Illustrations by Mark Dingo Francisco

Zen and Health: A Conversation with Ryushin Paul Haller

This interview series is part of First Mile Health, a collaboration between IDEO, Robert Wood Johnson Foundation, and Building H to imagine how we might design health into everyday life.

Joanne Cheung
IDEO CoLab Ventures
8 min readNov 5, 2020


The mind, the body, and the spirit are deeply connected — so how might we design for all three as a whole? How might we do that now, when damages to all three seem too much to fathom?

In this interview, Ryushin Paul Haller, teacher, former Abbot of the San Francisco Zen Center, and a member of the Zen Caregiving Project’s board of directors, helps us put 2020 in the context of a thousand-year-old spiritual practice. His hope? That history might offer clues for how, even in the hardest of times, we can become more in touch with ourselves and, as a result, with the world.

Joanne: From a Zen perspective, what does health mean to you?

Paul: I think “health” has a lot of overlap with wellness. The healthcare system narrows it down to something that I think of as the “fruition” of wellness. When the wellness factors are active, they will influence the organism in a way that brings forth health. That perspective is the foundation of the Zen approach.

When Buddhism started in India, there was a penchant for analysis of the workings of being into lists — and then as it moved to China, analysis became almost more poetic, a synergy of factors that don’t have to be parsed out and thoroughly understood in an analytical way. Given my own background in Zen, my thought is that you don’t have to know how the factors of health interact. You can trust the process of ripening them or bringing them into a vibrant expression. It’s an extraordinary combination between engaging in a long tradition and then bringing it into expression in the moment. In creating an intimate relationship to the process of well-being, you earn your own trust.

Putting the pandemic in perspective

Joanne: This pandemic is often portrayed as an “ahistorical moment”: “nothing like this has happened before”, “this is once in a hundred years”, “unprecedented”… In order to regain our bearings in a time like this, we need a reference point to the past and to engage with tradition. With such a wealth of tradition and history, are there particular Zen teachings that have become anchor points for you?

Paul: I would say that Zen, like many of the wisdom traditions, tries to get at the fundamental, existential proposition of life: what it is to be alive. Then, within that, find insights into the relationship between wellness and the fruition of health. In Zen that is not just a singular event. It’s a continuously unfolding relational event, not just humans, rather it’s the ecology of existence that includes all the different forms of being.

If I was to think about this pandemic from that perspective, I could say, “Yes, never before have we have faced this set of circumstances, this time in our development, these particularities of our social structure, this level of global interaction and movement of people.” But we have faced illness, we’ve had pandemics. We’ve had times when different forms of viruses or illnesses made a very significant impact on the global population.

There are things we can learn from our previous experience: see what’s implicated and find the insight to learn from what’s happening. From that perspective, you could look at all this and say, “This is so rich, we’re going to learn so much from the way the American healthcare system was just laid bare in its inadequacy, from the intertwining with politics, and how people rebelled when corralled into a certain lack of sociability.”

That’s very much the Zen methodology. So what are you experiencing? What do you see as implicated and what’s being learned? That could be anything from how you related to a moment or person, to how you’re relating to an issue in your life.

From a Zen perspective, you’re never done learning about how to get in touch.

Zen has traditional practices that help us explore how the mind, the emotions and the behaviors are expressing themselves and through those explorations, discover the fundamental qualities of existence that promote well-being. That is a tool that helps create the capacity to learn from what’s happening in the moment and then applies the learnings to the multiple dimensions of being alive.

Experiencing extraordinary moments

Joanne: The ability to draw from the depth of history seems to require a fundamental reorientation of how we structure time in everyday life. Do you think the collective perception of time has changed and is that inhibiting our ability to learn on a more fundamental level?

