Chod (Machig Labdron)

1. Introduction

Version followed: the Chöd (gcod, "cutting through" or "severance") of Machig Labdrön as presented publicly by its lineages and their publishers: the Mahamudra Chöd lineage traced to Machig, with Padampa Sangye named as one of her teachers, in the translations listed by Shambhala Publications (Sarah Harding's translations of Machik's Complete Explanation and Jamgön Kongtrul's Chöd: The Sacred Teachings of Severance; the Fourteenth Karmapa's practice manual; Zong Rinpoche's Ganden-tradition instructions; Alejandro Chaoul's Bön study), teacher articles by Alejandro Chaoul (Tricycle, 2008), Lama Zopa Rinpoche (FPMT, 2007) and Lama Tsultrim Allione (Snow Lion, 1991), and a current empowerment retreat taught by Khentrul Rinpoche. The traditional ritual is given here as a public outline only, because it is received through empowerment and oral instruction from a qualified lama. The one openly published, step-by-step adaptation is Lama Tsultrim Allione's Feeding Your Demons® (FYD), a five-step process based on Chöd principles, taught through Tara Mandala; its steps are paraphrased here. [source: Shambhala "Chöd: a guide for readers"; Chaoul 2008; Allione 2025 Lion's Roar; Rimé Foundation retreat page]

What it is. Chöd is a meditation practice found in both Tibetan Buddhist and Bön traditions. It uses chanting, music and visualisation to cut through fear, the afflictive emotions and the sense of a separate self, and it is linked to the Perfection of Wisdom (Prajñāpāramitā) sūtras. Machig Labdrön is placed in the eleventh to twelfth century (Allione gives 1055–1145) and is described as the only Tibetan to found a tradition that spread back to India. Lineages include Machig's Mahamudra Chöd, the Zhije (Pacification) teachings traced to Padampa Sangye, the Ganden (Gelug) tradition, Thangtong Gyalpo's oral-transmission lineage, and Bön Chöd, whose separate origin historians are still exploring. [source: Shambhala reader's guide; Chaoul 2008] Dates and attributions in older lineage histories are [uncertain: secondary, varying spellings and datings across sources].

How change is understood to happen (as the tradition states it). In the practice the practitioner, in visualisation, offers his or her own body as food to "guests": Buddhas, dakinis, gods, spirits and demons. The tradition holds that this repays karmic debt and loosens self-cherishing. Machig is quoted as teaching that a demon is anything that obstructs progress toward enlightenment and that the greatest demon is one's own self-grasping. Instead of battling inner and outer enemies, the practitioner nourishes them. Lama Zopa Rinpoche describes the "real" Chöd as the moment one's ego is hurt, when the emotional "I" shows itself as the object to be cut through with the understanding of emptiness and bodhichitta. [source: Shambhala reader's guide; Chaoul 2008; Lama Zopa 2007; Allione 2025] These are the tradition's own accounts of spiritual change, not psychological claims, and are reported as such.

In psychotherapy. The psychotherapist does not teach or lead the traditional Chöd ritual. The therapist's work is: client-led integration of the client's own Chöd practice in spiritually integrated psychotherapy; use of the published secular adaptation (FYD) where the client chooses it and the therapist is competent; trauma-sensitive adaptation; recognition and management of adverse experiences; and referral to and collaboration with the client's lama or a certified FYD facilitator. Related entries: Domain VII (contemplative and Buddhist psychotherapy, spiritually integrated psychotherapy), Domain II (MBSR, MBCT, MSC, CFT, for secular compassion and mindfulness work), Domain IV (trauma-sensitive yoga). [synthesis]

2. Framework

Chöd is a lineage practice, not a therapy, and has no published session protocol for psychotherapy. Two frameworks are relevant: the tradition's own path of training, and the therapist's process around it.

