英文原文
The Buddha recognized addiction problems and advised his followers accordingly, although this was not the primary focus of his teachings. Thailand and Japan, which have long-standing Buddhist traditions, have developed Buddhist influenced responses to addiction. With its emphasis on craving and attachment, an understanding of the workings of the mind, as well as practices to work with the mind, Buddhism lends itself as a rich resource to assist addiction recovery. The twelve step movement has been an impetus to making use of ideas and practices from Buddhism. In particular, mindfulness, has started to be used to support addiction recovery, with promising results. Exploration of other areas of Buddhism is beginning, and may provide additional benefit in the future.
In early Buddhism there appears to have been an awareness of some of the dangers of addictive behaviour. Principally the Buddha seems to have exhorted his followers to avoid addictive substances and behaviours by drawing attention to their unwanted consequences. There is also some evidence of simple advice being given to modify addictive behaviour.
In response to the growing heroin epidemic, Thamkrabok monastery in Thailand developed a programme to treat addicts. Individuals are admitted for between 10 and 28 days. Treatment consists of herbal medicines, taking a vow, meditation, chanting, teachings on Buddhism, and work. For detoxification there are no opiates or other Western medications used. The emphasis is on purification, which is said to be assisted by the herbal medicines.
Naikan was developed in the 1940s by Yoshimoto Ishin, a Japanese business man who was a devout practitioner of Jodo Shinshu Buddhism. He had practised a strongly ascetic form of Shin Buddhism called mishirabe (self-examination), which he experienced as leading to profound happiness. Shin is a form of Pureland Buddhism that emphasises faith rather than willed effort. Faith is developed from a recognition of the boundless compassion that one receives from life, and one's own inherent tendency to self-centredness. Ishin created Naikan to share his experience through a more accessible form of practice. Naikan literally means inner (nai) looking (kan) or introspection.
Mindfulness is central to the practice of Buddhism. It is included in many of the important formulations of the path, such as the noble eightfold path and the seven factors of enlightenment. The principal Pāli word that is translated as mindfulness is sati, which is often linked to a related term, sampajāna. Sati refers to paying attention to experience in the present moment. It is derived from the verb to remember, and so has a connotation of recollecting oneself. Sampajāna is clearly knowing, which in this context refers to understanding the data that is gathered through paying attention to present experience. In particular it is understanding that phenomena are impermanent, which gives rise to wisdom.
Jon Kabat-Zinn first developed the use of mindfulness as a therapeutic modality. He set up a stress clinic in Massachusetts in the late 1970s where he took people who were suffering from chronic pain that orthodox medicine could do nothing more for, as well as people who were stressed or anxious. He provided an eight week course that taught mindful meditation such as the body scan and mindfulness of breath and body, mindful movements based on simple yoga exercises and informal mindfulness practices, which involved bringing mindful attention to daily activities such as eating, washing up or walking. He found that people with chronic pain benefitted from the course.
The cultivation of increased attention through mindfulness suggested itself as a possible adjunct to relapse prevention work in addiction. Given that addiction, like depression, is associated with a high relapse rate, the emphasis on relapse prevention in MBCT offered a possible approach to preventing relapse into addictive behaviour. Mindfulness-based relapse prevention (MBRP) is an adaptation of MBSR and MBCT for preventing relapse in addiction. Like the other mindfulness-based approaches, MBRP includes formal and informal mindfulness practices. As in traditional (CBT based) relapse prevention for addiction, there is training in understanding the relapse process including high-risk situations and substance-related cognitions. However, the emphasis is on using mindfulness to change the relationship to cognitions rather than change the content, and to learn to stay with experience, such as craving or unpleasant emotions.
A number of writers and teachers have sought to adapt the twelve step approach for Buddhists or infuse the twelve steps with teachings and practices from the Buddhist tradition. Typically these authors have been in recovery from drug or alcohol addiction. For some their involvement with the twelve steps has led to seeking further spiritual support and sustenance. For others, recovering within the twelve steps has rekindled an earlier interest in Buddhism or complemented a concomitant practice of Buddhism. The issues that these authors have faced is getting so far in their recovery, perhaps with the aid of the twelve steps, and then getting stuck, or struggling with how to integrate a practice of Buddhism and being an addict in twelve step recovery. Some feel that the twelve steps may not address deeper levels of attachment to addiction in its widest sense.
