A Buddhist Approach to the Stress Management from

Perspective of Dependent Origination (DOSM)

Dr. Walmoruwe Piyaratana

Ṭhitañāṇo Bhikkhu (Andrus Kahn), Ph.D. Candidate

Abstract

This article aims to understand the Buddhist view to the stress management by
analyzing the conceptual framework of the Dependent Origination
(paṭiccasamuppāda).
Four noble truths as taught by Buddha says, the life is full of stress (dukkha),
there is a cause of this stress, it is possible to stop stress, and there is a way to stop
stress by following noble eightfold path, which is a right views, right aspiration, right
speech, right action, right livelihood, right effort, right mindfulness and right
concentration. The deeper explanation of stress (dukkha) is given by the Buddha in
Paṭiccasamuppādasutta, which include explaining detailed nature of stress and
describing the evolution or lifecycle of the all living beings.
Dependent Origination model is presented in Tipiṭaka in two ways: general
presentation, which do not specify each factor separately and detailed presentation,
which describes and analyzes each factor separately and comprehensively. This study
has been used both approaches to expound the causes and possible solutions to relieve
and release of stress.
Answer of possibilities in managing stress through Dependent Origination,
contains some theoretical and practical ideas, which are possible implemented to the
practice in perspective of self-help or professional therapy.

Key Words: Dependent Origination, stress, Stress Management.

 2

Introduction

What is life, the cause, condition, purpose and nature of it, has been the
subject of much philosophical, scientific and theological speculation. Different
concepts provide different possible ideas, opinions and dogmas as well. As some of
this concepts are based on the unverifiable belief or comes from unverifiable sash,
which scientists or the representatives of other religions cannot be accept (for
example, that life is created by god Brahmā), it is impossible to find one and only
understanding, which could be accepted by all.
Buddhist view of existence is based on the doctrine of DO which gives an
explanation describing the evolution of the World and cycle of life, from birth to the
death of all living beings. There is not possible to say, which factor is the “first cause”
in this cycle. This kind of interpretation equates the Buddha’s teaching to religions
paradigm, which contains a “first reason”, for example all-creator god as primary
reason and source for living and the nonliving manifestations. This kind of
understanding contradicts the doctrine of dependent origination (DO), which offers an
objective version of causality, whereby all conditioned phenomena’s are interrelated
and interdependent.
There are many researches about the effects of stress, confirm the damaging
and deadly effects of it. According to studies, the stress has been called “the silent
killer” which can lead to heart disease, high blood pressure, chest pain, and an
irregular heartbeat 1 . It is linked as well to the six leading causes of death: heart
disease, cancer, lung ailments, accidents, liver cirrhosis, and suicide.2 Chronic stress
floods the brain with powerful hormones that are meant for short-term emergency
situations. Chronic exposure can damage, shrink, and even kill brain cells.3 Whether
such damaging or deadly injury can be mitigated or prevented using the Buddha's
doctrine? If yes, how could it look like in practice? This work provides answers to
these questions and provides practical outputs, which are suitable for use in self-help
or therapeutic process, by examining concept of DO and applying ideas contained
therein of the daily routine.

1
Chilnick Lawrence, Heart Disease: An Essential Guide for the Newly Diagnosed,
(Philadelphia, PA: Perseus Books Group, 2008).
2
“How Does Stress Affect Us?”, (USA: American Psychological Association Website), the
article is last reviewed by John M. Grohol on January 30, 2013 and originally published on
PsychCentral.com on August 18, 2007, Retrieved November 3, 2015, from
http://psychcentral.com/lib/how-does-stress-affect-us//
3
Wallenstein Genem, Mind, Stress, and Emotion: The New Science of Mood, (Boston:
Commonwealth Press, 2003).
 3

The main aim intended to examine the concept of dependent origination

(paṭiccasamuppāda) as it occur in the Buddhist texts and find out interrelationship,
which correlates with modern approach of psychological stress in terms of liberation
of all the stress (dukkha) 4 , which is the summum bonum and the highest goal of
Buddha’s doctrine (Buddhadhamma).

1. Dependent Origination

Doctrine about the cycle of DO have given in various suttas, like Dependent
Origination (Paṭiccasamuppādasuttaṃ) 5 , Analysis of Dependent Origination
(Vibhaṅgasuttaṃ)6, Vipassi (Vipassisuttaṃ)7, Kaccana Gotta (Kaccānagottasuttaṃ)8,
Prerequisites (Upanisasuttaṃ)9 and Volition (Cetanāsuttaṃ)10,11 which all belong to
the same Nidānavagga - The Book of Casuation. DO have also been explained in
Right View sutta (Sammādiṭṭhisuttaṃ)12, which contains a thorough analysis of each
of the twelve factors (dvāsasaṅga) and applies the four noble truth (cattāri
ariyasaccāni) context. All this sutras deals in different ways with movement of the
consciousness to a new existence.
Like the Vibhaṅga Sutta, the Mahā Taṇhāsaṅkhaya Sutta 13 , too, presents
dependent arising in its order of arising and in its order of ceasing. This formula is an
example of dependent arising in a synchronic cycle, that is, in the course of an
individual’s life. The Bahudhātuka Sutta presents the formula by first making a
statement of the general principle of specific conditionality (idappaccayatā), followed
by both sequences together. The sutta that follows the Vibhaṅga Sutta in the Book of
Causality (Nidānavagga) of the Saṁyutta Nikāya is the Paṭipadā Sutta14, where the
forward formula (dependent arising) is called “the wrong way” (micchāpaṭipadā) and
the reverse formula (dependent ending) “the right way” (sammāpaṭipadā) 15 . The
seven suttas16 that follow the Paṭipadā Sutta describe the awakening of the six past

4
The Pali term dukkha encompasses pain and suffering as well as subtler forms of difficulty
and dissatisfaction. “Unsatisfactoriness” may be a better translation in some usage of dukkha (i.e.
whatever is impermanent is dukkha or unsatisfactory). In other cases, dukkha is clearly “pain”.
5
S.II.1.
6
S.II.2.
7
S.II.5.
8
S.II.16.
9
S.II.29.
10
S.II.65.
11
Saṃyutta Nikāya contains three identical named suttas, which deal with volition (cetanā),
but each in a different way viz.: Cetanāsuttaṃ (S.II.65), Dutiya cetanā suttaṃ (S.II.66) and
Tatiyacetanāsuttaṃ (S.II.67).
12
M.I.46.
13
M.I.256.
14
S.II.4.
15
Piya Tan (Tr.), “(Paṭiccasamuppāda) Vibhaṅga Sutta. The Discourse on the Analysis (of
Dependent Arising)”, Dharmafarer, 2003, Retrieved on 06 October 2015, from
http://dharmafarer.org/wordpress/wp-content/uploads/2009/12/5.15-Paticcasamuppada-Vibhanga-S-
s12.pdf
16
S.II.4-11.
 4

Buddhas, wiz: Vipassī (Vipassisuttaṃ), Sikhī (Sikhīsuttaṃ), Vessabhū

(Vessabhusuttaṃ), Kakusandha (Kakusandhasuttaṃ), Konāgamana
(Konāgamanasuttaṃ), Kassapa (Kassapasuttaṃ) and Gotama (Gotamasuttaṃ), as the
discovery of dependent arising and its ending.
It is important to mention that according to the Buddha explanation in
Anurādha Sutta, he has not taught anything else than stress (dukkha) and how to get
rid of it:
Sādhu sādhu anurādha, pubbe cāhaṃ anurādha, etarahi ca dukkhañce va
paññāpemi dukkhassa ca nirodhanti.17
Good, good, Anurādha! Formerly, Anurādha, and also now, I make known
just suffering [stress] and the cessation of suffering.18

1.2 DO Formula

In the Analysis of Dependent Origination (Paṭiccasamuppādasuttaṃ) Buddha

has explained, what is the meaning of DO as follow:
And what, bhikkhus, is dependent origination? With ignorance as condition,
volitional formations [come to be]; with volitional formations as condition,
consciousness; with consciousness as condition, name-and-form; with name-
and-form as condition, the six sense bases; with the six sense bases as
condition, contact; with contact as condition, feeling; with feeling as condition,
craving; with craving as condition, clinging; with clinging as condition,
existence; with existence as condition, birth; with birth as condition, aging-
and-death, sorrow, lamentation, pain, displeasure, and despair come to be.
Such is the origin of this whole mass of suffering. This, bhikkhus, is called
dependent origination.19
The whole formula meets today's modern logic, which says that “This being,
that exists; that through the arising of this arises. This not being, that does not exist;
that through the ceasing of this ceases.” This structural principle underlies almost
every aspect of the Buddha’s teaching.
According to Bhikkhu Bodhi explanation, DO formula works as follows:
Because of (1) ignorance (avijjā), lack of direct knowledge of the Four Noble
Truths, a person engages in volitional actions, wholesome (kusala) and
unwholesam (akusala) activities of body, speech, and mind; these are (2)
volitional formations (saṅkhārā), in other words, kamma. Volitional
formations sustain consciousness from one life to the next and determine
where it re-arises; in this way volitional formations condition (3)

17
S.III.116.
18
Bhikku Bodhi (tr.), The Connected Discourses of the Buddha: A Translation of the
Saṃyutta Nikāya, (Boston: Wisdom Publication, 2000), p.938.
19
Ibid., p.533.
 5

consciousness (viññāṇa). Along with consciousness, beginning from the

moment of conception, comes (4) “name-and-form” (nāmarūpa), the sentient
organism with its physical form (rūpa) and its sensitive and cognitive
capacities (nāma). The sentient organism is equipped with (5) six sense bases
(saḷāyatana), the five physical sense faculties and the mind as organ of
cognition. The sense bases allow (6) contact (phassa) to occur between
consciousness and its objects, and contact conditions (7) feeling (vedanā).
Called into play by feeling, (8) craving (taṇhā) arises, and when craving
intensifies it gives rise to (9) clinging (upādāna), tight attachment to the
objects of desire through sensuality and wrong views. Impelled by our
attachments, we again engage in volitional actions pregnant with (10) a new
existence (bhava). At death this potential for new existence is actualized in a
new life beginning with (11) birth (jāti) and ending in (12) aging-and-death
(jarāmaraṇa). 20
It is important to understand that in doctrine of the Buddha, there is no re-birth
or incarnation. There is no English word corresponding exactly to the Pali word
bhava, which mean “becoming to the existence”. According to the Buddhas teaching,
nothing can be re-born or born again - there is only arising and passing or appear and
disappear of consciousness.

