The Jewel and the Staff: A Look at What Buddhist Spiritual Care Might Look Like
Updated: Apr 27
Below is an article I wrote back in 2019. It explores a kind of spiritual care to others that is rooted in wisdom and naturally generates resilience. For all those who struggle with burnout or compassion fatigue, might this be of benefit to you.
The bodhisattva Ksitigarbha has always moved me. For those who aren't familiar, a bodhisattva is a being who, out of compassion for all sentient beings, vows to help each and every single one attain enlightenment before she does. The definition is indeed a paradox: one can't help but wonder if by "stalling" buddhahood, the bodhisattva has already realized it. Did realization beget the attitude of helping all beings? Or does helping all beings beget the bodhisattva's inevitable realization? Cue the wise yogini who, after being asked both questions, simply smiles and answers: "Yes."
Ksitigarbha is the bodhisattva who not only tells the Buddha "I will stay for all beings and help them uncover their own enlightenment" but also adds, "oh, and by the way, please send me to the hell realms." The teacher and author Vessantara describes Ksitigarbha as the "patron saint" of lost causes. She goes to the dark corners, to the places that humble and terrify us. She knocks on the gates of hell with a staff of compassion, holding a jewel of wisdom in her hands.
As many of you know, I'm working towards being a full-time hospital or hospice chaplain someday. Right now, I have the privilege of serving patients at a nearby hospital as a kind of chaplain-in-training (emphasis on the training part!) I was recently encouraged by my colleagues to contemplate and express what Buddhist spiritual care is from my point of view. Immediately, Ksitigarbha came to mind. I thought about how eagerly she volunteers to serve in the hell realms ("send me, Buddha!") and how she goes without getting caught in its undertows herself (with a subtle smile on her face no less).
The bodhisattva ideal of Ksitigarbha goes to the root of what I believe a Buddhist approach to spiritual care is. Buddhist spiritual care is care that emerges from wisdom. Wisdom is accessed by cultivating an experiential understanding of how things are. We aren't just talking about an experiential understanding of how things are in terms of events (e.g., "he had a car accident"), but an experiential understanding of the very nature and fabric of reality (e.g., what is the nature of a person, of suffering, of time, of any experience.) This understanding is cultivated - not through beliefs, ideas, or intellectualization alone - but principally through a different kind of knowing. This kind of knowing is experiential and more direct than thoughts. Contemplate, for example, how you know when you feel warm. Do you need a thought that says, "I feel warm" before you know you feel warm? Or do you just know you are warm whether or not a thought about it arises? For me, and according to Buddhist psychology, it is the latter. There is a way to repeatedly experience reality and know "it" with or without the presence of thoughts. This ability doesn't only apply to relative reality (it being warm) but also the ultimate reality (the nature of warmth itself). Repeatedly becoming familiar with the raw material of experience starts to reveal insights. Wisdom occurs when we experience the world around us not simply as it appears, but also as it ultimately is (and always was). One recognizes wisdom and its all-pervasive primordial nature. One doesn't "have wisdom" or possess it as some kind of trait. It is simply there, the way it is. And it can be experienced as an instinctive knowing of how things are, even before thought. One "knows" how it is with simple immediacy, just like one knows he or she is alive.
So how is it? What is it that one knows with simple immediacy? What is it that Ksitigarbha understands? What is it that a Buddhist spiritual care provider understands and practices understanding?
She knows that the nature of things is empty of any inherent self existence, and yet that phenomena nonetheless really do appear to exist. Say what?! That's a normal reaction. Let's unpack both sides of that sentence.
Emptiness: "the nature of things is empty of any inherent self-existence."
First, the doozy, the part that people have "difficulty believing," and ultimately, have to experience themselves: that phenomena are empty of any inherent self-existence. This means that, if you try to find a single independent solid "thing" in your experience, including your "self," you won't be able to find it. Instead, you'll find parts. And those parts will have parts. And those part's parts will have parts. And ultimately, there were never any "parts" at all. At the subtle level, one might be able to experience a shifting matrix of moving and dissipating energy, which is not a thing, but more akin to a process. It is nothing that can be held or "captured." Take a feeling in your body, for example. Just choose one (physical or emotional). Try to find its core, its essence, its "thingness" and hold onto "it." Find the part that doesn't move. Can you find it?
