This is an AI-generated transcript from auto-generated subtitles for the video Buddhist Chaplaincy Speaker Series: Reflections on Self-Care from the Zen Caregiving Project. It likely contains inaccuracies, especially with speaker attribution if there are multiple speakers.

Buddhist Chaplaincy Speaker Series: Reflections on Self-Care from the Zen Caregiving Project with Teresa Bouza and Mary Doane - Vanessa Able

The following talk was given by Vanessa Able at The Sati Center in Redwood City, CA on February 23, 2026. Please visit the website www.audiodharma.org for more information.

Buddhist Chaplaincy Speaker Series: Reflections on Self-Care from the Zen Caregiving Project with Teresa Bouza and Mary Doane

Introduction

Vanessa Able: Welcome everybody. It is nice to see you. Welcome to our February installment of the Buddhist Chaplaincy Speaker Series here at the Sati Center¹. I'm Vanessa, one of the co-organizers of this speaker series and faculty for the online Buddhist Chaplaincy Training Program, as well as the Anukampa² practice program.

Today, I am delighted to welcome our two guests from the Zen Caregiving Project. My inroad to the Zen Caregiving Project is my dear friend in the Dharma, Teresa Bouza. Teresa and I practiced together at Kannon Do Zen Center³ for many years in Mountain View, California, before we both moved away to Europe. Teresa, who is a journalist by profession, a caregiver, and a Zen practitioner, returned to Europe to care for her mom, who has Alzheimer's. She then became an instructor for the Zen Caregiving Project and regularly teaches online classes for family caregivers.

Joining her is Mary Doane, who is an alumna of the Sati Buddhist Chaplaincy Training Program from a few years ago. Mary has since become the Supervising Instructor of Education Programs at the Zen Caregiving Project. She started there as a hospice volunteer and then became a training facilitator and a volunteer program coordinator.

Today, Mary and Teresa are going to tell us a little bit more about the Zen Caregiving Project and about self-care—caring for caregivers. How do caregivers care for themselves given the massive amounts of energy, both physical and emotional, that go into caregiving? I am so looking forward to hearing from you both today on this topic. Thank you so much, Mary.

The Zen Caregiving Project: History and Philosophy

Mary Doane: Thank you so much. Hello, everyone. It's good to be with you today. It's morning where I am in Northern California in the San Francisco Bay Area. I am grateful to have the opportunity to be with you, and grateful to Vanessa and Teresa for inviting me to be part of this session.

I am especially grateful to the Sati program, which I attended in 2004. In fact, as I was preparing to be with you all today, I got out my physical three-ring binder from that era and found the acceptance letter I received in the mail on August 8th, 2004. It's really wonderful remembering my experience and I am very grateful to my teachers at that time: Jennifer Block⁴, Gil Fronsdal, and Diana Lion. It is wonderful to have this full-circle moment.

I want to begin by giving you a little bit of my own story, share some background about our organization, and then hand it over to Teresa to talk more about her specific experience and our topic for today.

I joined what was then the Zen Hospice Project in 2005 and became a volunteer caregiver in hospice. I was inspired to do that through the experience of being with my father through his illness and death from cancer. As I'm sure some of you know well, it is often the case that people who are inspired to serve or volunteer in hospice care come from a very personal experience, often the death of a loved one. I served as a volunteer for about ten years, and I am still with the organization twenty-one years later. I found a home, a Sangha⁵, a place of practice, a professional community, and work that continues to align with my values, nourish me, and inspire so much gratitude and joy of service.

I also want to say a little bit about my journey as a family caregiver, because it's central to the work that we do. I cared for my father at the end of his life, and also for my mother through her aging and up to her death. I have an adult daughter who is thirty-two, and I consider myself a caregiver to her as well. She is a person with autism and lives with some mental illnesses. She lives at home here with me and my husband, her father. I am a family caregiver day to day. This really informs the way that I approach my work and how I relate to the family caregivers we serve. Most importantly, I rely on and practice what we teach. I too am walking this path, relying on the skills of mindfulness, presence, boundaries, mindful communication, compassion, and self-compassion. These are vitally important to me off the cushion as a family caregiver.