1.2 Relational Context of DO Formula

The 1st factor of DO is ignorance (avijjā) of dukkha, of the origin of dukkha,

cessation of dukkha and of the right path leading to the cessation of dukkha. 21 This
kind on lack of direct knowledge of the Four Noble Truths leads a person in volitional
(cetanā) activities of body (kāya-kamma), speech (vacī-kamma), and mind (mano-
kamma). According to the Abhidhamma, avijjā includes ignorance of the past, of the
future, the past and future (pubbanta, aparanta, pubbantāparanta) and of DO. 22
Dukkhasutta 23 lists three kinds of dukkha: (1) the suffering due to pain, (2) the
suffering due to formation and (3) the suffering due to change.
Right view regarding the karma (kammassakatā sammā-diṭṭhi) means, that
only two things, wholesome (kusala) and unwholesome (akusala) actions performed
by all beings, are their own properties that always accompany them wherever they
may wander in many existences.24 Volitional activities also called kamma-formations.
These postulate the kammic cause for new appearance (bhava), thereby extending the
cycle of birth (jāti) and aging-and-death (jarāmaraṇa) or saṃsāra.

20
Ibid., p.518.
21
The division corresponds to the Four Noble Truths given in Buddha’s first sutra,
Dhammacakkappavattana Sutta (S.V.420).
22
Dhs.195-6.
23
S.IV.259.
24
Ledi Sayādaw, Maggaṅī Dīpanī: A Manual of the Path Factors, (England: Association
for Insight Meditation, 1984), p.1.
 6

Because of ignorance of kamma and its results, people perform all sorts of
unwholesome activities for immediate self-benefit. Because of delusion thinking that
sensual pleasures and jhānic ecstasy are real forms of happiness, people perform
dāna, sīla and bhāvanā so that they can attain such happiness in this life or in future
lives through rebirth as men, devas or brahmas. Thus people accumulate both moral
and immoral kamma (sankhāra) as a result of ignorance.25
The 2nd factor of DO is volitional formations (sankhārā), which covers bodily
volition (kaya-sankhāra), verbal volition (vacī-sankhāra) and mental volition (mano-
sankhāra). According to the Abhidhamma, sankhārā also contains a meritorious
formations or good karma (puññābhisankhāra), de-meritorious formations or bad
karma (apuññābhisankhāra) and fixed formations or special meritorious karma
(āneñjābhisankhāra).26 Sankhāra is the same as kammabhava in the sense that both
condition the process of new coming or manifestation of kamma.
The 3rd factor of DO is consciousness (viññāṇa). There is 6 kind of
consciousness: eye-consciousness (cakkhu-viññāṇa), ear-consciousness (sota-
viññāṇa), nose-consciousness (ghāna-viññāṇa), tongue-consciousness (jivhā-
viññāṇa), body-consciousness (kāya-viññāṇa), and mind-consciousness (mano-
viññāṇa).27
The 4th factor of DO is mind-body (nama-rūpa) - that, what we call the
personality, “where in contrast with nāma (as abstract, logical, invisible or mind-
factor), rūpa represents the visible (material) factor, resembling kāya.”28 Therefore, it
can be said, that a man is made up of nāma and rūpa.
The 5th factor of DO is the six sense bases or organs of sense (saḷāyatana)
(and the six objects) viz., eye (cakkhu), ear (sota), nose (ghāna), tongue (jivhā), body
(kāya), and mind (mano) (or as objects: forms, sounds, odouis, tastes, tangible things,
ideas).29
The 6th factor of DO is contact (phassa) as sense or sense-impression. Phassa
furnishes the contact between the sense object, the sense organ and the citta
(counsciousness). For example, the contact between visual object, visual organ (eye)
and eye-consciousness (cakkhu-viññāṇa) is accomplished by phassa.30
The 7th factor of DO is feeling (vedanā) or sensation. Feelings of pleasure
(sukhā), pain (dukkhā) and indifference or neither-painful-nor-pleasant
(adukkhamasukhā) arising from impingement on eye, ear, nose, tongue, body and
mind.31 Feeling can be divided also into five kinds: sukhaṃ, dukkhaṃ, somanassaṃ,

25
Chan Khoon San, Buddhism Course, (Malaysia: Chan Khoon San Publication, 2006), p.71.
26
Vibh.6. (Suttantabhājanīyaṃ, § 3-5).
27
D.II.58, 308; S.IV.68 sq.; VbhA.19.
28
PED., p.1289.
29
Dukkhavihārasuttaṃ, KN.4.28.
30
Mehm Tin Mon, The Essence of Buddha Abhidhamma, (Yangon: Mya Mon Yadanar
Publication, 1995), p.67.
31
Satipaṭṭhānasuttaṃ M.I.57-58. The same is given at D.III.275; S.II.53, 82 and IV.207.
 7

domanassaṃ and upekkhā. 32 In Saṃyutta is given as well categories of 2 to 108

modes of vedanā, 33 but mostly talking of emotions using the basic threefold
classification.34
The 8th factor of DO is craving (taṇhā). Taṇhā arises when the sense organs
come into contact with the outside world there follow sensation and feeling, and these
(if, there is no mastery over them) result in taṇhā.35
There is different kind of taṇhā divisions. The best known is threefold division
viz., craving for sensuous pleasure, for rebirth (anywhere, but especially in heaven),
or for no rebirth (kāma-taṇhā, bhava-taṇhā, vibhava-taṇhā). Another group of 3 aims
of taṇhā is given as kāma-taṇhā, rūpa-taṇhā and arūpa-taṇhā36 and yet another as
rūpa-taṇhā, arūpa-taṇhā and nirodha-taṇhā 37 . Sixfold taṇhā classification are
founded relating to the 6 objects of sense or sensations (bāhirāni āyatanāni), viz.
craving for forms (rūpa-taṇhā); craving for sounds (sadda-taṇhā); craving for smells
(gandha-taṇhā); craving for tastes (rasa-taṇhā); craving for bodily sensations
(poṭṭhabba-taṇhā); craving for mind objects (dhamma-taṇhā).38
Taṇhā binds a man to the chain of Saṃsāra, of being reborn and dying again
and again until Arahantship or Nibbāna is attained, taṇhā destroyed, and the cause
alike of sorrow and of future births removed.39
The 9th factor of DO is grasping (upādanā) or clinging. Upādāna lit. means
substratum by means of which an active process is kept alive or going.40 Four kind of
clinging’s are (1) clinging to sense objects (kāmupādanā), that is, sights, sounds,
smells, tastes and bodily sensations; (2) clinging to views (diṭṭhupādanā); (3) clinging
to rules and observances, believing that in themselves these rules and observances
lead to purity (sīlabbatupādanā); and (4) clinging to the concept of “I” or “self”
(attaupādanā), creating a false idea of self (atta) and then clinging to this idea.
The 10th factor of DO is becoming (bhava), and the three spheres of existence
are the sense-sphere (kāma-bhava), the fine-material sphere (rūpa-bhava) and the
immaterial sphere (arūpa-bhava).
The 11th factor of DO is birth (jāti) or “future life” as disposition to be born
again, “former life” as cause of this life. Jāti is a condition precedent of age, sickness and
death, and is fraught with sorrow, pain and disappointment. It is itself the final outcome
of a kamma, resting on avijjā, performed in anterior births.41 Essentially, this means (re-)

32
Vism.461.
33
S.IV.223 sq.
34
According to the Atthasālinī, “All feelings have the function of experiencing the taste, the
flavour of an object”, (I, Part IV, Chapter I, 109).
35
PED., p.676.
36
D.III.216.
37
Ibid.
38
D.II.58; Ps.I.6 sq.
39
Ibid.
40
PED., p.360.
41
PED., p.647.
 8

appearance or birth of the five aggregates or so-called personality

(pancupādānakkhandhā) the factors of the fivefold clinging to existence.
The 12th factor of DO is aging and death (jarāmaraṇa). Jarā: the aging
process, the fading of the faculties; and maraṇa: the breaking up of the khandhas, the
dissolution of the life principle or life faculty (jīvitindriya), death. Alternatively, the
degeneration and dissolution of specific phenomena.42 After a being is born, aging
and death will follow as inevitable consequence. This is because every ultimate reality
has the characteristics of arising or coming into existence, birth (uppāda), existing or
duration (ṭhiti) and dissolving (bhanga). So aging and death must unavoidably follow
bhava. They are the primary effects of bhava, as a consequence of bhava, sorrow
(soka), lamentation (parideva), pain (dukkha), grief (domanassa) and trouble,
turbulence (upāyāsa) may also arise.43 These five kinds of dukkhas are inescapable
consequences of bhava.
In this chain of events, we see one incident depends on one prior to it and
gives rise to one after it. Everything that we find in this world can be brought in a
chain of dependence like this. Nothing can originate without depending on something
else previous to it, and no originated thing can be conceived of, which does not give
rise to something else in its turn. Thus the process goes on. Anything can be traced
upwards to where it originated from and everything can also be traced downwards to
that which is produced depending on it.44 Thus DO formula conforms, that liberation
does not come from outside, from matter, because rūpa is just subject to the nāma,
which constant, uninterruptedly changing.

2. Stress in Modern Psychology

2.1 Definition of Stress

The effects of stress differ from individual to individual. By definition, stress

is any uncomfortable “emotional experience accompanied by predictable biochemical,
physiological and behavioral changes.”45 According to the Oxford Dictionary, stress
is “a state of mental or emotional strain or tension resulting from adverse or
demanding circumstances.”46 Generally, stress (also known as distress) is defined as
an organism’s total response to demands or pressures, or reaction to a change that
requires a physical, mental or emotional adjustment or response.