A. The traditional path (public outline only).

Entry: empowerment and instruction. Chöd is taught through empowerment, reading transmission and oral instruction from a lineage teacher. A current example: Khentrul Rinpoche's Machig Labdrön Chöd retreat (Rimé Foundation, 2021) gave the empowerment live (attendance required, no recordings), followed by practice and teaching sessions, with a private instruction text not to be shared. The retreat page stresses that merely attending an empowerment does not mean receiving it: the participant must understand what is happening. [source: Rimé Foundation retreat page] Kongtrul's compilation includes the texts on initiation and empowerment for practice. [source: Shambhala reader's guide]
Training in a peaceful place. Practitioners are first taught at a peaceful site. [source: Chaoul 2008]
Practice in frightening places. Once sufficiently trained, practitioners traditionally perform Chöd in frightening places such as cemeteries and charnel grounds, using a bell, a damaru drum and a thighbone trumpet, and offering a "white feast" and then a "red feast" to the guests in visualisation. [source: Chaoul 2008] The Ganden-tradition instructions discuss the degree of fear needed for practice. [source: Shambhala reader's guide]
Levels of understanding. Chaoul presents four levels at which the practice can be understood: shamanic, sutric, tantric and Dzogchen. [source: Chaoul 2008]
Daily-life Chöd. Teachers also describe Chöd as something practised in daily life: willingly accepting what is undesirable, or working with the moment the ego is hurt. [source: Rimé Foundation retreat page; Lama Zopa 2007]
Criteria for moving on are set by the teacher and the lineage, not by the therapist. No session counts or durations for traditional Chöd training are given in this guide.

B. Feeding Your Demons (published adaptation). Five steps practised in one sitting, preceded by setting a motivation and choosing a "demon": (1) find the demon in the body; (2) personify it; (3) become the demon; (4) feed the demon and meet the ally; (5) rest in awareness. The Lion's Roar text is described as an abbreviated version; full instruction and training are offered through Tara Mandala, which lists certified FYD facilitators, including psychotherapists. [source: Allione 2025; Tara Mandala FYD study page] In the one randomised study described, participants with prior meditation training and raised depression and anxiety symptoms practised FYD for one month (up to 15 sessions) and wrote a diary entry after each session. [source: Ekman et al. 2022; Tara Mandala FYD study page]

C. The therapist's process around Chöd [synthesis].

Assessment and consent: spiritual history, the client's lineage, teacher and commitments; mental-health and trauma history; what the client wants from bringing Chöd into therapy. Move on when the client has said in their own words what role, if any, Chöd should have in therapy and has given informed consent.
Client-led integration: exploring the meaning and effects of the client's own practice. Move on (or stay here) as the client chooses.
Optional FYD work in session: only if the client asks for it or agrees after explanation, the therapist is competent in it, and screening shows the client can stay within tolerable arousal. Move on when the client can complete the process and return to a settled state.
Review and consolidation: diary or between-session reflection, links to treatment goals.
Referral and collaboration: questions of doctrine, empowerment, commitments or advanced practice go to the client's lama; FYD training goes to Tara Mandala-certified facilitators.

No published session count for this therapeutic use was found in the sources consulted; length and frequency follow the client's treatment plan. [synthesis]

3. Guiding principles

The client's tradition, the client's lead. Chöd is brought in only as the client wishes, in the client's own terms and lineage. Practical meaning: ask before using any Chöd language; never introduce the practice as a technique to a client who did not raise it unless FYD is offered as a clearly secular option with consent. [synthesis]
Attribute concepts; do not rule on them. Demons, spirits, guests, karmic debt, dakinis and emptiness are described as the tradition holds them. Practical meaning: say "in your lineage, the demon is..." rather than either "demons are real" or "demons are only feelings". Note that Allione's adaptation itself treats demons as inner energies (fear, illness, depression, anxiety, trauma, addiction), whereas the ritual also addresses non-human guests. [source: Allione 2025; Chaoul 2008]
A demon is what obstructs, and fear feeds it. Allione teaches that the demon is the attachment to an experience, not the experience itself, that the demon is our own creation, and that fear strengthens it. Practical meaning: the target of work is the grip and the struggle, not the emotion's existence; approach rather than suppress. [source: Allione 1991]
Nurture rather than fight. Chöd's characteristic move is feeding, not battling, what is feared. Practical meaning: when the client wants to get rid of a symptom, explore what it needs before trying to remove it. [source: Allione 2025]
One feeding does not finish a demon. Allione notes that refusing a cigarette once does not mean the demon is gone. Practical meaning: expect repetition; frame change as practice over time, not a single cathartic session. [source: Allione 1991]
Restricted content stays with the lineage. The empowerment, instruction text and liturgy are received from a teacher; the retreat page treats them as not for sharing. Practical meaning: do not ask the client to recite, demonstrate or share restricted material, and never encourage a client to practise the ritual without the teacher's transmission. [source: Rimé Foundation retreat page]
The therapist is not the lama. Practical meaning: do not give empowerments, interpret doctrine authoritatively, or rule on whether a commitment was broken; refer these to the teacher. [synthesis]
Intensity is a feature of the practice, so safety is the therapist's job. Chöd is described as dramatic and confrontational and deliberately uses fear. Practical meaning: screen, titrate and keep the client within a tolerable window; trauma-sensitive mindfulness frames this around attention, arousal, relationship, dissociation and social context. [source: Shambhala reader's guide; Treleaven 2018 publisher description]
Informed consent for an unestablished method. FYD is not an established psychotherapy technique. Practical meaning: tell the client it is a developing method, its possible risks, alternatives, and that participation is voluntary (APA Standard 10.01(b)). [source: APA Ethics Code]
Competence and boundaries. Religion is among the factors for which competence may require training, consultation or referral (APA 2.01(b)); avoid multiple relationships that impair objectivity (3.05), for example being the client's Dharma teacher or fellow sangha officer. Vieten et al. (2013) propose 16 basic spiritual and religious competencies across attitudes, knowledge and skills. Practical meaning: get training or supervision before using FYD, and do not combine therapist and teacher roles. [source: APA Ethics Code; Vieten et al. 2013 summary]
No practice treats physical disease. Teachers' stories of healing through Chöd are personal accounts. Evidence status: there is no established evidence that Chöd or FYD treats physical disease. Practical meaning: medical symptoms go to a doctor; never position Chöd as an alternative to medical care. [source: Allione 1991 for the claims; synthesis for the evidence statement]
Even-handedness. Respect religious difference as part of people's rights and dignity (APA Principle E). Practical meaning: hold the same respectful, non-adjudicating stance whether the client is a committed Vajrayana practitioner, a Bön practitioner, or a secular FYD user. [source: APA Ethics Code]

