Cultivating The Mind – The Heart of Healing

Cultivating The Mind

The Heart Of Healing: Naikan As Applied Benevolence

By Henry McCann, DAOM

*First published on the online ToDo Institute Library of Japanese Psychology*


In the Huang Di Nei Jing, the core text of Chinese medicine that was written about 2000 years ago, there is a key chapter that describes the functions of the internal organs.  In this chapter (Su Wen Chapter 8, Ling Lan Mi Dian Lun) it is said that the Heart is the sovereign of the body, discharging the illumination of the spirit when healthy (心者,君主之官也,神明出焉).  In this same chapter it goes on to say that when the monarch (i.e., the Heart) is in a state of brilliant illumination, all the other organs will be at peace, ensuring health and longevity (故主明則下安,以此養生則壽).  Furthermore, when the monarch is in this state of brilliant illumination, everything under heaven will have great prosperity (天下則大昌).

The “Heart” that is talked about in this chapter however is not the simple pump that propels blood through our arteries and veins.  Rather, it is the symbol that describes the very spark of consciousness that defines being human.  It is the sum total of our awareness, our emotions, and our affects.  Thus, it truly is the sovereign of our life.

As someone who practices Chinese medicine, I find that treating this Heart in my patients is not so easy.  Typical therapies of Chinese medicine, for example acupuncture and Chinese herbal medicines, are often ineffective at really bringing patients into a state of illumination of the Heart, and thereby ensuring long-term wellness. This understanding is even found in typical Chinese folk sayings such as, “Disease of the Heart has never been treated with medicine” (心病從來無藥醫) and, “Diseases of the heart must be treated in the Heart [i.e., diseases of the Heart can only be treated by working with the mind]” (心病還用心藥醫). shutterstock_8770942

One of the solutions to this clinical conundrum that I have found for both myself and for my patients is the Japanese psychology method known as Naikan (内観), and we will see how it is an effective prescription for the ailing Heart that is so common today.


Naikan is a practice developed by Yoshimoto Ishin based on the Japanese tradition of Jodo Shinshu (Pure Land Buddhism), and can be traced to a rather austere meditation called Mishirabe (身調べ).  Yoshimoto, who himself achieved enlightenment in 1937 by practicing Mishirabe, sought to take this reflective practice and make it more secular and gentle.  In Naikan, the Naikansha (内観者, i.e., Naikan practitioner) reflects on their relationship with others using the framework of three seemingly simple questions about what they received, what they gave, and what troubles or difficulties they caused.  Traditionally one begins by reflecting on their relationship with their mother in a specific time frame, the questions becoming:

  1. 母親からしていただいたこと – What have I received from my mother?
  2. 母親にして返したこと – What have I given to my mother?
  3. 母親に迷惑をかけたこと – What troubles or difficulties did I cause my mother?

However, the subject of one’s reflections, can be on any individual, and even on a specific period of time, as when one uses the same questions to reflect on the past day (known as Nichijo Naijan 日常內觀 – Daily Naikan).  In this case, the questions remain the same, but encompass all encounters during the day with people, objects, and even forms of energy (e.g., heat or electricity).

In Japanese the word Naikan (內觀, Nei Guan in Mandarin Chinese) means “looking within.” However, when we look at the deeper meanings and connotations of the Chinese characters used to write Naikan, we understand better what the practice really does.  The character Nai/Nei (內) in the Shuo Wen Jie Zi, one of the earliest dictionaries of Chinese language that dates back to the 2nd Century C.E., is defined as “to enter.” (內:入也) The second character Kan/Guan is usually in modern times translated as “look.” However in the Shuo Wen Jie Zi the definition in Chinese is is Di, “to examine” or Shi “to inspect.” (觀:諦視也) In Buddhism the same word Di also means “the truth” (such as in the “Four Noble Truths,” Si Sheng Di – 四聖諦).

In Naikan there is an intense focus on actual activities done or actual things given or received.  This is done without reference to the motivation behind the giving or receiving, or the reason why trouble was caused.  For example, today I received payment from my patients. The fact that I provided them with treatment in exchange does not change the fact that I benefitted from money they gave me.  Likewise, my patients received treatment. The fact that they paid for it does not change that they benefitted from my labor. The particular night I started writing this essay I was running late and several patients had to wait. Even though I had a “good” reason for running late, it doesn’t change the fact that it was an inconvenience and trouble that I imposed on several of my patients.