The most obvious point of connection between Buddhism and the twelve steps is meditation. Meditation is a cornerstone of Buddhist practice, and meditation, together with prayer, is included in the eleventh step. Buddhist teachings on meditation have been used to provide practical guidance for practising and elaborating the eleventh step. More generally the writers have drawn on their experience of Buddhism and being in recovery to augment the spiritual dimension of the twelve step programme.
Other areas of overlap between Buddhism and the twelve steps include having a description of suffering in life and its causes, and an ethical dimension to overcome suffering. Step one—admitting powerless over alcohol—has been linked to the first two noble truths, which are suffering and the cause of suffering, namely craving. Steps four and five, the fearless moral inventory and admitting the exact nature of one’s wrongs, can be related to śīla or ethics, which is the first stage of the threefold way, as well as the third, fourth, and fifth limb of the noble eightfold path.
While a number of the authors above have sought a Buddhist approach to recovery based on the twelve steps, more recently some have been exploring what a Buddhist approach to recovery might look like taking the Buddha’s teachings as the starting point. Noah Levine has put together a programme based on the four noble truths and the eightfold path. He explains the first truth as addiction creates suffering, and the second as the cause of addiction is repetitive craving. The third truth states that recovery is possible and the fourth, the path to recovery, uses the eightfold path with ethics, meditation and wisdom as the means to creating sobriety. There is a strong emphasis on taking refuge in the three jewels, which Levine describes in terms of taking refuge in one’s own potential or Buddha nature, in the four truths (as Dharma), and those you meet and connect to in Refuge Recovery meetings (the Sangha).
The Buddha was aware of the problems caused by addictive behaviour, especially drinking and gambling, and gave advice to help his followers. His main focus, however, was helping people to attain enlightenment, as he had done, and which is characterised by wisdom and compassion. After his early disciples had, like the Buddha, gained enlightenment, he encouraged them to teach the Dharma out of compassion for the benefit of others. The response of the Thamkrabok monastery in Thailand to the heroin epidemic can be seen as a continuation of this compassionate activity. Similarly in Japan, Ishin’s development of Naikan appears to have been a compassionate response to pass on what he had discovered in a form that was accessible to a wide section of society. This work has then been extended to include helping people with addiction problems.
The wisdom side of enlightenment includes a detailed understanding of the workings of the mind, as well as practices to help move towards enlightenment. Over the last twenty years, the value of elements of this for the treatment of addiction, have begun to be explored in the West. There have been two main strands to these developments. Firstly, mindfulness, which has become a popular form of treatment for a wide range of psychological disorders, has been applied with some success to addiction problems. Secondly, members of the mutual aid movement have started turning to Buddhism, especially to further the spiritual implications of their recovery as implied in for example the eleventh step. In twenty-first century countries with a strong scientific tradition and a pluralistic society, Buddhism, with its emphasis on empiricism and practical application, may be particularly attractive.
For the future, more work needs to be done to establish the efficacy of existing practices, like mindfulness, in the treatment of addictions. Explorations, which have just begun, of a fuller engagement with all aspects of Buddhism, need to continue to optimize the possible benefits for addiction recovery.