Paul: When we return to being in the moment, time becomes a variable — the notion of time as a constant metric or a scarce commodity becomes a possibility but not an absolute. When time is distant or separate from what we are, it is susceptible to being related to as an objective truth. One of the founders of Zen, Dōgen Zenji, wrote a series of essays in the 13th century. One of the essays which was called “Being-Time” was very similar to Heidegger’s notion of time as an experience. I think that everybody has experienced an extraordinary moment when the experience of time intensified and expanded.

Given the way we’re barraged with experiences, it’s now much more challenging to create an extraordinary moment.

Being bombarded with rapidly changing images, music and concepts disrupts the capacity to be in the here and now and creates an ungroundedness that is susceptible to distraction and anxiety. In the Zen Center, we’re seeing the effects on young people who’ve grown up immersed in multimedia and one of the characteristics is anxiety.

There are two elements to it. One is experiencing what’s happening now, without some agenda that it should be anything different from what it is. Attending to physical sensations, the thoughts going through your mind, the emotions that are coming up supports body and mind to settle. Additionally the ability to make contact with the experience invites an acceptance of the psychological processes . These are the fundamental elements of wellness: acceptance and contact. They’re both a lifelong study.They will teach us about how we’re experiencing difficulties and joys of our life. And they will teach us how to relate to society and all the beings of our planet.

As people become more grounded in themselves and have worked through what’s painful and rewarding for them, they’re more available for advocacy and more skillful in administering it.

Starting to notice our own suffering that makes us empathetic. As we acknowledge what’s happening internally, we’re more inclined to see what’s happening relationally. In relating to many workers in hospitals, from the nurses to the gardener, I’m astounded by the consistency of their empathy. I just marvel at it thinking, “You do this eight or 10 hours every day, and you still do it with such an open heart.”

Empathy as a path to resolving our differences

Joanne: “Consistency” is an interesting word choice. What do you think creates the ability to be consistently empathetic? For example, if I have a certain experience that’s very deep for me, it allows me to empathize when I see that experience elsewhere, but it also makes me blind to things that are different. That’s kind of the opposite of consistency. Here I’m thinking about polarizing beliefs, and how there’s a lot of empathy within each bubble. In practice, a consistency of empathy is extremely difficult to do, because it potentially invalidates something about oneself.

Paul: I think that’s a profound question. You could go back to Margaret Mead, an anthropologist of over 50 years ago, and her saying, “In these primal cultures, this tribe would view this other tribe as other and they would be enemies.” There is something in us that tends to view other people who are different. And I guess it’s open to discussion as to whether that’s an evolutionary influence.

But I would also say, from the Zen perspective, it comes back to how deeply we get in touch with what’s going on for us. And then how thoroughly we can see that it is universal. We all want to love and be loved. We all want to eat and stay safe. We all want to express our being. The more we get into touch with those, what we might call fundamental drives, like Maslow’s hierarchy of needs, the more we can see that there are countless ways to address those needs.

The practice of humanizing others and then empathizing with their humaneness is the ground of our well-being and also the impetus for our advocacy.

Joanne: As a species, we share certain universal needs, but we also tend to disagree on process, on how we get there. It seems very hard to understand, trust, or gain empathy for different processes. And perhaps in some cases, certain processes are false.

Paul: I think the processes of trying to resolve our differences through violence are unskillful, although as humans it seems to be an attractive proposition. To just follow that point a little bit, if you look at our evolution over the last 10,000 years, we’re a lot less violent.

There was another point that I wanted to make there and it’s about how we relate to our differences. When there’s more connection to our humaneness, then we’re less frightened by our differences. They’re less of a threat to our well-being and then we can listen to them. Usually, when we listen deeply to our differences, our perspective and our appreciation of what’s happening broadens. When we touch humaneness, then there’s trust, and out of that trust, there’s empathy and a tolerance of difference. Within Buddhism and Zen, that humaneness and that tolerance of difference are fundamental tenants: direct your mind and your heart towards the benevolence of others rather than the hostility of difference. Everyone’s well-being will be enhanced.