Dr Tony Fernando: ‘Being compassionate requires a backbone’

Auckland psychiatrist Dr Tony Fernando says he's become a more easygoing person over the last 20 years thanks to Buddhist techniques like mindfulness.

"I became kinder, more tolerant, more compassionate. In my medical practice I realised I'm actually kinder to difficult patients and difficult staff," he tells RNZ's Mihi Forbes and Colin Peacock.

The sleep researcher, former Buddhist monk and "geek about the mind" shares advice on managing stress and finding peace in his new book Life Hacks from the Buddha.

After growing up "very Catholic" in the Philippines, Dr Fernando discovered the psychological potential of Buddhism via the 1998 book The Art of Happiness - a conversation between the Dalai Lama and psychiatrist Howard Cutler.

While he normally wouldn't pick up such "different-looking books", back in 2004 he had an "intellectual curiosity" in Buddhism after seeing his patients benefit from mindfulness practices.

The Art of Happiness - in which the Dalai Lama answers psychiatrist Howard Cutler's questions about life and anxiety - "blew him away" with its practical wisdom.

"Part of me is a little disappointed that in Western psychiatry training, we were not taught Eastern psychology, because it's so much healthier and it's so human. Not too theoretical."

While both traditional psychiatry and Buddhism are very interested in the human experience, Dr Fernando says, it's Buddhist teachings that can help anyone find greater acceptance and compassion in the moment.

True compassion doesn't mean being a doormat or putting up with mistreatment, he says. It requires that when you see bad behaviour you call it out, he says, hopefully in a helpful manner.

"[For example] You're beating me up. I'll actually report you to the police because that's what's necessary to correct your behaviour and your behaviour is causing harm."

One of the Buddha's main teachings is to not cause harm, Dr Fernando says, including to oneself.

"We cause incredible harm to ourselves by the narratives that we have. A very common narrative nowadays is 'I'm a loser. I'm not good enough. I'm such a bad mother'. There's a lot of self-beating up, self-flagellation. And from a Buddhist perspective it's not helpful."

Although mindfulness practices can cause psychiatric issues for a small percentage of people and those with severe anxiety and depression may need additional support, watching one's own mind will benefit most people, Dr Fernando says.

As animals, we experience stress partly to help us survive, he says, and it helps to become more aware of how irrational our own thinking can become in response.

"A lot of it is actually knowing how crazy our minds are and recognizing it's an interesting pattern to help us survive that lot of times also causes a lot of stress and dissatisfaction.

Overthinking is prevalent in people with insomnia, says Dr Fernando.

"I would say there is some sort of an epidemic of what we call sleep anxiety nowadays. Many people grasp at the idea that they should be sleeping perfectly and getting eight hours of sleep - if not 'I'll get dementia'.

"What's happening now is the brain latches on or is grasping at an expectation so when they go to bed and they're not sleeping, they become tense."

When you're trying to get to sleep, it can help to try and hold expectation more "lightly", he says.

"Like 'Okay so if I don't sleep as well tonight I'll be okaya. Won't be perfect, I'll be okay.

"It's holding the expectation lightly versus 'I should sleep. If I don't sleep, I'll be a wreck tomorrow. If I'm a wreck tomorrow, I'll be fired. If I get fired, I'll lose my house, if I lose my house'."

Consciously paying attention to your senses, including sensations within your body, is a helpful way to pause the "overthinking, analysing, catastrophising mind" in these moments, Dr Fernando says.

"It sounds simple, but it can be profound when you know how to do it."