People naturally at this point say things like, "Yeah but look at trees! And walls! And my body! Those are solid things!" As I write this, I'm looking at my favorite tree outside. A crow just landed on it. Is its "treeness" still in tact with the crow on it? Most people would say "yes." Okay, well what if I cut off two branches, would its "tree existence" still be there? How many branches would I have to cut before you would no longer consider it a tree? Three? Five? All? Was there any "treeness" in the branches that got cut off? Is it "a tree" when its leaves are green? If so, does that mean it's no longer "a tree" when its leaves are dead? We could try to find the solid self-existing tree, the core of "treeness" that does not change, but we won't be able to find it. For Buddhists, all things follow this pattern. The human body, the psycho-spiritual "self", mountains, a thought, physical pain, emotions, you name it.
Scientists are conceding this point. Studies show that, within seven to ten years, every cell we have in our body is "new," i.e., has been replaced. You are literally a different "body" every seven to ten years. Also, it turns out, a concrete wall is actually more space than it is matter. And, if you examined that matter, it's not still. It is made of quantum particles that are never in one place. The wall is actually more like an energetic process or pattern. And even that, scientists say, doesn't have a center that can be "located"; they can only speak in relative terms and describe probabilities of where particles might be located at any given moment. Some have even gone so far as to say that, actually, the world's substantiality (or lack thereof) is much closer to the nature of a hologram than to the Newtonian materiality we take for granted.
Buddhists say the mind too, like all phenomena, is empty. It is not some "thing" that needs protection, or that has limitations. It is actually like space: inherently free, observable and yet incapable of being "captured." Emptiness means there is freedom from the "thingness" we experience. Freedom from the "thingness" of the subject (the self), and freedom from the "thingness" of the object (phenomena). Freedom from duality, which means freedom of the notion that there is something "out there" because there is something or someone "in here." Freedom from suffering because suffering is not some "thing" that will destroy us. The jewel that Ksitigarbha holds is the knowing of this inherent freedom, this ultimate reality. She goes to hell for the lost beings because she knows there is no such thing as hell and no such thing as lost beings.
And yet...there is not nothing. Reality is experienceable. The "experienceableness" brings us to the second (and inextricable) half of the equation that Ksitigarbha knows.
Appearances: "and yet, phenomena really do appear."
The concrete wall may be mostly space but we still see the wall. We really do perceive "a tree." Though your body is a cluster of moving and regenerating phenomena, it really will appear before you when you step in front of a mirror. In short, "thingness" doesn't exist, but it really appears to. There are many real-life analogies that help explain appearances:
Consider a rainbow. When there's a rainbow, you can see it, right? It really does appear to exist. But if you tried to cut "it" into pieces, you wouldn't be able to. You won't be able to hold it or capture it. And yet, when certain causes and conditions arise, the appearance of a rainbow emerges, with magnificent colors, an arc, and it is often breathtaking in size. But when conditions are no longer sufficient, the appearance disappears.
Consider a mirage. When you're driving on a hot day, the road before you can appear watery. It can look like you're going to drive straight through a puddle. That perception really does appear. And yet, when you keep driving, you never "hit" the mirage at all.
Consider a dream. When you dream, "dream you" might walk out of your "dream house" and get into your "dream car." You might drive on "dream roads" and get in a "dream car crash" (yikes!) Suddenly, you wake up in a sweat. It would be pointless to say that the dream didn't appear, right? And yet, where did it go? If it really ultimately existed, we should be able to find it. But that's not how we experience the fleeting elusive vapor of dreamlike appearances.
Similarly, Buddhists would say that, it's not just rainbows, mirages, and dreams: on one hand, all phenomena really do appear. When they speak of "relative reality," they are speaking about this plane of appearances. Relative to a tree, a human appearance is distinct. Short appearances appear smaller than taller appearances. Pain really appears different than pleasure. Dark moods appear all together different than light-hearted ones. The mind vaguely strikes us as distinct from the body. But if we were able to somehow apply an experiential microscope to each of these, we would find that their substance, their nature, is the same: it is emptiness, freedom from any concreteness.
Although Ksitigarbha understands that, ultimately, there is no hell and there is no such thing as a "lost being," she nonetheless simultaneously knows that because we do not understand the innate freedom of ourselves and phenomena (their empty nature), we really do suffer as if hell and our "lost selves" did exist. Consider the dream example again: when our "dream car" crashes and we are "dream injured," our sleeping body really flinches. The pulse of our sleeping body really does quicken. We really do sweat. We suffer.
Similarly, Ksitigarba holds the staff of compassion because she understands that suffering occurs based on the rigidity of our perceptions, i.e., based on our misunderstanding of how things are. We were never limited in the ways we thought, but because we think we are limited, so it appears to be to us.