42
P.A. Payutto, Dependent Origination: The Buddhist Law of Conditionality, (Bangkok:
Chandrapen Publishing House, 2011), p.32.
43
Tatiya Anāthapiṇḍikasuttaṃ, S.V.388.
44
Chan Khoon San, Op. cit. p.64.
45
Baum A., “Stress, Intrusive Imagery, and Chronic Distress”, Health Psychology, Vol. 6,
(1990): 653-675.
46
Stress [Def. 2], in Oxford Dictionaries, Retrieved November 3, 2015, from
<http://www.oxforddictionaries.com/definition/english/stress>
 9

Stress is often described as a feeling of being overwhelmed, anxious or run-

down. It can affect people of all ages, genders and circumstances and can lead to both
physical and psychological health issues. 47 Some stress can be beneficial at times,
producing a boost that provides the drive and energy to help people get through
situations like exams or work deadlines. However, an extreme amount of stress can
have health consequences and adversely affect the immune, cardiovascular,
neuroendocrine and central nervous systems.48
In psychology stress is divided into positive (eustress) and negative (distress).
Stress can provide energy and motivation to meet daily challenges and helps to
challenge and meet the goals. Mostly people don’t consider this challenge as a type of
stress because achievement of the objectives and goals offers satisfaction and pleasant
feelings. However, too much stress can have both physical and psychological negative
impacts. When the challenges at work or personal life become too demanding or
strenuous and the pleasant feeling of satisfaction turns into tiredness, frustration, and
disappointment or unlikable, distress occurs.

2.2 Stressors

Stress is caused by an existing stress-causing factor or “stressor”. The most

frequent reasons for “stressing out” fall into three main categories:
1. The unsettling effects of change
2. The feeling that an outside force is challenging or threatening
3. The feeling that having lost personal control.49
Many Americans are stressed and anxious about their financial future. An
APA poll on the causes of stress reports that two-thirds (61 %) of Americans identify
the economy as a significant source of stress in their lives. Three-quarters (69 %) are
stressed by money and more than one in two report that housing costs are causing
them stress (57 %). In addition, almost one half of Americans report that job stability
is a significant cause of stress. Pop sources of stress according to the APA are listed in
the following table. 50

47
Mary K. Alvord, Karina W. Davidson & et al., “Understanding Chronic Stress”, (USA:
American Psychological Association APA Website), Retrieved November 3, 2015, from
http://www.apa.org/helpcenter/understanding-chronic-stress.aspx
48
Anderson, N.B., “Levels of Analysis in Health Science: A Framework for Integrating
Socio-behavioral and Biomedical Research,” Annals of the New York Academy of Sciences, Vol.
840, (1998): 563-576.
49
Introduction to Leadership MSL I, Department of the Army ROTC manual:
Introduction to Stress Management, (USA: Pearson Custom Publishing, 2009), p.88, Retrieved
August 31, 2015, from
http://www.mc.edu/rotc/files/5713/1471/5877/MSL_101_Personal_Dev_Sect_01_Intro_to_Stress_Man
agement.pdf
50
“Impact of Stress”, (USA: American Psychological Association APA Website), Retrieved
November 3, 2015, from http://www.apa.org/news/press/releases/stress/2012/impact.aspx
 10

Table 1. Top sources of stress according to data published by the APA

Source of stress Percent

Money 69 %

Work 65 %

The economy 61 %

Family responsibilities 57 %

Relationships 56 %

Family health problems 52 %

Personal health concerns 51 %

As the above table shows, the money of work and the two largest sources of
stress what are interrelated and interdependent.
The National Institute of Mental Health notes some of the more common
stressors for college students, which partially overlap in the above list:
• Increased academic demands
• Being on your own in a new environment
• Changes in family relations
• Financial responsibilities
• Changes in your social life
• Exposure to new people, ideas, and temptations
• Awareness of your sexual identity and orientation
• Preparing for life after graduation. 51
Work Related Stress (WRS) or occupational stress is stress is stress-involving
work. WRS is a growing problem around the world. WRS affects not only the health
and well-being of employees, but also the productivity of organization’s. There are
differences in underlying causes and triggers of WRS for everyone. However, some
workplace factors are more likely to lead to stress than others: badly designed shift
work, poor communications, and poor or even non-existent systems for dealing with

51
“Common Stressors for College Students”, (USA: National Institute of Mental Health
Website), Retrieved November 3, 2015, from http://www.nimh.nih.gov/search.jsp?query=stress
 11

bullying and harassment can all increase levels of workplace stress. 52 Among the
many stressors mentioned by employees, these are the most common:
• Lack of job security
• Company policies
• Coworkers who don't do their fair share
• Unclear expectations
• Poor communication
• Not enough control over assignments
• Inadequate pay or benefits
• Urgent deadlines
• Too much work
• Long hours
• Uncomfortable physical conditions
• Relationship conflicts
• Coworkers making careless mistakes
• Dealing with rude customers
• Lack of cooperation
• How the company treats coworkers. 53

A person can experience WRS as a result of various factors, often occurring at

the same time. Some of these are a matter of the individual’s perception in the
moment, it is difficult to ascertain whether the problem is the worker(s) responsibility
or error of a system. Table 1 and 2 below sets out some potential WRS causes.
According to job providing site “Career Cast”, firefighters have the most and
hair stylists have the least stressful job in America.54

Table 2. Career cast listed top ten most and least stressful jobs in America

10 most stressful jobs in America 10 least stressful jobs in America

1. Firefighter 1. Hair Stylist

2. Enlisted Military Personnel 2. Audiologist

52
“Work-Related Stress: A Guide for Employers”, (Iearland: Health and Safety Authority,
2009), Retrieved November 3, 2015, from
http://www.hsa.ie/eng/Publications_and_Forms/Publications/Occupational_Health/Work_Related_Stre
ss_A_Guide_for_Employers.pdf
53
Somaz, Wenk Heidi, Tulgan, Bruce, Performance Under Pressure: Managing Stress in
the Workplace, (Canada: HRD Press, 2003), p.7-8.
54
“Jobs Rated Most and Least Stressful Methodology 2015”, (CA: Career Cast Webside),
Retrieved 31 August, 2015 from
http://www.careercast.com/career-news/jobs-rated-most-and-least-stressful-methodology-2015
 12

3. Military General 3. University Professor

4. Airline Pilot 4. Medical Records Technician
5. Police officer 5. Jeweler
6. Actor 6. Medical Laboratory Technician
7. Broadcaster 7. Seamstress/Tailor
8. Event co-ordinator 8. Dietician
9. Photojournalist 9. Librarian
10. Newspaper reporter 10. Forklift Operator

The study also highlighted the stress score and median salary, the basis of
which cannot be unambiguous concluded that the most stressful occupations have
always higher paid. The same correlation applies to least stressful jobs.

Table 1. Contextual factors defining the hazard of WRS

Context to work – potential hazardous conditions

Organizational culture Poor communication, low levels of support for problem

solving and personal development, lack of definition of
organizational objectives.

Role in organization Role ambiguity and role conflict; responsibility for people
unclear.

Career development Career stagnation and uncertainty, under or over

promotion, poor pay, job insecurity, low social value to
work.

Decision latitude/ control Low participation in decision-making, lack of control over

work.

Interpersonal Social or physical isolation, poor relationships with

relationships at work superiors, interpersonal conflict, lack of social support.

Home-work interface Conflicting demands of work and home, low support at

home, dual career problems.

Table 2. Content factors defining the hazard of WRS

 13

Content of work – potential hazardous demands

Work environment and Problems regarding the reliability, availability, suitability

equipment and maintenance or repair of both equipment and
facilities.

Task design Lack of variety or short work cycles, fragmented or

meaningless work, underuse of skills, high uncertainty.

Workload/pace of work Work overload or underload, lack of control, over pacing,

high level of time pressures.

Work schedule Poorly managed shift working, inflexible work schedules,

unpredictable hours, long or unsocial hours.

Table 3. Career cast listed top ten most stressful jobs with stress score and median
salary in America

Profession Stress score Median salary $

1. Firefighter 71.59 45,600

2. Enlisted Military Personnel 70.78 28,840

3. Military General 63.11 196,300

4. Airline Pilot 60.46 98,410

5. Police officer 50.82 56,980

6. Actor 50.33 46,070

7. Broadcaster 50.30 60,070

8. Event coordinator 49.93 45,810

9. Photojournalist 49.22 42,530

10. Newspaper reporter 48.76 37,090

 14

Table 4. Career cast listed top ten least stressful jobs with stress score and median
salary in America

Profession Stress score Median salary $

1. Hair Stylist 5.47 22,770

2. Audiologist 6.30 69,720

3. University Professor 6.94 68,970

4. Medical Records Technician 7.55 34,160

5. Jeweler 8.10 35,350

6. Medical Laboratory Technician 8.98 47,820

7. Seamstress/Tailor 9.56 25,590

8. Dietician 10.23 55,240

9. Librarian 10.58 55,370

10. Forklift Operator 11.43 31,150

Generally can be said, that money, occupation and stress level is very closely
related. According to a nationwide survey conducted by APA in 2007, 2008, 2009,
2010, 2011, 2012, 2013 and 2014, 55 the four main stressors are money, work, family
responsibilities and health concerns.56
Stressors have a major influence upon mood, our sense of well-being,
behavior, and health. Acute stress responses in young, healthy individuals may be
adaptive and typically do not impose a health burden. However, if the threat is
unremitting, particularly in older or unhealthy individuals, the long- term effects of
stressors can damage health. The relationship between psychosocial stressors and
disease is affected by the nature, number, and persistence of the stressors as well as by
the individual’s biological vulnerability (i.e., genetics, constitutional factors),
psychosocial resources, and learned patterns of coping. Psychosocial interventions
have proven useful for treating stress-related disorders and may influence the course

55
Norman B. Anderson, Cynthia D. Belar, Steven J. Breckler & et al., “Stress in America:
Paying With Our Health”, The Annual Nationwide Survey in America Report, (February 4, 2015),
Retrieved 31 August, 2015 from http://www.apa.org/news/press/releases/stress/2014/stress-report.pdf.
56
In 2007, this option was presented to respondents as “personal health concerns”.
 15

of chronic diseases.57 In order to cope with stress, it is necessary to understand the

physical and mind-based (psychological) stress-causing factors.