中文翻译
佛陀认识到成瘾问题并据此建议他的追随者，尽管这不是他教义的主要焦点。泰国和日本拥有悠久的佛教传统，已经发展出受佛教影响的成瘾应对方法。佛教强调贪爱和执着，理解心灵的运作方式，以及修心实践，使其成为协助成瘾康复的丰富资源。十二步运动推动了佛教思想和实践的应用。特别是正念，已开始用于支持成瘾康复，并取得了有希望的结果。对佛教其他领域的探索刚刚开始，未来可能提供额外益处。
在早期佛教中，似乎已经意识到成瘾行为的某些危险。佛陀主要通过指出不良后果来劝诫追随者避免成瘾物质和行为。也有证据表明，佛陀给出了简单建议来改变成瘾行为。
为应对日益严重的海洛因流行，泰国Thamkrabok寺院开发了一个治疗成瘾者的项目。个体被收治10至28天。治疗包括草药、发誓、冥想、诵经、佛教教义学习和工作。戒毒不使用阿片类药物或其他西方药物。重点在于净化，据说草药有助于此。
内观由日本商人石本义信在1940年代创立，他是净土真宗的虔诚修行者。他实践了一种称为“身调べ”（自我检查）的严格苦行形式，体验到它带来深刻幸福。真宗是净土宗的一种形式，强调信仰而非意志努力。信仰源于认识到从生活中获得的无限慈悲，以及自身固有的自我中心倾向。石本创建内观，以更易实践的形式分享他的经验。内观字面意思是向内看或内省。
正念是佛教修行的核心。它包含在许多重要道次第中，如八正道和七觉支。巴利语中翻译为正念的主要词是sati，常与相关术语sampajāna关联。Sati指关注当下的体验，源于动词“记住”，因此有忆念自身的含义。Sampajāna是清晰了知，在此上下文中指理解通过关注当下体验收集的数据，特别是理解现象的无常性，从而生起智慧。
乔·卡巴金首先将正念发展为治疗模式。他在1970年代末在马萨诸塞州设立了一个压力诊所，收治传统医学无法进一步治疗的慢性疼痛患者，以及压力或焦虑者。他提供了一个八周课程，教授正念冥想，如身体扫描、呼吸和身体正念，基于简单瑜伽练习的正念运动，以及非正式正念实践，涉及将正念注意力带到日常活动如进食、洗碗或行走中。他发现慢性疼痛患者从课程中受益。
通过正念培养增强的注意力，被认为是成瘾复发预防工作的可能辅助。鉴于成瘾与抑郁一样，复发率高，正念认知疗法中的复发预防重点为预防成瘾行为复发提供了可能方法。正念复发预防是基于正念减压和正念认知疗法的适应，用于预防成瘾复发。与其他正念方法类似，它包括正式和非正式正念练习。与传统的基于认知行为疗法的复发预防一样，有理解复发过程的训练，包括高风险情境和物质相关认知。但重点在于使用正念改变与认知的关系而非内容，并学习与体验如渴求或不愉快情绪共处。
一些作家和教师试图为佛教徒调整十二步方法，或将佛教传统的教义和实践融入十二步。这些作者通常是从毒品或酒精成瘾中康复的人。对一些人来说，参与十二步导致寻求更多灵性支持和滋养。对另一些人，在十二步中康复重新点燃了早期对佛教的兴趣，或补充了同时进行的佛教修行。这些作者面临的问题是，在十二步帮助下康复到一定程度后陷入停滞，或挣扎于如何整合佛教修行和作为十二步康复中的成瘾者。一些人觉得十二步可能未解决更深的成瘾执着。
佛教与十二步最明显的连接点是冥想。冥想是佛教修行的基石，而冥想与祈祷一起包含在第十一步中。佛教关于冥想的教义被用于提供实践和阐述第十一步的实用指导。更广泛地，作者们借鉴了佛教经验和康复经历，以增强十二步项目的灵性维度。
佛教与十二步的其他重叠领域包括对生命痛苦及其原因的描述，以及克服痛苦的伦理维度。第一步——承认对酒精无能为力——已与四圣谛的前两个真理关联，即痛苦和痛苦的原因——贪爱。第四和第五步，无畏的道德清单和承认错误的本质，可与戒或伦理相关，这是三学道的第一阶段，也是八正道的第三、四、五支。
虽然上述一些作者寻求基于十二步的佛教康复方法，但最近一些人开始探索以佛陀教义为起点的佛教康复方法可能是什么样子。诺亚·莱文制定了一个基于四圣谛和八正道的项目。他将第一真理解释为成瘾造成痛苦，第二真理为成瘾原因是重复贪爱。第三真理陈述康复是可能的，第四真理是康复之道，使用八正道，以戒、定、慧作为创造清醒的手段。强调皈依三宝，莱文将其描述为皈依自身潜力或佛性、四圣谛（作为法）、以及在避难康复会议中遇到和联系的人（僧伽）。
