Mantra and Meditation in Buddhist Hospice Chaplaincy to Alleviate Anxiety by Karen Nelson Villanueva

Karen Nelson Villanueva has recently successfully defended her doctoral dissertation, “Invoking the Blessings of the Tibetan Buddhist Goddess Tara Through Chanting Her Mantra to Overcome Fear,”

Mantras are not just the prescribed sound formulas or sentences found in Eastern religions, but they can also be thought of as the words or phrases that we continually repeat to ourselves. The word mantra comes from Sanskrit and its roots are manas-, meaning “mind,” and -tras, which can be translated as “tool.” Thus, mantra is a tool to protect the mind.

How often do we engage in negative self-talk like “It’s my fault” or “I’m to blame for what’s happened to me” or “No one loves me”? These expressions can become mantras, as we believe their messages from constant repetition. In hospice and hospital settings, one often finds patients who have convinced themselves that “This is God’s punishment” or “Everyone has forgotten me” or “I’m so scared.” These phrases, rather than protect the mind, become what is believed by the mind and may lead to increased anxiety, stress, and depression, and consequently the need for spiritual and emotional support.

Chaplains, as members of the care team in hospice and hospitals, provide spiritual and emotional support to patients and their families. Most often, chaplains attentively listen to patients and their caregivers (often family members) about the patients’ life story, their relationships, their dreams unfulfilled, and their wishes for those whom they are leaving behind. Chaplains take part in family meetings where decisions are made about patients’ care, sometimes interjecting to ask for clarification of medical terms and to ensure that the family understands. Sometimes, the chaplain will lead prayer with the patients and their families, and at other times, the chaplain will pull other tools from her toolbox such as mantra meditation.

On November 3-4, 2018, I had the honor of presenting my paper “Mantra and Meditation in Buddhist Hospice Chaplaincy to Alleviate Anxiety” at the International Conference on Buddhist Approaches to Hospice Care and Life Education in Shanghai, China. The conference was attended by scholars from around the world to discuss the importance of hospice care and its growing need to support end of life with dignity. The research I presented was a furtherance of the work I had begun with my dissertation, “Invoking the Blessings of the Tibetan Buddhist Goddess Tara Through Chanting Her Mantra to Overcome Fear,” and which I continue to bring into the world as an Interfaith Chaplain in hospice and hospital care.

In my presentation, I examined the use of mantra in spiritual practice as a chaplain working in hospice care and at a quaternary, urban hospital with multiple campuses. First, my use of mantra was considered as a personal tool to protect the mind and then proposed as a means to help alleviate the experience of anxiety of patients through finding the spiritual words or phrases that resonate with the patient’s own religion and/or spirituality. Since I am a Vajrayana (or Tantric) Buddhist practitioner, mantras are an important part of my spiritual tradition. Therefore, mantras accompany me in my chaplain work.

Mantra is a part of my personal spiritual practice and I share this about myself in the hope that this may help others, too. Each and every day, I arise with the mantra, “May this be a day of happiness and enlightenment for all sentient beings, and may I be an instrument to this cause.” Also, “May the love, energy, and blessings of Mother Tara be with me and my loved ones.” Then, I chant the dharani of the 21 Taras as I begin my day’s ablutions.

A dharani is a particularly long mantra, one consisting of several lines. The dharani of the 21 Taras invokes the blessing of 21 of the manifestations of the Goddess Tara that are grouped together in her praises. Each of these manifestations has her own name, her own mantra, and her unique attributes such as Tara who dispels sorrow (10) and Tara who burns suffering (19). This makes this dharani a particularly powerful invocation presenting the supplicant with the potential to really serve her communities through these combined blessings.

As I enter a hospice or hospital setting, I chant the dharani of the 21 Taras to help me focus on being of service and put the bodhisattva vow into action: “For as long as space endures and for as long as living beings remain, until then may I, too, remain and dispel the miseries of the world.” However, as I enter patients’ rooms or walk the hospital halls, I change the mantra because it is no longer about me and maintaining my focus, but instead, becomes about the patient and his or her or their healing.

In my tradition, when one focuses on health and healing we chant the mantra of the Medicine Buddha. Either sublingually or silently, I chant his mantra (phonetically): Tayata Om Bekensay Bekensay Maha Bekensay Bekensay Radza Samugatay Soha!