2.3 Symptoms

Symptoms of distress are usually divided into three general, but interrelated,
categories - physical, mental, and emotional. Table 3 below sets out some emotional
and physical symptoms of stress.

Table 3. Emotional and physical symptoms of stress 58

Emotional symptoms of stress Physical symptoms of stress

• Becoming easily agitated, frustrated • Low energy

and moody
• Feeling overwhelmed, like you are
losing control or need to take control
• Having difficulty relaxing and
quieting your mind
• Feeling bad about yourself (low self-
esteem), lonely, worthless and
depressed
• Avoiding others.
• Headaches
• Upset stomach, including diarrhoea,
constipation and nausea
• Aches, pains, and tense muscles
• Chest pain and rapid heartbeat
• Insomnia
• Frequent colds and infections
• Loss of sexual desire and/or ability
• Nervousness and shaking, ringing in
the ear
• Cold or sweaty hands and feet
• Excess sweating
• Dry mouth and difficulty swallowing
• Clenched jaw and grinding teeth.

Behavioral changes are also expressions of stress. They can include irritability,
disruptive eating patterns (overeating or under eating), harsh treatment of others,
increased smoking or alcohol consumption, isolation and compulsive activity
(shopping, etc.).

57
Neil Schneiderman, Gail Ironson, & Scott D. Siegel, “Stress and Health: Psychological,
Behavioral, and Biological Determinants”, Annual Review of Clinical Psychology, Vol. 1, (April,
2005): 607-628.
58
“Physical Symptoms of Stress”, (UK: WebMD, Stress Management Health Centre Website),
Retrieved October 26, 2015, from http://www.webmd.boots.com/stress-management/physical-stress-
symptoms
 16

2.4 Effect of Stress

The effects of stress differ from individual to individual. Many factors

influence the individual and his/her interpretation of ‘threat’, response to threat and
recuperation after a threatening experience. Different personality styles, gender
difference, age, context, family history, emotional state, understanding of self and
general social awareness will all influence each person’s stress levels.59 Theories of
the stress-illness link suggest that both acute and chronic stress can cause illness, and
several studies found such a link.60
As demonstrated in the above list, stress can have wide ranging effects on
emotions, mood and behavior. Equally important but often less appreciated are effects
on various systems, organs and tissues all over the body.

2.4.1 Nervous system

When stressed-physically or psychologically--the body suddenly shifts its

energy resources to fighting off the perceived threat. In what is known as the "flight
or flight" response, the sympathetic nervous system signals the adrenal glands to
release adrenaline and cortisol. These hormones make the heart beat faster, raise
blood pressure, change the digestive process and boost glucose levels in the
bloodstream. Once the crisis passes, body systems usually return to normal.

2.4.2 Musculoskeletal system.

Under stress, muscles tense up. The contraction of muscles for extended
periods can trigger tension headaches, migraines and various musculoskeletal
conditions.

2.4.3 Respiratory system.

Stress can make you breathe harder and cause rapid breathing - or
hyperventilation - which can bring on panic attacks in some people.

2.4.4 Cardiovascular system.

Acute stress- stress that is momentary, such as being stuck in traffic--causes an

increase in heart rate and stronger contractions of the heart muscle. Blood vessels that
direct blood to the large muscles and to the heart dilate, increasing the amount of
blood pumped to the parts of the body. Repeated episodes of acute stress can cause
inflammation in the coronary arteries, thought to lead to heart attack.

59
“Work-Related Stress: A Guide for Employers”, Op. cit., p.9.
60
Introduction to Leadership MSL I, Department of the Army ROTC manual: Introduction to
Stress Management, Op. cit., p.88.
 17

2.4.5 Endocrine system.

Adrenal glands: When the body is stressed, the brain sends signals from the
hypothalamus, causing the adrenal cortex to produce cortisol and the adrenal medulla
to produce epinephrine - sometimes called the “stress hormones.”
Liver: When cortisol and epinephrine are released, the liver produces more
glucose, a blood sugar that would give you the energy for “flight or flight” in an
emergency.

2.4.6 Gastrointestinal system.

Esophagus: Stress may prompt you to eat much more or much less that you
usually do. If you eat more or different foods or increase your use of tobacco or
alcohol, you may experience heartburn,or acid reflux. Stomach: Your stomach can
react with "butterflies" or even nausea or pain. You may vomit if the stress is severe
enough.
Bowels: Stress can affect digestion and which nutrients your intestines absorb.
It can also affect how quickly food moves through your body. You may find that you
have either diarrhea or constipation.

2.4.7 Reproductive System.

In men, excess amounts of cortisol, produced under stress, can affect the
normal functioning of the reproductive system. Chronic stress can impair testosterone
and sperm production and cause impotence. In women stress can cause absent or
irregular menstrual cycles or more painful periods. It can also reduce sexual desire.61
An extreme reaction to stress is a panic attack. According to the National
Institute of Mental Health, about 6 million American adults have been diagnosed with
panic disorder. A panic attack is a sudden, intense fear or anxiety that may make you
feel short of breath, dizzy, or make your heart pound. People who have panic attacks
may feel out of control, like they are having a heart attack, or are about to die. Panic
attacks may happen with no clear cause, but they can be brought on by living with
high levels of stress for a long time.62

2.5 Stress Management

While elimination of stress is unrealistic, stress management is an attainable

and practical way to prevent and manage stress. That can be achieved by a number of
strategies. Stress Management is methods of controlling factors that require a
61
Steven M. Teagarden, “Overview of Effects of Stress on the Body”, (USA: Emergence Care
Homepage), Retrieved November 3, 2015, from http://www.emergencecare.com/stress_body.html
62
“Stress Management - Effects of Stress” (UK: WebMD, Stress Management Health Centre
Website), Retrieved October 26, 2015, from
<http://www.webmd.com/balance/stress-management/stress-management-effects-of-stress.
 18

response or change within a person by identifying the stressors, eliminating negative

stressors, and developing effective coping mechanisms to counteract the response
constructively. Examples include progressive muscular relaxation, guided imagery,
visualization, meditation, biofeedback, breathing techniques, active problem solving
etc.
Techniques of stress management varies according to the philosophical
paradigm. Positive outcomes are observed using a combination of non-drug
interventions in Autogenic Training, Anger Management, Talking and Cognitive
Therapy, Biofeedback, etc. 63 Solution-Centered Therapy, Hypnosis, Self-Hypnosis
and Neuro-Linguistic Programming (NLP) also provide an excellent positive
therapeutic effect.
Both work as a non-work-related stress, the stress prevention and management
should analyze the following 4 aspects:

•What are the aspects •Prioritize them

that have the potential according to severity
to cause stress? and likelihood of
negative outcome;
or eliminate the risks
– change the system so
that the stressful
1. aspect is eliminated.
2.
Identify
Assess
Causes of
the Risks
Stress

4. 3.
Monitor Contain
the Risks the Risks
•Continually review •Limit the impact
levels of stress. and/or reduce the
number of causes of
stress; or protect from
the risks – reduce the
degree of exposure to
the factors that cause
stress.

Figure 1: Four steps of stress prevention and management

63
Wolfgang Linden, Joseph W. Lenz & Andrea H. Con, “Individualized Stress Management
for Primary Hypertension: A Randomized Trial”, Arch Intern Med, Vol. 161, (August, 2009): 1071-
1080.
 19

Psychologists have provided a number of ways to cope with everyday stress,

that people can learn to manage stress and lead happier, healthier lives. Typically,
these include the following recommendations:
• Keep a positive attitude.
• Accept that there are events that you cannot control.
• Be assertive instead of aggressive. Assert your feelings, opinions or beliefs
instead of becoming angry, defensive or passive.
• Learn and practice relaxation techniques; try meditation, breathing exercises,
yoga or t’ai chi.
• Eat healthy, well-balanced meals.
• Learn to manage your time more effectively.
• Get enough rest and sleep. Your body needs time to recover from stressful
events.
• Don't rely on alcohol, drugs or compulsive behaviors to reduce stress.
• Identify the sources of stress. Try to figure out what's causing your stress
symptoms. Maybe you have too many commitments and feel fatigued and
irritable. Once you identify the sources of stress, try to minimize these as
much as possible.
• Talk it out. Talk to a friend, family member or therapist if your stress level is
too high. Getting your feelings out without others judging you is crucial for
good mental health.
• Set priorities. Use the time-management tips and make a To-Do list. Decide
what is really important to get done today, and what can wait.
• Take time for yourself. Before you reach your breaking point, take time for
solitude. Take time to nurture yourself, away from the cares and
responsibilities of the world. Find time for inner strength and emotional
healing.
• Set limits. Never hesitate to say ‘no’ before you take on too many
commitments. Especially if you are balancing work and family, it's important
to priorities. Saying ‘no’ can help bring your stress to a manageable level and
give you more control over your life.
• Exercise daily. Exercise is thought to increase the secretion of endorphins,
naturally produced substances in the brain that induce feelings of
peacefulness. Many studies show that exercise, along with the boosted
endorphin levels, really does increase confidence and self-esteem and reduce
tension.
• Practice facing stressful moments. Think about the event or situation you
expect to face and rehearse your reactions. Find ways to practice dealing with
the challenge.
• Examine your expectations. Try to set realistic goals. It’s good to push
yourself to achieve, but make sure your expectations are realistic. Watch out
for perfectionism. Be satisfied with doing the best you can. Nobody’s
 20

perfect—not you, not your fellow Cadet, nobody. Allow people the liberty to
make mistakes, and remember that mistakes can be a good teacher.
• Live a healthy lifestyle. Get plenty of exercise. Eat healthy foods. Allow time
for rest and relaxation. Find a relaxation technique that works for you—
prayer, yoga, meditation, or breathing exercises. Look for the humor in life,
and enjoy yourself.
• Learn to accept change as a part of life. Nothing stays the same. Develop a
support system of friends and relatives you can talk to when needed. Believe
in yourself and your potential. Remember that many people from
disadvantaged backgrounds have gone on to enjoy great success in life.64
As often is the stress caused by lack of time, time management specialists are
recommended to monitor the time-sensitive actions and habits. Here are some
strategies for dealing with time-related stress:
• Schedule time for vacation, breaks in your routine, hobbies, and fun activities.
• Try to arrange for uninterrupted time to accomplish tasks that need your
concentration. Arrange some leisure time during which you can do things that
you really enjoy.
• Avoid scheduling too many appointments, meetings, and classes back-to-back.
• Allow breaks to catch your breath. Take a few slow, deep breaths whenever
you feel stressed. Breathe from the abdomen and, as you exhale, silently say to
yourself, “I feel calm.”
• Become an expert at managing your time. Read books, view videos, and
attend seminars on time management. Once you cut down on time wasters,
you’ll find more time to recharge yourself.
• Learn to say “no.” Setting limits can minimize stress. Spend time on your
main responsibilities and priorities rather than allowing other people’s
priorities or needs to dictate how you spend your time.
• Tap into your support network. Family, friends, and social groups can help
when dealing with stressful events.65

3. Practical Applications of DO in Stress Management

Buddha’s teaching of DO as well as all of his other teachings, are applicable to

bring about wellbeing that are relevant to everyday life and solve everyday life
problems. This does not mean that people should achieve supernatural powers or
medical treatment for solves everyday stressful problems.