4. Intervention inventory

The traditional Chöd ritual itself (empowerment, liturgy, visualisation sequence, use of damaru, bell and thighbone trumpet, practice in charnel grounds) is not a therapist intervention and is not given step by step; it belongs to the lama and the lineage. The interventions below are the psychotherapist's own work with Chöd and its published adaptation. [synthesis, framed by sources in sections 1–3]

4.1 Spiritual and clinical assessment for a client who practises Chöd

Purpose / when: at intake or whenever the client mentions Chöd, a Vajrayana teacher, retreat plans or experiences with spirits or demons. Establishes lineage, teacher, level of training, commitments, mental-health and trauma history, and what the client wants. [synthesis]
Steps:
1. Ask about the client's tradition (Buddhist or Bön), lineage, teacher, whether they have received empowerment and instruction, and how and where they practise (daily recitation, group practice, retreat, practice in cemeteries or other frightening places). [synthesis; lineage forms from Shambhala reader's guide and Chaoul 2008]
2. Ask what Chöd means to them: what they understand they are cutting, who the "guests" are for them, and how the practice has affected their mood, sleep, fear and relationships. [synthesis]
3. Take a mental-health history with attention to trauma, dissociation, psychosis, bipolar disorder, panic and current crises, since the practice deliberately evokes fear. [synthesis; intensity from Shambhala reader's guide]
4. Use a cultural formulation approach, such as the DSM-5-TR Cultural Formulation Interview and its supplementary module on spirituality, religion and moral traditions, to hear the problem in the client's own terms. [uncertain: not verified]
5. Ask what role, if any, the client wants Chöd to play in therapy, and record consent.
Example language (illustrative): "You mentioned Chöd. Can you tell me how you practise it, who you learned it from, and what it means for you?" / "Some people find practices that work with fear very helpful, and some find they stir things up. What has it been like for you?" / "Would you like your practice to be part of what we talk about here, or would you rather keep it separate?"
Watch for: practice in isolation without a teacher; recent intensification (long retreats, practising alone at night in remote places); reports of fear that does not settle after sessions; sleep loss; the client's wish to keep therapy and practice separate, which should be respected. Working: the client can describe the practice in their own terms and both of you are clear about its role in therapy. [synthesis]