Imagine you realized that the war-zone you were in was actually dreamlike. Vibrations appeared, but flowed through you. Your body is experienced as a rainbow: it appears but, like realizing a dream is a dream while still dreaming, you know its not really there as a concrete harm-able "thing." It is an unimaginable freedom that you experience, but one that you can't describe in words. You see appearances and yet experience that these appearances are joy and freedom itself. And yet, looking around, you see your loved ones screaming, weeping. You see them in pain when their dream hopes dissolve, transforming and disappearing like a mirage on the road. You see their dreamlike being is just as fantastically free as the one you experience. There is the hearing and feeling of grief, and yet you can tell there is no "you" or "sensations" that could ever be in any kind of conflict because all of it is of the same ineffable free and unconfined substance that is no substance whatsoever. You are "awake," seeing how things appear as a nightmare, but unafraid of the nightmare because you know what it is and what you and others are. At the same time, you see that others do not experience the dreamlike nature.
Compassion emerges naturally from this knowing. You are moved to help others, not out of sheer willpower or belief, but because it is as if you are watching others hit themselves with a hammer of their own perception and cry out in pain. Ksitigarba is moved. She uses her staff - her staff of skillful means and compassion - to knock on the gates of hell because she understands that to be liberated while others are suffering is no liberation at all. The staff of compassion is like a song that emerges from the mouth of realization. It bellows because that's what the mouth of realization does. Compassion for the spiritual care provider is not "forced" or "mustered up" or "imitated," it is expressed as the natural emergence of wisdom itself.
Not One, Not Two; and why the Buddhist emphasis on the mind?
Though the mind is seen as having the same empty nature as all phenomena, it is considered unique in one important sense. It is the mind that is able to know its own empty essence. The mind can "know" that its own nature is "nothing whatsoever." It is for this reason that the nature of reality is sometimes described in apophatic terms: not one, not two. The relative appearances are not separate from their empty nature. This is why the Heart Sutra reminds us, "form is emptiness and emptiness is form." Appearances were always free and empty to begin with. The mind too, and indeed our true nature, was never anything but free, even while the karma of appearances continues to manifest.
The late Master Tulku Urgyen Rinpoche summarizes it beautifully:
"The claim that buddha nature is a 'thing' that exists is incorrect. It is not a concrete thing with distinguishable characteristics; instead, it is wide open and indefinable, like space. However, you cannot claim that it is nonexistent, that there is not any buddha nature, because this nature is the very basis or source of everything that appears and exists....This buddha nature of ours, which is primordially free from the two extremes of being and not being, is described with the word 'unity.' What does unity mean in this context? Right now, visual forms, sounds and smells and so on are all present in our experience. If buddha nature were nonexistent, there could be no such experiences taking place. But if we say buddha nature does exist, then what is it that experiences? Can you pinpoint it? Thus, there is no confining these two. While perceiving, buddha nature is empty of a perceiver, while being empty, there is still experience."
Buddhist Spiritual Care
So what do we do as Buddhist or Buddhist-inspired spiritual care providers? Wait for realization of the empty nature of all phenomena to dawn and then serve beings? I don't think so. Here comes the paradox of the bodhisattva again. We can start anywhere on the circle. We can start by "being compassionate," in the most authentic (and probably limited) way we know how, and subsequently come to see the nature of things, which in turn will make us realize we never needed to "attempt" or "will" compassion into being in the first place. It naturally arises from wisdom. Alternatively, we can meditate on the nature of things while serving a patient, a friend, a colleague. While with them, we try to understand. We look, we listen, we perceive. It turns out, that the attentiveness and willingness to be with whatever (and whomever) arises, to understand their nature, is compassion. Either way, moment by moment, step by step, we serve while holding the knowing of the not one, not two truths. When we are overwhelmed, it means we need a little more of the jewel of wisdom, the part of us that knows how free reality really is; when we are arrogant, we need a bit more staff, to knock on the gates of hell, and see that suffering really does appear and can be experienced.
And when a patient is weeping and grieving because they know they are not going to recover from this latest bout of cancer, we aspire to, with a stable and relaxed knowing awareness, abide in wisdom. We do not fear because we know that this beautiful being is like the mind we are observing within ourselves: free by nature. And, we deeply honor and respect the relative, the cries of suffering that we ourselves know well. We take a leap, and the words come, the presence springs forth, and the tender empathy accompanies. We make it about their healing, their wholeness, and their enlightenment, because ours and theirs were never separate to begin with.