64
“Physical Symptoms of Stress”, (UK: WebMD, Stress Management Health Centre Website),
Retrieved October 26, 2015, from
http://www.webmd.boots.com/stress-management/physical-stress-symptoms
65
Introduction to Leadership MSL I, Department of the Army ROTC manual: Introduction to
Stress Management, Op. cit., p.90.
 21

3.1 DO Based Stress Management Model (DOSM)

In order to use DO effectively either individually or in therapy, requires a deep

understanding, acceptance and observance of following principles of DOSM, viz.:

1) DOSM principle #1: Self-Development

Conscious self-development, in order to overcome ignorance. Accordingly
from the Buddha’s doctrine, the first step in stress management is self-improvement,
expansion of knowledge and understanding of reality/truth. This requires knowledge
of the Four Noble Truths and Eightfold Path - the first of the Buddha's teachings - and
substantive analyze of the Four Noble Truths, Eightfold Path and DO formula.
Implementation of the DO model in stress management requires acceptance
and following the following principles:
• All living creatures experience suffering (dukkha) in this life. Negative or
not desirable perceptions and dissatisfaction are a normal part of existence.
66
There is no need to fear or hate suffering because it only increases
experience of the suffering. Learn to see suffering with wisdom, which
shows the inevitable consequence of the sensory world.
• Follow the Eightfold Path that leads out of suffering

2) DOSM principle #2: Taking responsibility

Cultivating understanding, that every action has a consequence, which
corresponds to the nature of the act, which in essence means taking responsibility for
own actions and their consequences. This includes taking responsibility for all own
physical as well mental activity (behavior, thinking, speaking).
In Western contacts all these principles fit under the term of “responsibility”,
which in more general context is the base for “success”. It is necessary to understand
that success is based on the meaningful, conscious, focused, knowledge-based action,
which is based on three principles:
a) one should be self-reliant and generate the conditions, which led to success;
b) to generate the conditions, which led to success, one must comprehensively
understand each factor, their nature, and the dynamics of functioning mutual
relationship between the other factors;
c) a person cannot rely on hope, desire, fate, divine beings, or supernatural
powers. Unreasonable belief should be discarded.

66
It is important remember that the meaning of the dukkha in teaching of the Buddha and the
concept of suffering in the context of Western culture are different. Dealing with stressed person no
point to emphasize that life is suffering - it may unnecessarily increased psychological stress and
probably this statement will not find at that time complete understanding.
 22

Implementation of the DO model in stress management requires acceptance

and following the following principles:
• Each act will return to the maker, will help cultivate consequences-based
thinking and make wholesome (kusala) choices.
• The law of karma is not controlled by anyone else. I'm the creator of what
is happening in my life

3) DOSM principle #3: Awareness

Also, modern psychology has discovered the beneficial effect on the psyche
and the body of awareness. Mindfulness is the most studied new field in modern
psychology.
Mindfulness [sati in Pāli] is a mental state achieved by focusing one’s
awareness on the present moment, while calmly acknowledging and accepting one’s
feelings, thoughts, and bodily sensations, used as a therapeutic technique.67 The more
consciously aware of this process we become, the more we are able to develop the
capacity to accept and, if we chose to, adjust our thinking. Mindfulness is a state of
present-centered awareness that awakens the individual from the sleep of habitual
responses—responses that are conditioned by beliefs and expectations with origins in
the past that frequently become projected onto the future. Mindfulness involves
paying conscious attention to one’s internal and external experience to create a
receptive space in which one observes thoughts, feelings, and bodily sensations as
they are, without judging or trying to suppress or deny them. It is direct contact,
unobstructed by thoughts and judgments, with ourselves and the world around us.
Mindfulness practice cultivates the ability to observe and accept the ongoing
unfolding of one’s experience without becoming over-identified with or attached to
the content of thoughts, emotions, and sensory experiences, regardless of whether
these are painful or pleasurable.68
According to Dr. Greg Flaxman and Dr. More Flook, study may be highlight
the following links of awareness and physical and mental health.
a) Brain & immune system
A burgeoning field of study has grown out of interest for the effects of
mindfulness practice on the brain. Current literature points towards the potential for
mindfulness to affect the structure and neural patterns present in the brain. Scientists
have seen these results last not only during mindfulness practice, but also during the
daily life of practitioners. The results of one study published in NeuroReport in 2005
show thicker cortical regions related to attention and sensory processing in long-term

67
Mindfulness [Def. 2] in Oxford Dictionaries, Retrieved November 3, 2015, from
<http://www.oxforddictionaries.com/definition/english/mindfulness>
68
Dan Mager, “Mind Full or Mindful: Recovery as a Process of Awakening”, Psychology
Today Webpage, (Sep 24, 2013), Retrieved November 3, 2015, from
<https://www.psychologytoday.com/blog/some-assembly-required/201309/mind-full-or-mindful>
 23

meditation practitioners compared to non-meditators. These findings also suggest that

meditation practice may offset cortical thinning brought on by aging69. A recent study
outlines the difference in neural functions related to emotion in expert meditators and
novice meditators. Individuals performed compassion meditations, while researchers
measured how the regions in the brain responsible for emotion regulation reacted to
varying stimuli. The more advanced meditators showed more activation in those areas
of the brain that detects emotional cues, demonstrating a heightened empathic
awareness70.
However, not all studies involve expert meditators. A 2003 study focused on
how an 8-week training course would affect the brains and immune systems of
individuals. This investigation provided some evidence of increased activation in a
region of the brain correlated with positive affect, as well as evidence that the immune
system would react more robustly in antibody production after meditation training71.
Another recent study showed better stress regulation, as measured by a faster decrease
in levels of the stress hormone cortisol following a stressful laboratory task, among
Chinese undergraduates after 5 days of meditation training at 20 minutes a day. These
students also reported less anxiety, depression, and anger compared to a group of
students that received relaxation training72.
b) Relationships
Mindfulness training may affect an individual’s ability to harbor successful
social relationships as well. A University of North Carolina at Chapel Hill study
demonstrated a correlation between mindfulness practice in couples and an enhanced
relationship. The couples reported improved closeness, acceptance of one another,
autonomy, and general relationship satisfaction. 73 A 2007 study replicated this
finding, also demonstrating a correlation between mindfulness and quality of
communication between romantic partners. 74 Mettā meditation, which can involve
positive imagery or wishes directed toward others or self, can affect how one relates
to others. A recent study examined how individuals reacted to viewing photographs of
strangers after mettā meditation. The meditation significantly affected the positive

69
Lazar, S., et al., “Meditation Experience is Associated With Increased Cortical Thickness”,
NeuroReport, 16 (17), (2005): 1893-1897.
70
Lutz, A., et al., “Regulation of the Neural Circuitry of Emotion by Compassion Meditation:
Effects of Meditative Expertise”, PLoS One, Vol. 3, (2008): 1-10.
71
Davidson, R., et al., Alterations in Brain and Immune Function Produced by Mindfulness
Meditation, Psychosomatic Medicine, Vol. 65, (2003): 564-570.
72
Tang, Y., et al., “Short-term meditation training improves attention and self-regulation”,
PNAS, Vol. 104 (43), (2007): 17152-17156.
73
Carson, J., et al., “Mindfulness-Based Relationship Enhancement”, Behavior Therapy, Vol.
35, (2004): 471-494.
74
Barnes, S., et al., The Role of Mindfulness in Romantic Relationship Satisfaction and
Response to Relationship Stress. Journal of Marital and Family Therapy, Vol. 33 (4), (2007): 482-
500.
 24

values they attributed to those strangers, demonstrating a relationship between mettā

meditation and social connectedness75.
Mindfulness practice can benefit familial relationships. Parents of children
with developmental disabilities described increased satisfaction with their parenting,
more social interactions with their children, and less parenting stress as a result of
mindfulness training76. In another study carried out by the same researchers regarding
parents of children with autism, the same results of increased satisfaction in their
parenting skills and relationship applied 77 . In both studies, the children of these
parents benefited from the mindful parenting practice, showing decreases in
aggressive and non-compliant behavior.
In addition, a mindfulness intervention for adolescents with externalizing disorders
that involved their parents in the treatment showed improvement in the happiness of
the children, as well as the parents’ perception of their child’s self-control78.
c) Clinical
A popular form of mindfulness intervention, devised by Jon Kabat-Zinn, is
Mindfulness-Based Stress Reduction (MBSR). This intervention originally came
about to help those with chronic pain issues or stress-related disorders. Typically in
MBSR programs, individuals go through an 8-10 week session in which they practice
for at least 45 minutes a day. Numerous therapies incorporating mindfulness have
sprouted in recent years. Mindfulness-based cognitive therapy, similar to MBSR,
teaches individuals to recognize their thoughts and feelings with a nonjudgmental
attitude. When researchers studied its effectiveness in preventing a relapse of
depression for those in remittance from a depressive episode, 37% of those that went
through an 8-week MBCT program experienced a relapse compared to 66% of those
not in the program79.
Helping professionals can use mindfulness to improve their abilitiy to
empathize with those they serve as well. A study of an 8-week MBSR course for
nurses showed that their mindfulness practice facilitated empathic attitudes, as well as
decreased their tendency to take on others’ negative emotions80. A previous study of
health-care professionals going through the 8-week MBSR program presented results