Therefore what Naikan does is asks us to look at the objective facts of our lives.  By doing so we start, sometimes for the first time, to see the truth of the whole of our lives rather than just narrow slices of our experience, or what we want or have been conditioned to see.  Put together we can see why Naikan is a practical method of “entering into the truth.”

Distancing from the Truth

Even though we previously mentioned three basic questions as the Naikan framework for reflection, we should be aware of a fourth question –  “what troubles or difficulties did others cause me?” This question, known in Naikan practice as “Gaikan” (Wai Guan in Chinese 外觀), or “external viewing,” is purposely not asked during Naikan reflection.  Focusing on how “I” have been wronged is, in many cases, the cause of one’s suffering.  This self-focus is the fast track to missing the love, support, and grace that allows us to live at all in society.  In the Shuo Wen Jie Zi Gai/Wai is defined as yuan – to distance oneself from something. (外:遠也) Thus this fourth question, Gaikan, can be seen as something that “distances oneself from the truth.” Interestingly, modern research bears this out. Self-focused attention is associated with depression, anxiety and a wide range of other psychological disorders (Ingram, 1990). Beyond that, self-focused attention is also associated with physical disorders such as chronic pain and cardiovascular disease (Turk, 1983; Scherwitz et. al., 1986).

shutterstock_1635456Confucianism and the Heart

Confucianism is one of the native philosophical systems of China, and despite its reputation of being stuffy and conservative; some of the most important teachings of Confucius were specifically about the Heart.  For example, in the text known as the Great Learning (Da Xue 大學) there is a beautiful cascade that reads:

“The people of ancient times wishing to illuminate brilliant virtue throughout everything under heaven first sought to order the country. Wishing to order the country they first regulated their families. Wishing to regulate the families, they first cultivated their selves.  Wishing to cultivate their selves, they first rectified their Hearts.” 古之欲明明德於天下者,先治其國;欲治其國者,先齊其家;欲齊其家者,先修其身;欲修其身者,先正其心。

The way Confucianism rectifies the Heart can be explored by looking at some of the key concepts in Confucianism.

Goodness (Shan)

Confucianism teaches that the true nature of man is one of selfless goodness.  In the Book of Mencius (Mengzi), one of the core texts of the Confucian tradition, the philosopher Mencius expressly states, “the true nature of man is goodness” (孟子道性善 Menzi, Book 5).  However, because of how we live and are socialized, even though Goodness is our true nature it is something that always has to be practiced. The fifteenth book of the Analects, another core Confucian text recording the oral teachings of Confucius, says:

“Is there one word which may serve as a rule of practice for all one’s life?’ The Master said, ‘Is not Forgiveness such a word? What you do not want done to yourself, do not do to others.’ “  子貢問曰:有一言而可以終身行之者乎?”子曰:“其恕乎!己所不欲,勿施於人。

This line points out the idea, as mentioned above in the Great Learning quote, that the Heart has to be rectified somehow.  Here Confucius recommends the practice of Forgiveness as one such method.  In this way we can relearn our true heavenly nature of Goodness, rectify the Heart, and allow everything under heaven to prosper.

Ritual (Li )

The word Ritual requires a little more explanation than Goodness to really understand because of its numerous connotations.  In a very narrow context Ritual actually means the practice in ancient times of religious or other ritual. The purpose of ritual in ancient China was to create some sort of communication with either the ancestors, or the Heavens as the abodes of the gods and spirits.  Thus the purpose of ritual was to reestablish some sort of proper relationship, and this idea of proper relationships permeates Confucian thinking.  In more mundane settings Confucianism worries for example about proper social relationships, such as the relationship between parents and children or between friends.  How we enter into these proper relationships is thus an aspect of Ritual as well. ritual

The definition of ritual in the Shuo Wen Jie Zi is rather cryptic.  In it, it says, “Ritual means shoes.” (禮:履也) What do shoes have to do with Ritual?  To understand this we have to think about why we wear shoes. We wear shoes of course so we can walk.  Shoes are the tools that allow us to walk along a road or path of some sort.  Likewise, Ritual is the tool that lets us walk along the path of Goodness.  Thus, anything we do to enter into proper relationship and communication with our closest loved ones, our friends, and our communities is an aspect of Ritual.  It can be as simple as holding open a door for someone in need, or taking care of young children.  Everything we do with a Heart of goodness is an act of Ritual.