Putting Your Own Mask On First

When Teresa and I were coming up with how we wanted to frame this, we thought of the idea of putting your own mask on first. This metaphor has become familiar to many of us—if you picture being in an airplane and the instruction to put on your oxygen mask first so that you can then serve others best. I do my best to practice that, but I also know that it's really hard. As caregivers, and as parents, there can be a very natural instinct to do just the opposite. When we're focused on the well-being and the reduction of suffering of another person, it can feel almost in conflict with remembering our own needs. I just want to name that challenge: remembering to include ourselves in the care and compassion.

We use a very broad definition of caregiving in our approach. Of course, it includes caring for those who are ill, aging, or in need, but it also encompasses a broad perspective of human relationships as relationships of care. In our workshops, we do an exercise called "Imagining the Mindful Caregiver." We invite people to remember a time when they received care. It could be when they were ill as a child and a parent tended to them, but perhaps it was a chaplain, a teacher, a neighbor, or a grandparent who made them feel safe, heard, and honored. What were the qualities we remember? What did we receive, witness, or feel that gave us a sense of being cared for?

The Evolution of the Zen Caregiving Project

What we now call the Zen Caregiving Project began as the Zen Hospice Project in the 1980s in San Francisco. Students at the San Francisco Zen Center saw tremendous suffering in their community—people living and dying in the streets, homelessness, and the AIDS crisis. Zen students wanted to bring their practice off the cushion and into their community. This idea of socially engaged Buddhism was the spirit: reducing suffering, turning toward it, listening, and meeting yourself as you serve. The person in the bed who is suffering mirrors back your own experience, your own vulnerability, and perhaps your own fears.

Our volunteer caregiver program continues thirty-plus years later in San Francisco at two sites: Laguna Honda Hospital, a public rehabilitation center with a palliative care ward, and the Cadillac Hotel, a single-room occupancy hotel in the Tenderloin neighborhood. The volunteer training program is about forty hours. We ask our volunteer caregivers for a one-year commitment to five hours of service per week.

We start the training by asking people to investigate their own relationship to change and loss. How does each of us hold our relationship to our mortality and our vulnerability? Our volunteers also practice action and reflection. At the beginning or end of their five-hour shifts, they sit in a shift change meeting where they meditate together for a few minutes and then reflect on their experiences. They discuss their feelings, what obstacles or hindrances they noticed, and find support in the Sangha.

In 2015, we began our mindful caregiving education. There was an intention to bring the wisdom we had learned at the bedside for thirty-plus years beyond just hospice work, extending it to families and other caregivers. I want to honor Jennifer Block, who began that work during her time with the Zen Hospice Project. In 2017, our organization received a grant to focus specifically on the experience of family caregivers. There is a lot of overlap, but there are also important differences between hospice caregiving and caring for a family member with a chronic illness.

In 2019, we changed our name from the Zen Hospice Project to the Zen Caregiving Project. We learned that for some people, the name "hospice" was a bit limiting; it's a deep and important realm of service, but it doesn't encompass all of caregiving. Today, we offer open-enrollment live online courses, self-paced courses, caregiver support circles, custom workshops for health systems, and weekly community meditation.

Mindful Caregiving: Putting On Your Mask First

Teresa Bouza: Thank you, Mary. I love what you said about this broad concept of caring. Once I asked my Zen teacher, Les Kaye's⁶ wife, about her support for him over the years. She said she supported him 100% because she saw him bloom through his meditation practice. I am very happy to see that Vanessa has also bloomed through her meditation practice.