75
Hutcherson, C., et al., “Loving-Kindness Meditation Increases Social Connectedness.!
Emotion, Vol. 8 (5), (2008): 720-724.
76
Singh, N., et al., “Mindful Parenting Decreases Aggression and Increases Social Behavior in
Children with Developmental Disabiltiies. Behavior Modification”, Vol. 31(6), (2007): 749-771.
77
Singh, N., et al., “Mindful Parenting Decreases Aggression, Noncompliance, and Self-
Injury in Children with Autism”, Journal of Emotional and Behavioral Disorders, Vol. 14(3),
(2006): 169-177.
78
Bögels, S., et al., “Mindfulness Training for Adolescents With Externalizing Disorders and
Their Parents”, Behavioural and Cognitive Psychotherapy, Vol. 36, (2008): 193-209.
79
Teasdale, J., et al., “Prevention of Relapse/Recurrence in Major Depression by
Mindfulness-Based Cognitive Therapy”, Journal of Counseling and Clinical Psychology, Vol. 68(4),
(2000): 615-623.
80
Beddoe, A. & Murphy, S., “Does Mindfulness Decrease Stress and Foster Empathy Among
Nursing Students?”, Journal of Nursing Education, Vol. 43(7), (2004): 305-312.
 25

of increased self-compassion and reduced stress in those individuals81. Such self-care

may trickle down to improve upon the quality of the relationship between those
professionals and their clients.
While the majority of mindfulness studies have focused on adults, some
pertain to the practice of mindfulness in children and adolescents. A series of studies
have documented its use as an intervention for youth with psychological disturbances.
In one 6-week study with anxious children, teachers reported an improvement in
academic functioning and decrease in symptoms of anxiety in the children82. Another
utilized mindfulness-based cognitive therapy with the result of significantly reducing
observable internalizing and externalizing symptoms. Over 80% of children and
parents involved in this study thought that schools should teach mindfulness 83 . A
mindfulness intervention for several adolescents with conduct disorder resulted in a
significant decrease in aggressive behavior. They reported benefits from mindfully
returning their attention to the soles of their feet during distressing situations84. In a
recent study for adolescents with ADHD, mindfulness training significantly reduced
symptoms associated with their disorder85.
d) Education
There is increasing interest in the utility of mindfulness practices in
educational settings. A study of 1st-3rd grade children that involved a 12-week
program of breath awareness and yoga (delivered once per week every other week)
showed improvements in children’s attention and social skills as well as decreased
test anxiety in children who went through the training as compared to controls 86 .
Another program that combined elements of MBSR and tai chi for a small group of
middle school students in a 5-week program found that students reported an increased
sense of calm, connection to nature, and improved sleep after going through the
training 87 . Two pilot studies conducted through UCLA’s Mindful Awareness
Research Center indicate improvements in selfregulatory abilities among preschool
and elementary school students who participated in an 8-week mindful awareness
practices training program (developed and taught by InnerKids in two 30-minute

81
Shapiro, S., et al., “Mindfulness-Based Stress Reduction for Health Care Professionals:
Results from a Randomized Trial”, International Journal of Stress Management, Vol. 12(2), (2005):
164-176.
82
Semple, R., Reid, E., & Miller, L., “Treating Anxiety with Mindfulness: An Open Trial of
Mindfulness Training for Anxious Children”, Journal of Cognitive Psychotherapy, Vol. 19(4),
(2005): 379-392.
83
Lee, J., et al., “Mindfulness-Based Cognitive Therapy for Children: Results of a Pilot
Study”, Journal of Cognitive Psychotherapy, Vol. 22(1), (2008): 15-28.
84
Singh, N., et al., “Adolescents with Conduct Disorder Can Be Mindful of Their Aggressive
Behavior”, Journal of Emotional and Behavioral Disorders, Vol. 15(1), (2007): 56-63.
85
Zylowksa, L., et al., “Mindfulness Meditation Training in Adolescents and Adults with
ADHD: A Feasibility Study”, Journal of Attention Disorders, Vol. 11(6), (2008): 737-746.
86
Napoli, M., Krech, P., & Holley, L., “Mindfulness Training for Elementary School
Students: The Attention Academy”, Journal of Applied School Psychology, Vol. 21(1), (2005): 99-
125.
87
Wall, R., “Tai Chi and Mindfulness-Based Stress Reduction in a Boston Public Middle
School”, Journal of Pediatric Health Care, Vol. 19(4), (2005): 230-237.
 26

sessions per week). Specifically, children who were initially less well-regulated
showed the strongest improvements subsequent to training, as compared to children in
the control group who did not receive the training 88 . These preliminary findings
suggest potential benefit and practical applications of mindfulness for children in
school settings.
e) Other mind/body practices
Mindfulness is not alone in the world of mind/body awareness practices
currently studied by scientists. A 2006 qualitative study followed the effects of one
year of Transcendental Meditation (during the first and last 10 minutes of each school
day) on ten middle school students. Themes that emerged from individual interviews
with students included a greater ability at self-control and improved social
relationships, as well as better academic performance. Other investigators have
evaluated the benefits of Yoga as well89. Investigators found Sahaja Yoga Meditation,
an awareness practice related to mindfulness, as an effective intervention for children
with ADHD and their families. Results included an improvement in the self-esteem of
the children, a reduction in their ADHD symptoms, and an improved relationship
between parent and child90. A study of Iyengar Yoga as a complement to medication
in the treatment of depression found significant reductions in overall depression,
anger, and anxiety among participants.
Participants also consistently rated their moods higher after the completion of
each class than before each one commenced91. The underlying mechanisms involved
in these typesof practice remain to be understood, although it appears that each does
health benefits.
Implementation of the DOSM in stress management:
• Mindfulness of oneself - awareness and observation of body
• Mindfulness of feelings - awareness and observation of feelings and
emotions
• Mindfulness of thought - awareness and observation of thoughts and
thinking
• Mindfulness of reality - awareness and observation of mental objects or
phenomena (dhamma).

88
Flook, L., Smalley, S.L., Kitil, M.J., Dang, J., Cho, J., Kaiser-Greenland, S., Locke, J. &
Kasari, C., “A mindful Awareness Practice Improves Executive Function in Preschool Children”,
Poster presented at the Center for Mindfulness in Medicine, Health Care and Society, 6th Annual
Conference in Worcester, 2008 April.
89
Rosaen, C. & Benn, R., “The Experience of Transcendental Meditation in Middle School
Students: A Qualitative Report”, Explore, Vol. 2, (2006): 422-425.
90
Harrison, L., Manocha, R., & Rubia, K., “Sahaja Yoga Meditation as a Family Treatment
Programme for Children with Attention Deficit-Hyperactivity Disorder”, Clinical Child Psychology
and Psychiatry, Vol. 9(4), (2004): 479-497.
91
Shapiro, D., et al., “Yoga as a Complementary Treatment of Depression: Effects of Traits
and Moods on Treatment Outcome”, Evidence-Based Complementary and Alternative Medicine,
Vol. 4(4), (2007): 493-502.
 27

Important aspects: healthy diet; renunciation of stimulants (caffeine, sugar, energy-

drinks etc.), renunciation of alcohol, cigarettes, and drugs; enough sleep.

4) DOSM principle #4: Completeness/Wholeness

Knowledge about DO reduced identification with material things as a “self” or
“I”, which is base of peace of mind.
Because the body and mind (nāmarūpa) are one system, physical health of
body is important factor for the well-being. However, since the matter subordinate by
mentality, more important is that a person would have a positive mental state.
Western society is mostly material-centered and the awareness of death or fact
of temporality may adversely distress. Awareness of death is essential mostly
unavoidable in older age. Therefore, psychological preparation is reasonable and
essential in order to managed and prevent stress, which is connected with aging and
mortality. If death awareness meditation seem more stressful, it is possible to start
from meditation about 31 (32) part of the body. Such meditation can also help reduce
unhealthy perfectionism, associated with the body.
• Inferiority complex and a sense of superiority connected with ignorance
and from the unnatural expectations of self, other people and the world.
• Perfectionism is a major source of avoidable stress. This stress is my
(conscious or non-conscious) choice, and I can get rid of it.

5) DOSM principle #5: Prevention

The senses are much easier to control, as to avoid people, places and situations
that cause stress.

6) DOSM principle #6: Sanity supporting activities

Contact (phassa) represents in DO model cognition of sense object, or the
connection between consciousness and the outside world.
Mostly, people tend to believe that is necessary answer to every external
stimulus. For example, when the phone rings, it is necessary to answer. Depending on
the situation, yes, it is sometimes necessary, but not every time. However, it is
possible to avoid the stress, if after the end of the working time the phone is turned
off. It is also not necessary to read or watch the news on television every day, to find
out who, where, and how many people are killed and the like. The industry news has
mostly built on the transmission of problems and conflicts, and the reading of this
information is voluntary.
 28

Also there is no need to go to a party when friends call. Phone (material

things) and friends (people) do not make the choices that cause stress - the man
himself does.
Reducing the number of contacts stressors can reduce stress level.