One of the classical phrases in Chinese medicine is that “pain arises from stagnation” (不通則痛). The word we translate as ‘stagnation,’ tong (通), also means communication.  Therefore, the phrase can also be read as “pain arises from lack of communication.” In the body this means that when the circulation of Qi and Blood are not moving smoothly there is physical pain.  However, this also means when our relationships with people around us are broken and not an expression of our innate Goodness, we also experience pain.  Thus Ritual can also be translated as “Sacred Connection.”

Benevolence (Ren )

Benevolence, also translated as Compassion, is one of the most important concepts in Confucianism, and in Chinese thoughts is one of the highest virtues.  The definition of Benevolence in the Shuo Wen Jie Zi is the Chinese word ‘Qin.’ (仁:親也) This word ‘Qin’ can be translated as one’s parents, intimacy, or closeness.  The Chinese character itself is made up of the character for ‘person’ (人), and the character for the number two (二). Thus the meaning of Benevolence is that feeling of love and closeness that should be experienced when interacting with a close loved one or family member.  Ideally it is also the feeling that arises when we interact with any other person, for real compassion is that which is felt for everyone universally.

In the Confucian tradition this Benevolence is associated with selflessness.  Here is the definition for Benevolence that Confucius himself gives us:

“Subduing the self and returning to the state of Sacred Connection (Li), this is what is called Benevolence.”  克己復禮為仁  (Analects Book 12)

Confucius links the Heart of compassion and benevolence with the practice of entering into relationships (Li, Sacred Connection) with others that express Goodness (Shan).  The way this is done is by forgetting the self, or, in other words, turning away from selfish behaviors.  This idea is certainly found in other traditions.  Shinran, the founder of Jodo Shinshu Buddhism, believed that humility characterized the enlightened person.

“The person who has entered the gate of religion sees “zero” value in himself.  Far from slighting or respecting the self, he does not recognize any value in the self [i.e., either slighting or recognizing because of the lack of true self].  Both our anguish and our grief exist because of our sense of self-importance.” Rev. Kiyozawa Manshi (1863-1903, Shin teacher)

Naikan teaches us, in a very real, simple and yet powerful way, that our life is full of Sacred Connection (Li). Practicing Naikan reflection engenders gratitude for all the support we receive on a day-to-day basis, and as such brings us better into Sacred Connection, specifically by subduing a sense of self-importance.  As such, it perfectly embodies the Confucian definition of Benevolence and Compassion: “Subduing the self and returning to the state of Sacred Connection (Li), this is what is called Benevolence.”

Rectifying the Heart

Chinese medicine sees the body as ideally being in a state of dynamic homeostasis.  Each of the internal organs has it’s own function, but more important than the individual functions are how they interact with each other in proper relationships.  In my own practice, I see many patients’ suffering Hearts, and for many years I searched for a practical method of rectifying the heart that the Chinese medical and Confucian classics call for as the way to health and wholeness.  In Naikan we see an example of a real method that is practical and easy, and, with consistent effort, one that can bring about a rectification of the Heart.  Once the Heart is rectified, eventually everything under heaven will become at peace.  Once the Heart is rectified, Sacred Connection is reestablished, and pain finally disappears, like snow melting under hot water.



Freuhauf H. All Disease Comes From the Heart: The Pivotal Role of the Emotions in Classical Chinese Medicine. Journal of Chinese Medicine 90/96.

Haneda N. Dharma Breeze: Essays on Shin Buddhism. Berkeley: Maida Center of Buddhism, 2007.

Ingram RE. Self-focused attention in clinical disorders: review and a conceptual model. Psychol Bull 1990 Mar;107(2):156-176.

Krech G. Naikan: Gratitude Grace, and the Japanese Art of Self-Reflection. Berkeley: Stone Bridge Press, 2001.

Scherwitz L, Graham LE 2nd, Grandits G, Buehler J, Billings J. Self-involvement and coronary heart disease incidence in the multiple risk factor intervention trial. Psychosom Med 1986 Apr;48(3-4):187-199.

Turk DC. Pain & Behavioral Medicine. New York: Guilford Press; 1983.

Henry McCann

Henry McCann

Henry McCann, DAOM, LAc (馬爾博) practices in Madison, NJ, and is the author several articles and books on Chinese medicine. In addition to his regular teaching duties at the Oregon College of Oriental Medicine and the Pacific College of Oriental Medicine, he frequently lectures on classical Asian medicine throughout the United States and Europe. Dr. McCann has a certificate in Japanese Psychology from the ToDo Institute in Vermont. He can be reached at 

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