The image of the oxygen mask is commonly used when talking about self-care to convey the idea that you cannot effectively help others if you are incapacitated yourself. At the end of 2019, I moved from the US back to Spain, my native country. Soon after my arrival, I became my mother's main caregiver. She is 93 now and has Alzheimer's. In 2021, I was introduced to Roy Remer, the director of the Zen Caregiving Project, to participate in a program to translate their mindful caregiving curriculum into Spanish and to become an instructor for Hispanic family caregivers.

The Zen Caregiving Project's goal is to support caregivers of persons with chronic or terminal illnesses by teaching mindfulness-based caregiving approaches, tools, and practices. During the five years before moving back to Spain, I practiced regularly at Kannon Do Zen Center. We sat at 5:30 a.m. every day, and Vanessa was also there most mornings. Those were the happiest years of my life. If someone asked me what the best thing they can do to support themselves and others is, I would say without hesitation: sitting in meditation regularly with a group and a teacher.

I cannot explain exactly how meditation works or what the magic of zazen⁷ is. What I know is that during those five years of daily practice, I felt my life was flowing like water without obstruction, regardless of challenges. In his book, Les Kaye says: "When our minds are quiet and still we touch the source of existence and express our infinitude. This is why the meditation hall is a holy place." During a Dharma talk, he also said: "When we sit in meditation we limit our activity to our breath... We empty our minds of ideas such as usefulness, efficiency, or productivity... When we can do that, we can see everything as a gift."

The Four Pillars of Mindful Caregiving

The four-week course we teach has four main topics: Mindfulness, Compassion, Loss, and Boundaries. The curriculum emphasizes that investing in your own well-being helps you provide better care.

Mindfulness Our working definition of mindfulness is a flexible state of mind that allows you to pay attention to the present moment experience on purpose and without judgment. Beginners sometimes think they should achieve an empty mind, but we emphasize that distraction is natural. The brain secretes thoughts, plain and simple. We discuss three key benefits of mindfulness for caregiving:

1. A focused mind: A focused mind is a less exhausted mind and minimizes human error.
2. Increased awareness: It interrupts getting stuck in thought patterns and supports healthy self-care.
3. A calm mind: This minimizes reactivity and calms those you are caring for.

We recommend the STOP practice to delay our response when something isn't right:

• Stop
• Take a breath
• Observe your environment
• Proceed with your activity

Compassion Every wisdom tradition highlights compassion as a noble way to treat others. We present compassion as a skill that can be strengthened through practice. We encourage caregivers to be easier on themselves when they find they are resistant or hesitant in the face of suffering. Humans evolved to equate suffering with pain and to distance themselves from it.

I love to share that the root of the word courage is cor, meaning heart. To be in touch with our heart as caregivers—to allow ourselves to be fully present to the suffering we witness—is to exhibit tremendous strength. Most caregivers find it easier to direct compassion toward others than toward themselves, but we are no less deserving of our own compassion.

Loss Loss is an unavoidable, universal experience. Caregivers witness and experience a variety of losses. Change brings loss, and if it goes unacknowledged or unprocessed, it eventually catches up with us. We create our self-identity with objects, activities, roles, the people in our lives, and our bodily characteristics. Once we clarify the components of self-identity, we can look at the way these qualities naturally shift and fall away, especially when dealing with chronic and terminal illness.

During a Dharma talk called Blades of Grass, Les Kaye said: "In each moment, no matter what capacities we have or have lost, we have the capacity to do our best... We will find joy in our life when we pay respect to the capacity that we have now. And we lose that joy if we regret the capacity that we have lost."

Boundaries A boundary shows where one thing ends and another begins. An emotional boundary is the limit of what feels acceptable. One of the challenges in caregiving is noticing when our body or heart says something is not right, and gathering the courage to protect oneself when a boundary has been trespassed.

When a boundary is crossed, the STOP practice can keep us from reacting unskillfully. We can step back, breathe, recognize that we have the right to protect ourselves, and proceed in a mindful way. We always have a choice, although it might be an incredibly difficult choice. By recognizing our choices, we can move from a place of helplessness to a position of inner strength.