4.2 Client-led exploration of the meaning of the client's own practice

Purpose / when: when the client wants to understand what happens in their Chöd practice, or links it to their difficulties (fear, grief, illness, self-criticism). Integration in spiritually integrated psychotherapy, in the client's own tradition and language. [synthesis]
Steps:
1. Invite the client to describe a recent practice session in general terms only (not the restricted liturgy or instruction text).
2. Reflect back using the client's vocabulary: guests, demons, offering, cutting, self-grasping.
3. Explore links the client draws between the practice and their life: what they are giving up, what they are afraid of, what feels freed.
4. Ask what their teacher has said about such experiences; note doctrinal questions to take back to the teacher.
Example language (illustrative): "In your tradition, the demon is whatever blocks the path. When you sit with that, what comes up for you?" / "You said the offering felt like letting go. What were you letting go of?" / "That sounds like a question for your lama. Would it help to note it down for when you next see them?"
Watch for: the therapist sliding into teaching or interpreting doctrine; the client disclosing restricted material out of a wish to please (gently redirect); spiritual bypassing, where the practice is used to avoid painful feelings or necessary action. Working: the client reports greater clarity, less self-attack, and a sense that therapy respects their practice. [synthesis]

4.3 Daily-life Chöd: the moment the ego is hurt

Purpose / when: for practitioners in the Gelug/FPMT or Rimé settings, whose teachers present Chöd as something practised in daily life: willingly accepting the undesirable, and using the moment of being criticised or hurt to see the self-grasping "I". Useful when the client brings shame, criticism or interpersonal hurt and wants to work with it in their tradition's frame. [source: Lama Zopa 2007; Rimé Foundation retreat page]
Steps:
1. Choose, with the client, a recent incident of being criticised or hurt.
2. Slow it down: what happened, what was felt in the body, what the client told themselves.
3. If the client wishes, invite them to reflect on it as their teachers describe, as a chance to notice the emotional "I" that feels injured, without forcing a conclusion.
4. Separate the spiritual reflection from practical questions (Is the criticism fair? Is the relationship safe? Is a boundary needed?).
Example language (illustrative): "Your teacher talks about the moment of being hurt as real Chöd. When your manager said that, where did the hurt land?" / "There's the practice question, and there's also the practical question of whether this was fair to you. Can we look at both?"
Watch for: using "cutting the ego" to excuse mistreatment, abuse or exploitation (by partners, employers or teachers); self-blame dressed as practice. Working: the client can feel the hurt, see their own reaction with some space, and still protect themselves. [synthesis]

4.4 Naming the client's demons

Purpose / when: preparing for FYD or for reflection on the client's own practice. Allione describes demons as whatever drains energy and blocks awakening: fear, illness, depression, anxiety, trauma, relationship difficulty, addiction. She gives personal examples such as an abandonment demon and a tobacco demon, and in her 1991 article names the demon of attachment to the body, the demon of death and the demons of the three poisons (passion, aggression, ignorance). [source: Allione 2025; Allione 1991]
Steps:
1. Ask what currently drains the client's energy most.
2. Help the client give it a short working name in their own words.
3. In relationship problems, locate the demon in the client's own feeling (for example, jealousy), not in the other person, as Allione advises. [source: Allione 2025]
4. For a first session, choose a demon of moderate intensity, not the most traumatic material. [synthesis]
Example language (illustrative): "If you had to name what's been draining you most this week, what would you call it?" / "Rather than your partner as the demon, what's the feeling in you that keeps getting fed?"
Watch for: choosing a perpetrator or a traumatic memory as the demon (see 4.7); the client personifying a symptom that needs medical assessment. Working: the client has a clear, manageable target and feels some curiosity rather than dread. [synthesis]