To the Bhagawan with equal compassion for all

Whose name when just heard dispels lower realms’ suffering

Dispeller of disease and the three poisons

I prostrate to Medicine Buddha Lapis Light.

I chant this mantra because of my belief that it will benefit the patient. However, I do not chant it aloud because if the patient does not share in my belief it may upset her or him or them. Personally, I believe that upsetting the mind of an individual and perhaps causing them fear can harm them and impede their healing. Nonetheless, the chanting of mantra is like any prayer; it is a hope for a positive outcome. And while the mantra of the Medicine Buddha is for healing, the mantra of the Goddess Tara protects the mind from fear.

Tara is a Buddha and a goddess or meditational deity, a yidam. In her principal form, she is green and 16 years old. She is seated on a lotus throne with her left leg drawn in to symbolize her sexual autonomy and her right leg extended so that she can spring forth to aid when asked. Her 10-syllable mantra is OM TARE TUTTARE TURE SOHA!

OM = Setting the intention for the blessings of the mantra

TARE = Tara who liberates from the suffering of old age, sickness, and death

TUTTARE = She who eliminates all fears, particularly the 8 disturbing internal thoughts, which are the main dangers and come from ignorance, attachment, anger, pride, jealousy, miserliness, doubt and wrong views

TURE = She who grants all successes and eliminates ignorance of the ultimate nature of the “I” or self, in other words, it is a desire to realize the true interconnectedness of all

SOHA = Rejoice! It is done.

Researchers have found that there is a positive impact on people who use a spiritually meaningful mantra and study participants who used a spiritually based mantra experienced a decrease in anxiety, a significant increase in positive mood, and a 50% increase in the time they tolerated painful stimuli. When used in combination with meditation, mantra can improve the beneficial effects of meditation such as decreased stress demonstrated by lower blood pressure, decreased anxiety, and increased emotional well being.

As a chaplain, I am often requested by nurses, doctors, social workers, and the patients themselves, to see a patient when he or she or they are experiencing anxiety. An example of this was when a social worker requested that I visit an adolescent cancer patient. After introducing myself, I asked the patient what made her fearful. She told me that she did not want anyone to touch her “down there.” She explained that as a young child she had been sexually abused and did not want her genitalia to be touched. So I asked her what she felt would help her to overcome her fear, and she said that she did not know but that slowing her breathing did not seem to work. Then I asked her what she liked to do and she told me she loves to sing. I then inquired, “Who’s your favorite singer?” And she told me the name of an R&B artist. We talked about the singer’s relationships and family. I suggested that she choose one of her favorite songs of his and to try to sing this whenever she was frightened, and she immediately began to sing me a song.

In visiting patients, I often lead them to find their personal mantra or offer mantra meditation as a means to calm their mind and internally focus on their healing. This table illustrates mantras that may be used from a variety of spiritual traditions.













Our Father

The presence of God


Hail Mary

Mother Love



Welcoming peace


Sh’ma Yisroel

The Lord is our God


Insha’ Allah

God willing


Bismillah ir-Rahman ir-Rahim

In the name of Allah, the merciful, the compassionate



He who draws us to himself



To rejoice; the joy that is in each of us


Om mani padme hum

Jewel in the lotus of the heart that lies in each of us


Used with the permission of the author, Roxanne Raffin Chan, “Mantra meditation as a bedside spiritual intervention,” in Medsurg Nursing (March-April 2014); 23(2): 84-100.

As a chaplain, I am also requested to use the formulaic form of mantra as from my own Buddhist tradition. One instance of this was with a psychiatric patient who had been sexually abused by their father and feared they might commit suicide when released. Because of the nature and immediacy of this request, I felt the necessity to chant an entire mala of the Tara Mantra with the patient in order to have it enter their mind stream and body.

Normally, I would never chant 108 mantras with a patient. My research and experience has taught me that people can delightfully chant a mantra for 21 times, but beyond this point they begin to question: “How long is this going to go on?” “How many more mantras are there?” “Will this ever end?” And they begin to think: “This is ridiculous!” “Oh my gosh!” Up to around the 54th bead of the mala, people often start to feel irritation and some anger. It is at this point, if the person hung in there and gave in to the chant rather than trying to control the process that the chanting begins to vibrate within. Once resigned to the process and no longer expecting particular results, the universe, the divine, or the great whatever steps in and every fiber of the person’s being vibrates with the power of mantra and the interconnectedness of all beings. Hence, this is what I did with this patient. I risked alienating the patient in order to permit the mantra to vibrate within them, and they survived that night and to the day they were released.