To end, I would like to share a quote by Viktor Frankl⁸, a psychiatrist and survivor of a concentration camp, from his book Man's Search for Meaning: "Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom."

Q&A Session

Nicholas: I am in the Sati program for an introduction to chaplaincy, and I'm very interested in boundaries. I often tell my students that we are always crossing boundaries. I don't see myself living in a bubble. The minute I step into a room with a client or a patient, I'm already crossing a boundary. How do you deal with crossing boundaries in a compassionate way, knowing that we are porous creatures?

Mary Doane: Thank you for the question. Yes, we are porous. If we literally had no boundaries or overlap with other beings, we couldn't survive. To manage that with compassion requires an intention, an orientation towards compassion in our own heart. If I move through the world with that as my starting place, knowing that those bumping-up places are going to happen, it is easier for me to trust my intuition when something feels unsafe or inappropriate. It comes down to a respect for interconnection and a heart orientation of compassion.

Teresa Bouza: Thinking about what Mary said earlier regarding people who cared for you—in my experience, those people had cultivated a lot of space. When you cultivate space in your mind, there will be natural compassion, less room for mistakes, and less reactivity when a boundary is crossed with us. Cultivating space through meditation, while also taking practical care of ourselves and trusting our feelings, is vital.

Casey: I'm part of the in-person chaplaincy program focusing on prison chaplaincy. I was really struck by the shift change meeting you mentioned, Mary. That just seems so wise for everybody involved. Is there a history to how that came to be?

Mary Doane: It really feels like the secret sauce. Being at the bedside, or serving in a prison, it's such a privilege. Connecting with others and being reminded that you're not the only one who has doubts or needs support—that Sangha is so important. In our organization, service is a form of practice. Learning and deepening in community ensures that we, as caregivers, benefit, and that benefit is passed along to those we serve. Our volunteers consistently report that the shift change meeting is one of the most beautiful parts of the whole experience.

Padmakumara: I'm over in the UK and I also support my mom. I've had my own health struggles over the past year and a half, so I find myself in an odd situation where I'm being supported and cared for as well as caring for someone else. I heard Frank Ostaseski⁹ talk on a podcast recently about the experience of caregiving in a hospice context. What have you learned from the practice of caring that enhances your ability to care overall? Also, on a practical note, how much do your programs cost?

Mary Doane: Thank you for bringing Frank Ostaseski into the circle; he is the founding Executive Director of the Zen Hospice Project and does beautiful work. Regarding your question on what we learn: I've heard paid clinicians—doctors and nurses—say that when they themselves became the patient and needed surgery or were ill, it made them a much better clinician.

When we train our hospice volunteers, part of the experience involves getting into a hospital bed. For many people, it's their first time having people stand over them while they are in a bed. It's really powerful and changes how you interact with someone who is bedridden when you are privileged to be upright. The direct experience of vulnerability—of needing care and being obligated to accept care—is hugely influential in what it's like to be a caregiver.

As for the courses Teresa and I teach, they are on a sliding scale, but it's generally around $200. We also offer options to ensure accessibility.

Teresa Bouza: I completely agree with Mary about direct experience. Since returning to Spain, I underwent a major surgical procedure. It was very hard because I didn't have close family members nearby besides my mother, who has Alzheimer's. I felt very lonely. Looking up from a hospital bed, I learned the incredible difference it makes when someone caring for you has a cultivated, warm heart.

In these past few years, I have also thought a lot about my father, who passed away in 2017. Frank Ostaseski once said that the relationship with your parents continues after they die. It's true. My own physical vulnerability helped me understand my father better and the losses he went through before he died. I hold him in my heart very tenderly now, with an understanding I didn't have before. Through suffering comes understanding; I just wish we didn't have to suffer.

Vanessa Able: Thank you both very much. I've really enjoyed hearing your stories and learning about this trajectory from personal experience to teaching and supporting others. We are very grateful for the work you both do and for coming today to share it with us.