4.5 Feeding Your Demons®: the five-step process (Allione)

Purpose / when: a secular adaptation of Chöd for working with an inner "demon" by nourishing rather than fighting it. Use only when the client chooses it after explanation, the therapist has trained in it or works alongside a Tara Mandala-certified facilitator, and the client can tolerate eyes-closed imagery and strong affect. FYD is a process created by Allione and copyrighted by Tara Mandala; the outline below is a brief paraphrase of her published abbreviated version, not a script. [source: Allione 2025; Ekman et al. 2022; Tara Mandala FYD study page] Trauma caution: FYD deliberately evokes and intensifies difficult feelings and imagery and can bring on flashbacks, panic or dissociation in clients with trauma histories. Screen first; use the trauma-sensitive adaptations in 4.7; never make a perpetrator or a traumatic memory the "demon"; and do not use it during active PTSD symptoms, psychosis, mania or severe dissociation without specialist consultation. [synthesis; Treleaven 2018 publisher description]
Steps (paraphrased): 0. Preparation: the client sets a sincere motivation to practise for their own benefit and that of others, and chooses the demon (see 4.4).
1. Find the demon in the body: recall a situation in which the difficulty was strong and notice where and how it is felt in the body (in therapy, only as far as tolerable, see 4.7).
2. Personify the demon: let the felt sense take an imagined form, and ask it what it wants, what it really needs, and how it will feel when it gets that.
3. Become the demon: take the demon's perspective and answer those questions from its point of view.
4. Feed the demon and meet the ally: return to one's own perspective and, in imagination, offer the demon what it said it needed until it is satisfied; then meet a helping "ally" figure and ask how it will help.
5. Rest in awareness: rest briefly, then reorient to the body and the room with eyes open.
Example language (illustrative): "Let's start by setting an intention for this practice, in your own words." / "Where in your body do you feel this right now? What shape or colour might it have?" / "If this feeling stood in front of you as a being, what would it look like?" / "Now, if you're willing, move into its place. As the demon: what do you want? What do you really need?" / "Let yourself offer it exactly that feeling, as much as it needs, and watch what happens to it." / "Just rest here for a moment. When you're ready, feel your feet on the floor and open your eyes."
Watch for: rising arousal without settling (shaking, breath catching, panic); dissociation (blankness, losing track, feeling unreal); traumatic memories intruding; a demon that will not be satisfied or becomes more threatening; the client being unable to return to their own place. Working: in the study diaries, participants described challenging emotions previously seen as enemies or personal faults turning into insight, self-compassion and acceptance, and increased empathy. In session, signs include a softening of the demon image, a felt shift in the body, and the client leaving more settled than they arrived. [source: Ekman et al. 2022 abstract; watch-for list synthesis]

4.6 Post-practice reflection and diary

Purpose / when: after each FYD session, in session or between sessions, to consolidate what emerged and track effects. The randomised study used brief written diary entries straight after each session. [source: Ekman et al. 2022]
Steps:
1. Give the client a few minutes after step 5 before talking.
2. Invite a short note: the demon, what it needed, how it changed, the ally and its pledge, how the client feels now.
3. Link the ally's pledge to concrete next steps in the client's life. [synthesis]
4. Review notes at the start of later sessions to see patterns across repeated feedings.
Example language (illustrative): "Before we talk, would you jot down what the demon needed and what the ally offered?" / "The ally said it would remind you to slow down. What could that look like this week?"
Watch for: distress emerging hours later; diaries showing escalating fear or sleep problems; the practice becoming a compulsive ritual. Working: notes show the same demon losing intensity over repetitions, and allies' qualities appearing in the client's behaviour. [synthesis]

4.7 Trauma-sensitive adaptation

Purpose / when: for any client with trauma history, dissociation or high arousal who uses Chöd or FYD. Treleaven argues that mindfulness practised without trauma awareness can worsen traumatic stress, with flashbacks, dissociation or retraumatisation, and organises trauma-sensitive practice around five principles concerning attention, arousal, relationship, dissociation and social context, with 36 modifications. Chöd's deliberate use of fear makes this especially relevant. [source: Treleaven 2018 publisher description; Shambhala reader's guide] The specific modifications below are [synthesis] and are not quoted from Treleaven.
Steps:
1. Attention: allow eyes open or a soft downward gaze; let the client shift attention to a neutral anchor (feet, hands, sounds in the room) at any time.
2. Arousal: in step 1 of FYD, do not intensify sensation beyond what the client can stay present with; agree a hand signal to pause; shorten or stop after step 2 if needed.
3. Relationship: the client chooses whether to change places physically or only in imagination; the therapist checks in between steps; the client may decline any step.
4. Dissociation: if the client goes blank or distant, stop the imagery and orient to the room.
5. Social context: do not choose a perpetrator or an oppressive social force as the "demon" to be fed; work with the client's own feeling (fear, shame) instead, and do not frame feeding as forgiving or appeasing someone who harmed them.
6. For clients whose lineage practice involves charnel-ground or corpse imagery, ask whether such imagery is triggering (for example after bereavement, violence or medical trauma) and suggest the client discuss gentler forms or pacing with their teacher.
Example language (illustrative): "You're in charge of the pace. If you want to stop at any point, just raise your hand and we'll come back to the room." / "You can keep your eyes open if that feels better." / "Let's not make the person who hurt you the demon. What's the feeling in you that we could work with instead?"
Watch for: flashbacks, numbing, collapse, shame after the session; the client feeling they "failed" by stopping. Working: the client stays present, uses the pause signal freely, and ends settled. [synthesis]

