How do you use mala beads during meditation?

1. insert into anus

2. meditate

3. ???

4. profit!

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Depends on what you're using them for... and what kind of meditation you're doing. My own mala (juzu) I just hang on to it because it's a reminder of my practice. For some, you can use the mala to count recitations of mantras just to keep track of how long you've been chanting. Unless you're doing a formal service (and you're given specific instructions for what you're supposed to be doing with your mala), you can just keep it on your left wrist.

Edit:

Fun fact! Catholics stole the idea for their rosary from the Buddhist counting beads! :D