7) DOSM principle #7: Management of feelings

Modern psychologists disagree on the use of the term feeling. The earlier
definition accords with that of the American psychologist R.S. Woodworth, who
defines the problem of feeling and emotion as that of the individual’s “internal state.”
Many psychologists, however, still follow the German philosopher Immanuel Kant in
equating feeling to states of pleasantness and unpleasantness, known in psychology as
affect.92
Feelings are very important part of the experience of existence to conventional
or worldly people. Many people are struggling for the enjoyment of sensual pleasure,
which are nothing but enjoyable feeling. In the Law of DO, contact is the condition
for arising of feelings, and feeling is the condition for the arising of craving, which is
the most important cause of dukkha in the Buddha's teaching. 93 Since feelings are
directly related to stress, it is important to learn to control the emotions.
In the Tipiṭaka it is stated that meditating (samadhi) on feelings can lead to
deep mindfulness (sati) and clear comprehension (sampajañña). 94 With this
improvement, one can experience directly within oneself the reality of impermanence
(anicca) and the nature of attachment.95 Such a realization draws mind from desire
experience of feeling. When emotions will subside in focused mind (jhāna), calm
mind is made, and arises a deep feeling of bliss (pīti).
Therefore the main method of DOSM is mindfulness of feelings
(vedanānupassanā satipaṭṭhānaṃ).

8) DOSM principle #8: Craving management

In the first teaching of the Buddha on the four Noble Truths, the Buddha
identified desire as a principal cause in the arising of stress (dukkha). 96 Obsessions,
compulsions, and addictions are desires out of control, desires gone wild. 97 As
overcoming of destructive desire without consistent Buddhist meditation is
impossible, there is an alternative: conscious conversion unwholesome (akusala)

92
Feelings [Psychology] Encyclopedia Britannica, Retrieved November 3, 2015, from
<http://www.britannica.com/topic/feeling>
93
Dhammacakkappavattana Sutta, S.V.420.
94
Cha Chakka Sutta, M.III.280.
95
Samādhibhāvanā sutta, A.II.44.
96
Dhammacakkappavattana Sutta, S.V.420.
97
Leifer Ron, The Happiness Project, (NY: Snow Lion Publication, 1997), p.93.
 29

desire to wholesome (kusala) desire. But of course, nothing can replace a meditation,
so after conscious conversion it would be logical to continue with meditation.
• A first criterion in DOSM craving management could be awareness of
intention behind the action.
• If an action is intended to bring harm to someone (oneself, others or both),
then it should be abandon from such kind of action.
• If an action conduces to the good of oneself, to the good of others or to the
good of both, it does not harm anybody. Since such an intention / behavior
would cause stress, is unlikely.
• A second criterion in DOSM craving management is the roots of action.
All action arises from certain mental factors or roots (mūla). These are the
causal factors underlying action or the sources of action. All unwholesome
actions come from three unwholesome roots, viz.: greed (lobha), aversion
(dosa), and delusion (moha). Greed is selfish desire aimed at personal
gratification, expressed as grasping, craving and attachment. Aversion is ill
will, hatred, resentment, anger and a negative evaluation of the object.
Delusion is ignorance, mental unclarity and confusion. Also there are
three roots in the wholesome (kusala) side: non-greed (alobha), non-
aversion (adosa) and (amoha) non-delusion. 98 Non-greed becomes
manifest as detachment and generosity. Non-aversion is expressed
positively as good will, friendliness and loving kindness. Non-delusion is
manifested as wisdom, understanding and mental clarity.

9) DOSM principle #9: Renunciation

Clinging or tight attachment to the objects as a source of stress is well-known
phenomenon in modern psychology and psychotherapy. Because many people
identify themselves through material things, arises a strong desire for possession. The
same applies to the persons: people don't like to accept the disruption of the relations
since desired to maintain joying this relationship.
Using the above four divisions of upādanā (clinging to sense objects, views,
rules and observances and concept of “self”)
Implementation of the DO model in stress management requires conscious and
gradual abandonment of:
• strong emotion triggers, connected with the pleasant sights, sounds, smells,
tastes and bodily sensations;
• limiting obsessional (blind faith-based) beliefs and attitudes;
• rules and observances, which allow achieve without mind-training
(meditation, training of consciousness etc.) to achieve freedom of mind (as
prayer, countless repetition of certain words, etc.);

98
Sammādiṭṭhi Sutta, M.I.46.
 30

• self-centeredness thinking.
In overcoming self-centered thinking has an important role in a willing to
compromise. If both parties are willing to bend at least a little, there is a good chance
of finding a mutually satisfactory middle ground.

10) DOSM principle #10: Working others/public good

The process of bhava is entire range of behavior in response to craving and
grasping (kamma-bhava as active process) and the subsequent condition of life
(uppatti-bhava as passive process) conforming to craving, grasping and behavior.
Overcoming of behavior based in craving and grasping, one option is to give
up this kind of action and start to work for the benefit of society. Sometime are people
so busy with one’s self’s, with his needs, expectations and dreams, that not even
notice others and their needs. Such selfish behavior can be the source of much stress.

11) DOSM principle #11: Continuity of change

Since the last links of DO (birth, aging and death) corresponds to the western
perception of normal lifecycle these may be viewed as a one whole.
In generally, Western world positioning the birth and life of a miracle
(Christian world as god's creation and his will) and death as an inevitable end of life.
As in Western culture, there is no such phenomenon as reincarnation or DO-
compliant approach; death in Western culture is quite depressed.
The other extreme is popular new-age movements and theories, constitute a
mix of many different teachings. Mostly this modern new-age knowledge is not for
free. They have a teacher-centered, which means that every teacher selects for himself
a suitable approach, start to practice it, and to teach to others. This approach from
stress management point of view may not be negative because there can be degrading
effects of stress, but it does not lead to practitioners to final end of stress (dukkha).
At the same time, knowing that death has potential for new life, which
actualized in a new life beginning, can be powerful stress-reducing effect.
Implementation of the DO model in stress management:
• Learning to see the birth, existence, aging and death as an integral whole
that is constantly alternating flux.
• Accepting death as normal part of life, which is necessary for the new
appearance (bhava).
• Accepting aging, which is a natural part of life progress.
• Accepting that everyone and everything is part of a continuous changing,
and there is nothing to hold onto.
 31

3.2 Stress Management and Bhāvana

According to the suttas like: Sabbāsava, Sāmaññaphala, Jāliya, Mahāli
of Dīgha Nikāya; Kandaraka, Ariyapariyesana, Aṭṭhakanāgara of Majjhima
Nikāya; Jhāna Saṃyuttaya of Saṃyutta Nikāya; Satipaṭṭhāna of Dīghanikāya
and Majjhimanikāya; also Dhammasaṅganī and Vibjaṅga of Abhidhamma
Piṭaka; and commentaries like Vissuddhimagga and Atthasāḷinī- the basic
meaning of bhāvana, as a whole, can be rendered as the development of
spiritual qualities or wholesome potentialities (sattabodhyaṅga) or development
of wholesome doctrines “Bhāveti kusaladhamme vaḍḍhetīti bhāvanā”.99 What
kind of meditation object (kammaṭṭhāna) is suitable for person depends on his
type of personality. There are four major character types, which are prone to
mental disorder and stress. They are:
(i) Rāga type - sexual desire driven type
(ii) Dosa type - anger driven type
(iii) Moha type - delusion driven type
(iv) Māna type - those who compare oneself with others all the
100
time.
Since of the above studies have confirmed the beneficial effects of
meditation on the mind, I bring out some tranquility meditation (samatha
bhāvanā) techniques that help reduce and overcome stress and to whom these
techniques are suitable.
(1) 10 kasiṇa’s (devices) are simple physical phenomena upon which
one can meditate.101
The first four are the traditional elements: earth, air, fire, and water.
People of all dispositions can use these.
The next four are on the four colors, blue, red, white, and yellow. People
with hateful natures should use these.
The last two are space and light. People of all dispositions can also use
these.
(2) Ten asubha’s (Objects of impurity or loathsome) are various sorts of
corpses. Meditating on corpses is useful is reducing lust. This practice should

99
Rathnasiri, R.M., “Cognitive, Behavioral and Psychotherapeutic Aspects as Reflected in
Insight Meditation and Methods of Ingsight”, IABU: Buddhist Psychotherapy, (Bangkok:
Mahachulalongkornrajavidyalaya University Press, 2012): 63.
100
H.S.S Nissanka, Buddhist Psychotherapy, (Sri Lanka: Buddhist Cultural Centre, 2009),
p. 61.
101
Paravahera Vajirana Mahathera, Buddhist Meditation in Theory and Practice,
(Malasia: Buddhist Missionary Society, 1962), pp.139-165.
 32

only be followed under the guidance of a master. Below is a list of the asubha’s
and who will find them useful.
• Swollen corpse: Those who lust after beauty of form.
• Discolored corpse: Those who lust after beauty of the skin and
complexion.
• Festering corpse: Those who lust after a sweet-smelling body, using
perfumes.
• Fissured corpse: Those who lust after the firmness and solidity of the
body.
• Mangled corpse: Those who lust after fullness of the flesh, such as
the breasts.
• Dismembered corpse: Those who lust after graceful movements of
the body.
• Cut and dismembered corpse: Those who lust after perfection of the
joints of the body.
• Blood-stained Corpse: Those who lust after beauty produced by
adornments.
• Worm-infested Corpse: Those who are attached to the idea that the
body is “I” or “mine.”
• Skeleton: Those who lust after perfection of the teeth and nails.

(3) Ten anussati’s (recollections). The first six anussati’s are

meditations morality, and generosity. These meditations are most useful for
those with devotional natures. These practices will gladden the mind when it is
in distress and will increase faith and virtuous tendencies. The first three are
particularly useful in reducing fear and dread.102
The next anussati is concentration on breathing. It is a particularly
useful meditation, being the only one the Buddha described which can lead to
both mindfulness and insight. This is the only meditation, which can lead a
practitioner from beginning practice all the way to enlightenment.
Concentration on breathing is especially recommended for those who are
deluded or excitable.103
The eighth anussati is meditation on death (maranānussati). This is
useful for people who are intelligent. This meditation leads to a deep
realization of impermanence.