4.8 Screening before intensive retreat or practice in frightening places

Purpose / when: when a client plans a Chöd retreat or practice in cemeteries, charnel grounds or other frightening, isolated places, which the tradition undertakes only after training. [source: Chaoul 2008] Observational studies report much higher rates of meditation adverse events than experimental studies (33.2% vs 3.7% in Farias et al. 2020), and adverse events occur even in people with no prior mental-health history. [source: Farias et al. 2020 abstract]
Steps:
1. Review current stability: recent crises, sleep, substance use, bereavement, psychiatric history (especially psychosis, mania, severe dissociation, PTSD).
2. Ask what the teacher has said about readiness, and whether a teacher or experienced practitioner will be present.
3. Plan practical safety for night practice in isolated places: telling someone where they are, a way to call for help, safe locations. [synthesis]
4. Agree warning signs that would mean pausing practice and contacting therapist, teacher or doctor.
5. If the client is currently unstable, discuss postponing, with the decision left to the client and teacher.
Example language (illustrative): "Before the retreat, can we look at what support you'll have if things get intense?" / "What has your teacher said about when someone is ready for this?" / "If you stop sleeping, or the fear doesn't fade after practice, what would you want to do?"
Watch for: the client minimising risk to prove commitment; pressure from a group to attend despite instability. Working: a written plan exists and the client feels supported rather than policed. [synthesis]

4.9 Grounding and dose reduction for adverse experiences

Purpose / when: when practice leads to persistent fear, panic, intrusive imagery, perceptual changes, energy-like body sensations, changes in sense of self or sleep loss. Lindahl et al. (2017) documented meditation-related challenges in Western Buddhists, and Cheetah House offers consultation, support groups, crisis help and training for teachers and clinicians. Farias et al. (2020) found the most common reported adverse events were anxiety, depression and cognitive anomalies. [source: Cheetah House VCE page; Farias et al. 2020 abstract]
Steps [synthesis unless marked]:
1. Normalise without dismissing: such experiences are documented in meditators.
2. Grounding: orient to the room, feet on floor, eyes open, naming objects, slow normal breathing, physical activity, regular meals and sleep.
3. Reduce dose: shorter sessions, fewer sessions, eyes-open forms, pause intensive practice; agree any change with the client's teacher if the client wishes.
4. Shift practice: from fear-evoking imagery to gentler forms the client's tradition offers, as chosen with the teacher.
5. Coordinate: medical review for sleep loss or physical symptoms; consider specialist consultation (for example Cheetah House). [source for Cheetah House services: Cheetah House VCE page]
Example language (illustrative): "What you're describing has been reported by many meditators. It doesn't mean you've done something wrong." / "For now, could we look at making your practice shorter and lighter, and check that with your teacher?"
Watch for: symptoms persisting after practice is reduced; suicidal thoughts (assess using standard risk assessment); functional impairment. Working: symptoms ease with reduced dose and grounding. [synthesis]

4.10 Telling spiritual experience apart from illness

Purpose / when: Chöd explicitly invites spirits, demons and other guests, so a practitioner may report encounters with non-human beings, intense fear or dissolution of the sense of self as part of the practice. The task is neither to pathologise religiously normative experience nor to miss psychosis, mania, depression or dissociation. DSM-5-TR lists "religious or spiritual problem" among other conditions that may be a focus of clinical attention (Z65.8).
Steps [synthesis]:
1. Ask whether the experience fits what the client's teacher and community describe as part of Chöd, and whether it occurs during practice or spills into daily life.
2. Check function: sleep, eating, work, relationships, self-care.
3. Look for features that suggest illness: experiences outside practice that the client cannot set aside; fixed beliefs not shared by their own tradition; grandiosity, pressured speech, reduced need for sleep; command hallucinations; persistent depersonalisation; hopelessness or suicidal thinking.
4. With consent, ask the teacher whether the experiences are expected for this practitioner at this stage.
5. If illness is possible, arrange psychiatric and medical assessment promptly while respecting the client's frame.
Example language (illustrative): "In your practice you invite many kinds of beings. Is what you've been experiencing the kind of thing your teacher talks about, or does it feel different?" / "Are these experiences staying within practice times, or are they following you through the day?" / "I'd like a doctor to check how your sleep and body are doing too. That isn't a judgement on your practice."
Watch for: the therapist's own beliefs (sceptical or credulous) colouring judgement; the client hiding experiences for fear of being called mad. Working: the client feels heard, and appropriate medical or spiritual support is in place.