I hope that you will find your own mantra or adopt one of the mantras suggested above, and whatever you choose, may the words and phrases you repeat to yourself nourish you, feed you, and heal your heart and soul.


Karen Nelson Villanueva, MPA, PhD was a Chaplain Intern at the University of California at San Francisco (UCSF) in the Year-Long Chaplain Internship program, and a former Hospice Chaplain and Bereavement Coordinator. She has also been a College Lecturer at the California Institute of Integral Studies (CIIS), Holy Names University, and San Francisco State University. She is a Vajrayana (Tantric) Buddhist in the Tibetan Gelug School and earned a doctorate in Philosophy and Religion with an emphasis in Women’s Spirituality from CIIS. Currently, she volunteers in the No One Dies Alone (NODA) program at Laguna Honda Hospital in San Francisco, leads meditation at the Five Keys Navigation Center, and is on sabbatical from teaching at the Institute for Contemporary Buddhist Ministry.

15 thoughts on “Mantra and Meditation in Buddhist Hospice Chaplaincy to Alleviate Anxiety by Karen Nelson Villanueva”

  1. I like your idea that a mantra not only shapes the mind but also reshapes it, getting rid of old “mantras” that harm. I used to be stuck on “no one loves me” and I expelled it in part by memorizing many of Sappho’s poems and repeating them when the bad matra came up when I was trying to sleep.

    Liked by 2 people

    1. Thank you Carol. This is exactly what I mean by my essay. We have the ability to choose the message that empowers us and calls to the divine within.


  2. I learned the Om Tare mantra back in about 1988 when I took refuge with Dagmola Jamyang Sakya and Green Tara. I used to sing it to myself while I was driving on the SoCal freeways. Nowadays, still a chronic asthmatic (it’s under control) and self-employed, I have two new, brief mantras: Breathing Is Good and Income Is Useful. I tell myself these truths frequently during the day.

    Thanks for a thorough and thoroughly interesting and informative post.

    Liked by 1 person

    1. Breathing is Good and Income is Useful shall become my new mantra! It’s so calming. Thank you for sharing this, Barbara, and for your comment.


      1. You’re welcome. I hope you’ll write again about the value of mantras. I share my two short mantras with everybody. Most people chuckle and nod their heads.


  3. Agreed— interesting, inspiring and informative! I used Om Mani Padme Hum as Spirit was beginning to introduce me to the power and necessity of self-compassion. I was reminded that indeed the seed has grown in me over the past 5 years and extended to so many others. Thank you for sharing


  4. Hi Karen — Nice to see you back on FAR! I enjoyed your post.Tthe first part of it about negative self-talk is the topic of my latest article in _SageWoman_ magazine, “Overcoming Self-Sabotage.” I also talk about meditation as a means to overcome these negative “autopilot” stories that we tell ourselves, but also about divination as another method to the same purpose (a la _The World is Your Oracle_, my book of divination methods). Like you, I practice tantric meditation, and I love your description of finding the best meditation practice for each individual, in the case you mentioned singing the person’s favorite song. I’m about to counsel a woman about her best approach to meditation, and I will be basing it on the _Radiance Sutras_, a translation of the _Vijnan Bhairava Tantra_, which includes 112 methods. But I will first ask the same kinds of questions you asked to come up with the way(s) in which she already instinctively knows how to meditate.


    1. Your work sounds fantastic! I will look for your article and try to purchase your book. May you continue to help others through all you do in the world, Nancy! And thank you for your comment on my essay!


  5. Reading your beautiful post brings tears to my eyes! May every body be so lucky as to have a compassionate presence with them in their final hours. You embody your work in such a beautiful way. Your chant at our PNW AAR conference last Spring changed the room and all of us in it. Thank you for your work and for this essay, Karin!


    1. Thank you Mary Beth! You always make me smile. I appreciate your kind affirmations of my work in the world. This is high praise indeed because you are one of the best presenters I have ever seen.


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