102
Ibid., pp.183-208.
103
Ibid., pp.227-258.
 33

The ninth anussati is mindfulness of the body. This is useful for those
with lustful natures. This is probably the only meditation of these forty which
will be useful to Westerners in reducing lust, as the other meditations for
reducing lust all require a decaying human corpse, and these are difficult to
come by.104
The last anussati is meditation on tranquility. Not surprisingly, this leads
to peace and tranquility. It is useful for those who are intelligent.105
(4) Four brahma-vihāra’s (sublime adobes or excellent qualities or stete
of living) are friendliness (mettā), compassion (karuṇā), sympathetic joy
(mudita), and even-mindedness or equanimity (upekkā). Meditation on these
qualities leads to an increase of them, causing excellent conduct in interactions
with the external world. They are “an essential preliminary to the whole
training of the religious aspirant”. 106 Meditation on these qualities is
especially useful for those with hateful natures.107
(5) Āhāre patikula saññā (perception of the loathsomeness of food) is
meditation, designed to eliminate the greed and sensual excitement, which is
often caused by food. This practice is most suited to those who are
intelligent.108
(6) Catu-dhātu-vavatthāna (analysis of the 4 physical elements) “The
main object of this meditation is to free the mind from the conception of
individuality in regard to the physical body and to realize its elemental nature
with no thought of personal distinction. The meditation consists of noticing
how the body is merely a synthesis of physical elements, without entity. This
practice is most suited to those who are intelligent.109
(7) Four ārupa’s (formless spheres) are four formless stages, which are
developed in turn after all psychological impediments are removed. In order,
they are the sphere of infinite space, the sphere of infinite consciousness, the
sphere of nothingness, and the sphere of neither perception nor non-perception.
The goal of these stages is complete self-possession, free from all thoughts of
the world. This is not nirvana, but it is very close to nirvana. These formless
spheres are suitable for people of all dispositions, after they have reached the
fifth absorption level.110

104
Ibid., pp.209-226.
105
Ibid., pp.259-262.
106
Ibid., p.263.
107
Ibid., pp. 263-313.
108
Ibid., pp.314-317.
109
Ibid., pp.318-331.
110
Ibid., pp.332-340.
 34

Table 8. Summary table of findings

Link of DO Instructions for stress management

[1. Ignorance (avijjā)] DOSM principle #1: Continuous self-development (in

order to overcome ignorance)
1. Accepting the stress as normal, unavoidable part of
existence and as its is (result of birth-aging-and-death)
2. Knowing/studying the way of practice leading to the
cessation of stress and ignorance

Implementation of DOSM:
1) Understanding that there is no wisdom without 4 Nobel Truths, which could be led
to the final cessation of stress
2) Knowledge and understanding the truth/reality (Four Noble Truths)
3) Following the Eightfold Path, leads out of stress
4) Observing the world through the DO model: This is, because that is; This is not,
because that is not

2. Volitional DOSM principle #2: Taking responsibility

(kammic) formations 1. Accepting bodily, verbal, and mental fabrications/volitions
(saṅkhāra) as they are (result of ignorance)
2. Knowing/studying the way of practice leading to the
cessation of volitional formations

Implementation of DOSM:
1) Understanding that every action has a consequence, which corresponds to the
nature of the act
2) Accepting that reality is the fruit of our creations
3) Realizing that deep understanding is commensurate with the insight (meditation)
based wisdom
4) Cultivating in everyday activities (behavior, thinking, speaking) consequences-
based (kamma) thinking and making wholesome (kusala) choices
5) Understand that success is based on the meaningful, conscious, focused,
knowledge-based action, which is based on three principles:
a) one should be self-reliant and generate the conditions, which led to success
b) to generate the conditions, which led to success, one must comprehensively
understand each factor, their nature, and the dynamics of functioning mutual
 35

relationship between the other factors

c) a person cannot rely on hope, desire, fate, divine beings, or supernatural powers.
Unreasonable belief should be discarded

3. Consciousness DOSM principle #3: Being aware

(viññāṇa) 1. Accepting six kind of consciousness as they are (result of
volitional formations)
2. Knowing/studying the way of practice leading to the
cessation of six kind of consciousness

Implementation of the DOSM:

1) Being aware of ignorance as one is the world
2) Renunciation of stimulants (caffeine, sugar, energy-drinks etc.)
3) Renunciation of alcohol, cigarettes, and drugs; enough sleep (all of which affects
consciousness)
4) Developing awareness
a) Mindfulness of oneself - awareness and observation of body
b) Mindfulness of feelings - awareness and observation of feelings and emotions
c) Mindfulness of thought - awareness and observation of thoughts and thinking
d) Mindfulness of reality - awareness and observation of mental objects or
phenomena (dhamma)

4. Name-and-Form DOSM principle #4: A holistic view

(mentality and 1. Accepting mentality and corporeality as they are (result of
corporeality) consciousness)
(nāmarūpa)
2. Knowing/studying the way of practice leading to the
cessation of mentality and corporeality

Implementation of DOSM:
1) Understanding that the body and mind are related, they affect each other and can
not exist separately
2) Accepting body as a result of the past behavior
3) Abandonment of the ego-centered view (There is no “I”)
4) Abandonment of identifications himself through materiality or mentality (stuff,
body, learned skills, qualities of mind and body, etc.)
6) Observing the world through four (five) elements
5) Healthy diet (healthy body - healthy mind) of the body and mind
 36

5. Six-fold sense DOSM principle #5: Control of habits

bases (saḷāyatana) 1. Accepting six-fold senses as they are (result of mentality
and corporeality)
2. Knowing/studying the way of practice leading to the
cessation of six-fold senses

Implementation of DOSM:
1) Limiting the number of contacts of stressors (avoiding stressful people, places and
situations)
2) Controlling habitual tendencies at the senses by sīla (5 precepts)

6. Contact (phassa) DOSM principle #6: Calmness supporting activities

1. Accepting contact as it is (result of six-fold sense)
2. Knowing/studying the way of practice leading to the
cessation of contact

Implementation of DOSM:
1) Seeing contact as a unavoidable consequence
2) Understanding that none of the contacts themselves are neither good nor bad,
neither skillful or nor unskillful, but they are act as causes for future good (beneficial)
and bad (limiting) result; the quality of the contacts depends on a personal attitude
3) Coming in to contact with awareness, that past action will result in the present
experience

7. Feeling (sensation) DOSM principle #7: Feelings management

(vedanā) 1. Accepting feelings as they are (result of viññāṇa)
2. Knowing/studying the way of practice leading to the
cessation of feelings

Implementation of DOSM:
1) Awareness, that feelings as the biggest stressors
2) Emotion management: exemption the mind from desire experience of (some
particular) feelings
3) Mindfulness of feelings
4) Accepting whatever feelings arises
5) Understanding that neither negative or positive feelings do not determining my
understanding of who I am
 37

8. Craving (taṇhā) DOSM principle #8: Non-involvement

1. Accepting craving as it is (result of feelings)
2. Knowing/studying the way of practice leading to the
cessation of craving

Implementation of DOSM:
1) Awareness of intention behind the action
2) Renunciation of behavior which bring harm to someone (oneself, others or both)
3) Controlling desires
4) Follow the intent, which is based on non-greed (detachment and generosity), non-
aversion (good will, friendliness and loving kindness) and non-delusion (wisdom,
understanding and mental clarity)
5) Observance of the principle of non-involvement

9. Clinging DOSM principle #9: Renunciation

(attachment) 1. Accepting clinging as they are (result of craving)
(upādāna)
2. Knowing/studying the way of practice leading to the
cessation of clinging

Implementation of DOSM:
1) Knowing your emotion triggers (connected with the pleasant sights, sounds, smells,
tastes and bodily sensations)
2) Limiting obsessional (blind faith-based) beliefs and attitudes
3) Limiting beliefs, rules and observances, which allow without mind-training
(meditation, training of consciousness etc.) to achieve freedom of mind (as prayer,
countless repetition of certain words, etc.)
4) Reduction of self-centeredness thinking

10. Becoming (bhava) DOSM principle #10: Adaption

1. Accepting becoming as it is (result of clinging)
2. Knowing/studying the way of practice leading to the
cessation of becoming

Implementation of DOSM:
1) Reduction of behavior based in craving and grasping
2) Working for the benefit of society, for public good (in order to achieve the previous
p. 1)
 38

3) Observing the existence as a temporary process of appearance and cessation of

nāma-rūpa.

11. Birth (jāti) & DOSM principle #11: Accepting impermanence

12. Aging and death (continuity of change)
(jarāmaraṇa) 1. Accepting birth, aging and death as they are (result of
becoming)
2. Knowing/studying the way of practice leading to the
cessation of birth, aging and death

Implementation of DOSM:
1) Learning to see the birth, existence, aging and death as an integral whole
3) Accepting aging, which is a natural part of life progress
2) Accepting death as normal part of life, which is necessary for the new appearance
4) Accepting that everyone and everything is part of a continuous changing; there is
nothing to hold onto: all life is constant process of arising and ceasing
5) Willing to compromise

Conclusion

While this research gives one a glimpse into the many topics of study
involving believes, feelings, consciousness, mindfulness, desires etc., it does not
capture the complete picture. At the same time, the study provides a firm basis for the
claim that the DO model is sufficiently broad to cover the whole theme of stress and
stress management.
Future investigations may increasingly shed light on both how stressed mind
works as well as comparing various forms of practice of counseling, psychology,
psychotherapy etc., with DO formula.
 39

Abbreviations

Primary Sources

D. : Dīghanikāya
Dhs. : Dhammasangaṇi
M. : Majjhimanikāya
S. : Saṃyuttanikāya
Vibh. : Vibhanga
Vism. Vissuddhimagga

The PTS issued editions of the Pali canon references follow the PTS
numeration. The initial letter (S) refers to the book, in this example the Saṃyutta
Nikāya. The Roman numeral (II) denotes the volume number, and the Arabic numeral
(2) denotes the page number. Thus the reference S.II.2 is to volume two, page 2, of
the Saṃyutta Nikāya.

Other Abbreviations

Et al. : Et alia / and others

Ibid. : Ibidem / in the same place
PED : Pāli-English Dictionary
PTS : Pali Text Society
DO : Dependent Origination
 40

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