4.11 Referral to and collaboration with the lama or an FYD facilitator

Purpose / when: for questions about empowerment, commitments, doctrine, readiness, practice modifications, or FYD training. Chöd empowerment is received live from a teacher and the instruction text is private; FYD has a directory of certified facilitators, including psychotherapists. [source: Rimé Foundation retreat page; Tara Mandala FYD study page] APA Standard 2.01(b) names religion among the factors that may call for consultation or referral. [source: APA Ethics Code]
Steps:
1. Ask whether the client wants their teacher involved; get written consent for any contact and agree what will be shared.
2. Keep roles clear: the teacher advises on practice; the therapist on mental health.
3. For FYD, refer to a certified facilitator or train before using it yourself.
4. If the client has no teacher and wants one, suggest they look for an established lineage centre, without recommending specific individuals. [synthesis]
Example language (illustrative): "Would it help if I spoke with your lama about pacing your practice while things are hard? Only with your permission, and you decide what I share." / "That's a question about your commitments. Your teacher is the right person for it."
Watch for: the client feeling handed off; the teacher contradicting medical advice (keep medical care with the doctor); confidentiality breaches in small communities. Working: the client has clear, non-competing sources of support. [synthesis]

4.12 The teacher relationship, power and coercive control

Purpose / when: Vajrayana practice places the student in a close relationship with a teacher who gives empowerments and commitments. When a client describes pressure, secrecy, harm or fear of leaving, this power must be considered. In the Rigpa Fellowship case, an independent investigation by Lewis Silkin LLP (report to trustees, August 2018) concluded on the balance of probabilities that some students in Sogyal Lakar's inner circle were subjected to serious physical, sexual and emotional abuse, and that senior people knew of some of this and failed to act. The Charity Commission's 2020 inquiry report (later withdrawn and archived, in 2023) criticised safeguarding policies for blurring the distinction between consent and submission. [source: Charity Commission inquiry report, Rigpa Fellowship] This case does not concern Chöd specifically.
Steps [synthesis]:
1. Ask neutral, open questions about the teacher relationship and community.
2. Listen for signs of coercive control: isolation from outside relationships, secrecy demands, punishment for questions, financial or sexual exploitation, reframing harm as "practice" or "cutting the ego", threats about breaking commitments.
3. Separate genuine religious commitment from coercion; do not label the group, and do not dismiss the tradition because of a teacher's conduct.
4. If abuse is disclosed, follow safeguarding and reporting duties for your jurisdiction; abuse can be reported to police and relevant authorities. [source for reporting: Charity Commission inquiry report]
5. Support clients leaving a group: grief for community and teacher, loss of meaning, fear of spiritual consequences, religious trauma; help them find their own relationship to practice.
Example language (illustrative): "How do things work between you and your teacher? Are you free to question or say no?" / "Sometimes harm gets explained as spiritual training. Has anything like that happened to you?" / "Leaving can mean losing a whole world. What are you most afraid of losing?"
Watch for: the client defending the teacher reflexively, then feeling disloyal for having spoken; fear of samaya consequences used to silence the client. Working: the client can think freely about the relationship and makes their own decisions. [synthesis]

4.13 Commitments, fear of breaking them, and scrupulosity

Purpose / when: empowerments in Vajrayana often come with commitments (samaya). Some clients develop anxious, repetitive worry about having performed the practice wrongly, missed recitations or broken commitments. Where worry is excessive, repetitive and driven by compulsions, consider scrupulosity (religious OCD) and adapt exposure and response prevention with consultation with the client's teacher. [synthesis; uncertain: not verified]
Steps [synthesis]:
1. Distinguish ordinary conscientiousness from compulsive checking, repeating or reassurance seeking.
2. With consent, ask the teacher what the tradition actually requires and how it understands repair of broken commitments; use that as the reference point.
3. Build exposure and response prevention within what the teacher confirms is acceptable (for example, not repeating a recitation "until it feels right").
4. Avoid the therapist ruling on what the commitments are.
Example language (illustrative): "How do you know when you've done the practice correctly? What happens if you're not sure?" / "Could we ask your teacher what the tradition actually asks of you here, and work from that?"
Watch for: reassurance seeking moving from teacher to therapist; the practice expanding to fill hours. Working: the client practises as the teacher advises, with less checking and distress.

5. Handling problems

Published sources say little about problems in therapeutic use. Guidance here is [synthesis] unless a source is named.