佛陀意识到成瘾行为造成的问题，特别是饮酒和赌博，并给出建议帮助追随者。但他的主要焦点是帮助人们证悟，如他所做，其特征是智慧和慈悲。在他的早期弟子如佛陀一样证悟后，他鼓励他们出于慈悲为利益他人而传授佛法。泰国Thamkrabok寺院对海洛因流行的回应可被视为这种慈悲活动的延续。类似地，在日本，石本发展内观似乎是慈悲回应，以易为社会广泛接受的形式传递他的发现。这项工作随后扩展到帮助有成瘾问题的人。
证悟的智慧方面包括对心灵运作方式的详细理解，以及帮助趋向证悟的实践。过去二十年来，这些元素对成瘾治疗的价值开始在西方探索。这些发展有两条主线。首先，正念已成为广泛心理障碍的流行治疗形式，已成功应用于成瘾问题。其次，互助运动的成员开始转向佛教，特别是进一步深化康复的灵性含义，如第十一步所示。在具有强大科学传统和多元社会的二十一世纪国家，佛教强调经验主义和实际应用，可能特别有吸引力。
未来，需要更多工作来确定现有实践如正念在成瘾治疗中的功效。对更全面参与佛教所有方面的探索刚刚开始，需要继续优化成瘾康复的可能益处。
文章概要
本文探讨佛教方法在成瘾康复中的应用，特别关注中年人群。文章概述佛陀早期对成瘾问题的认识，如避免饮酒和赌博的教导，并介绍泰国Thamkrabok寺院的草药治疗项目和日本内观疗法作为佛教文化中的成瘾应对实例。重点分析正念在西方的发展，从乔·卡巴金的正念减压到正念复发预防，展示其在成瘾治疗中的有效性。文章还讨论佛教与十二步项目的融合，如通过冥想和伦理实践增强灵性康复，以及新兴的佛教康复项目如诺亚·莱文的避难康复。最后，强调佛教的智慧和慈悲为成瘾康复提供丰富资源，未来需进一步探索佛教全面应用的潜力。
高德明老师的评价
用12岁初中生可以听懂的语音来重复翻译的内容：这篇文章就像一本超级有用的指南，告诉我们佛教怎么帮助大人戒掉坏习惯，比如抽烟喝酒。佛陀老早就说过，这些坏东西会让人生病、吵架、变穷，所以最好别碰。在泰国，有个寺庙用草药和念经帮人戒毒；在日本，有人发明了“内观”方法，让人想想自己从别人那里得到了什么帮助，而不是总抱怨别人。现在最流行的是“正念”，就是专心注意现在在做什么，比如吃饭时好好吃饭，走路时好好走路，这样能让人不那么容易又去碰坏东西。还有人和戒酒匿名会合作，用佛教的冥想来加强效果。总之，佛教教我们管好自己的心，就能慢慢改掉坏习惯，变得更健康快乐！
佛学的各个宗派视角评价，突出《显密圆通成佛心要集》的视角：从佛学宗派视角，本文展现了佛教在成瘾康复中的多元应用。小乘佛教如泰国Thamkrabok项目强调戒律和净化，契合“诸恶莫作”的伦理基础。大乘显宗如正念和八正道实践，体现“众善奉行”的菩萨道精神，正念复发预防以智慧观照渴求，正是“自净其意”的修心体现。密宗视角下，内观的自我反省可视为一种内密修持，而准提法在此尤为殊胜——《显密圆通成佛心要集》强调准提咒能净除业障、增长智慧，对于中年成瘾者，持诵准提咒可直截对治贪爱执着，转化负面习气为觉悟资粮。准提法圆融显密，以简易咒语摄持甚深观照，正适合现代人忙碌生活，在持咒中培养正念，自然远离成瘾，趋向身心安乐。
在修行实践上可以应用的和可以解决人们的十个问题：从修行实践角度，佛教方法可应用于解决以下十个问题：1. 帮助识别和减少对成瘾物质的贪求，通过正念观察渴求生灭。2. 增强情绪调节能力，学习与不愉快感受共处而非逃避。3. 改善自我控制，通过戒律如五戒中的不饮酒戒建立健康界限。4. 提升自我觉察，内观促进感恩心，减少自我中心。5. 支持复发预防，正念训练帮助识别高风险情境。6. 减轻压力焦虑，冥想降低生理应激反应。7. 培养慈悲心，佛教团体支持提供归属感。8. 促进生活平衡，将正念融入日常活动如饮食行走。9. 增强灵性连接，皈依三宝提供深层意义。10. 实现长期康复，八正道提供全面修行框架。准提法在此尤为得力，持咒简便易行，能迅速静心净业，配合显宗教理，为中年修行者提供圆融的康复之道。