will end up being questionned. If someone believe he is stuck in a stage he isn't he will works to get unstuck anyway. On the opposite, if someone believe he is make progress that he isn't really making, he will eventually it a wall.

On the other hand, when you know the map, eventually you will end up being able to self-diagnose yourself. It might take a while to get it right but this period of adjustment is definitely worth it as it will make things much easier after that.

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