No demon image appears in FYD. Stay with body sensation (step 1) and let the client describe it in plain words; a colour or texture is enough. If nothing forms, end with resting and grounding and treat it as information, not failure. Allione's process already allows that the ally may not appear and must be invited. [source for the ally point: Allione 2025] (illustrative) "It's fine if no picture comes. What do you notice in your body right now?"
The demon becomes more frightening or will not be satisfied. Slow down, open the eyes, ground. Allione notes that feeding may take a while; in therapy, it is acceptable to stop and return later. [source for duration point: Allione 2025] (illustrative) "Let's pause here and come back to the room. We can return to this another time."
Overwhelm, flashback or dissociation. Stop the imagery, orient to the room, use the trauma-sensitive steps in 4.7 and the grounding in 4.9. Review whether FYD suits this client now.
Client treats Chöd as a cure for physical illness. Respect the meaning, attribute the healing accounts to their sources, and route physical symptoms to the doctor. Teachers' healing stories (for example in Allione 1991) are personal accounts; there is no established evidence that Chöd or FYD treats physical disease. (illustrative) "Your practice can be part of how you face this illness. I'd also want your doctor fully involved."
Client asks the therapist to teach Chöd or give instructions. Decline the teacher role; refer to the client's lineage or a Tara Mandala facilitator. Do not share restricted texts or encourage practice without transmission. [source for restricted status: Rimé Foundation retreat page]
Client practises alone in frightening places while unstable. Use the screening plan in 4.8; involve the teacher with consent; discuss postponing.
"Cutting the ego" used to tolerate mistreatment. Separate the spiritual frame from the practical question of safety and fairness (4.3, 4.12).
Non-adherence to between-session FYD. Explore what gets in the way (time, fear, doubt about the method). Practice is voluntary; offer shorter forms or stop. In the randomised study, more sessions completed predicted better outcomes, but this is a reason to explore, not to push. [source: Tara Mandala FYD study page]
Rupture: the client feels the therapist dismisses spirits or the practice, or over-identifies with it. Name it, apologise for the misstep, re-state respect for the client's frame (APA Principle E), and check the therapist's own beliefs in supervision. [source for Principle E: APA Ethics Code]
Therapist's own religious commitments. Disclose only when it serves the client; avoid evangelising for or against Buddhism; avoid multiple relationships, such as practising in the same sangha as a client (APA 3.05). [source: APA Ethics Code]
Teacher advice conflicts with clinical advice. Keep medical and psychiatric decisions with clinicians; discuss the conflict openly with the client; with consent, talk to the teacher.
Ambiguous experiences (spirits, voices, loss of self). Use 4.10; do not decide alone whether an experience is spiritual or pathological; consult the teacher (with consent) and a psychiatrist when indicated.
Grief and charnel-ground imagery. Corpse and death imagery may be harder after a bereavement; suggest the client discuss pacing with the teacher, and work on the grief directly in therapy.
Disclosure of abuse by a teacher or within a community. Follow safeguarding and reporting duties; abuse can be reported to police and relevant statutory agencies. Believe and support without pressuring the client to leave or to report on your timetable, except where law requires reporting. [source for reporting: Charity Commission inquiry report]
Suicidal thoughts during or after intensive practice. Assess risk following current standard practice; suicidal behaviour is among the adverse events reported in the meditation literature. [source: Farias et al. 2020 abstract]

Sources

Web pages:

Books cited (as listed by their publishers):

Machig Labdrön, Machik's Complete Explanation, trans. Sarah Harding (Shambhala/Snow Lion).
Jamgön Kongtrul Lodrö Taye, Chöd: The Sacred Teachings of Severance, trans. Sarah Harding (Shambhala/Snow Lion).
Fourteenth Karmapa Thekchok Dorje and Jamgön Kongtrul, Chöd Practice Manual and Commentary, trans. Lama Lodo Rinpoche (Snow Lion).
Kyabje Zong Rinpoche, Chöd in the Ganden Tradition, ed. David Molk (Snow Lion).
Alejandro Chaoul, Chöd Practice in the Bön Tradition (Snow Lion).
Tsultrim Allione, Feeding Your Demons.
David A. Treleaven (2018), Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing.
Vieten, C., Scammell, S., Pilato, R., Ammondson, I., Pargament, K. I., & Lukoff, D. (2013). Spiritual and religious competencies for psychologists. Psychology of Religion and Spirituality, 5(3), 129–144.
ICD-10-CM Z65.8, Other specified problems related to psychosocial circumstances (includes 'Religious or spiritual problem')

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