How to Be Sick

by Toni Bernhard

  When someone merges in front of us in traffic even though we have the right-of-way, we can simply observe that the mental sensations of judgment and aversion feel unpleasant and leave the experience at that — without reacting to it as anything more than one of the thousands of momentary contacts we encounter every day. If we do this, not only will we become attuned to the truth of impermanence, but also, suffering will not arise, and before we know it, we’ve moved on to the next contact of the day, which might be a sympathetic smile from another driver.

  This takes us to a practice I developed that combines the teachings of the wheel of suffering with the four sublime states — even though they may appear to be an unlikely partnership.

  Practicing with the Wheel of Suffering and the Four Sublime States

  The idea for this practice began with a teaching from the wise and wonderful Sylvia Boorstein, whom I mentioned earlier. Sylvia is one of Spirit Rock’s founding teachers. In her book Happiness Is an Inside Job, she tells the story of how she and her husband, Seymour, were visiting a ski resort in Europe. As Sylvia watched people learning to ski, she recalled all the times she and Seymour had tackled the slopes together before reaching the age where it was no longer safe for them to do so. When her mind began to “wobble,” as she puts it (my wobble would have been straight to the unpleasant mental feeling of envy), she looked around at all the fun people were having and suddenly felt great delight in their joy, especially that of a little girl who was just learning to ski. And so with her wisdom mind, Sylvia turned that approaching negative mental state into the sublime state of empathetic joy.

  Shortly after I read this chapter in Sylvia’s book, Tony and I were talking about how we seem to be hard-wired to experience contact as pleasant, unpleasant, or neutral. This includes both physical and mental contact: I can no more turn touching a hot stove into a pleasant experience than I can turn hearing a racist comment into one. The question for me becomes whether I can get off the wheel of suffering at that point, before the unpleasant experience of something such as a racist comment turns into aversion — the “don’t-want” side of desire. Once I react with aversion, clinging isn’t far behind, and before I know it I’ve completed going around the wheel of suffering and have been “reborn” as a person so full of anger that I’m unable to take wise action to counter the comment.

  I had been mulling over both Sylvia’s skiing chapter and this discussion with Tony when the time came for me to try to nap. I lay in bed, my body aching with flu-like symptoms, my heart pounding with wired fatigue. Of course, I was experiencing this as an unpleasant physical sensation. My mind began its usual movement — Sylvia’s “wobble” — from the experience of the unpleasantness to aversion, when I realized how to find that doorway out that S. N. Goenka and others talk about. In other words, I found a way to break the vicious cycle of suffering. I did it by consciously moving my mind toward one of the four sublime states.

  As I lay in bed, the flu-like symptoms were indeed physically unpleasant. But instead of mindlessly allowing aversion to arise as I had done thousands of times in the past, I realized I had a choice of where to put my mind. So I consciously moved my mind to metta by being kind to myself, silently repeating, “Dear sweet, innocent body, may you feel better soon.” Directing this kindness toward my own body was my doorway out of the wheel of suffering. I was free from aversion to my illness and from all that can follow from that aversion — for example, becoming and being reborn as a bitter and resentful person.

  Of course, I was so conditioned to moving straight to aversion or desire that this breakthrough didn’t mean I no longer had to work at all this. Every day I have to work on learning to observe sensations objectively, and sometimes I don’t make it out that door. But I practice hard at it.

  I practice by first becoming mindful that, yes, this bodily sickness feels unpleasant. Then I consciously move my mind to whatever sublime state works for me at that moment. So I may move to metta practice — kindness — as in chapter 7. Or I may evoke compassion for myself, silently saying, “It’s so hard to feel this sick. It’s hard to feel under attack by some mystery virus and not be able to find a treatment that works.” Often as I say this, I pet one arm with the hand of the other. Sometimes my mind inclines toward equanimity and I silently say, “This is how it is. My body is sick. It’s okay. This is just how my life is.” Recently I’ve developed the ability to cultivate empathetic joy so that, as I lie in bed experiencing unpleasant bodily sensations, I’m able to feel happy, even if just a little, for those who are in good health.

  I also use empathetic joy in the same way Sylvia did. When I’m not able to visit with my family in the front of the house and I experience it as unpleasant, instead of getting stuck in aversion and all the suffering that inevitably follows, I intentionally try to feel joyful that they’re able to spend this time with one another.

  I have used this practice of combining awareness of the wheel of suffering with the four sublime states to help me through the most difficult of circumstances. For example, I had a period of two days and nights when I stopped sleeping. It wasn’t insomnia. The malaise and the oppressive, heart-pounding fatigue of my illness were too strong to allow my body to fall asleep in the same way as someone in pain can’t sleep. When people who are well have a couple of sleepless nights, they don’t feel good during the day, but they can function. For me, a good night’s sleep is only partially restorative, so you can imagine how not sleeping at all affected me.

  During those two sleepless nights, my previous reaction would have been to go straight from the unpleasant physical sensation to aversion followed by misery. I would have lain in bed getting increasingly frustrated and angry at my body. Instead, I consciously moved my mind among the four sublime states.

  At one A.M., I treated myself with kindness: “Rest as best you can, sweet body.”

  At two A.M., I felt empathetic joy: “I’m glad that others are able to sleep tonight.”

  At three A.M., I evoked compassion for myself: “It’s so hard to lie in bed, needing to sleep but not being able to.”

  At four A.M., I cultivated equanimity: “This is how things are; my body is not able to sleep right now.”

  On the third night, I slept.

  I’m convinced that using these practices to keep the unpleasant sensations from turning into frustration and aversion kept my symptoms from increasing more than they already had and eventually allowed the flare-up to subside. I’m so grateful that these two Buddhist practices teamed up to help me through that difficult time.

  11

  Tonglen: Spinning Straw into Gold

  O that my monk’s robe were wide enough to gather up all the suffering people in this floating world.

  — RYOKAN

  TONGLEN IS a compassion practice that comes from the Tibetan Buddhist tradition. Nonetheless, the above Zen poem by Ryokan captures for me the essence of tonglen. Of course, they are both inspired by the example of the Buddha.

  When I first got sick, it didn’t take long for me to accumulate a collection of healing CDs from a variety of spiritual traditions. They had one thing in common: I was instructed to breathe in peaceful and healing thoughts and images, and to breathe out my mental and physical suffering. In tonglen practice, however, the instruction is to do the opposite. We breathe in the suffering of the world and then, as we breathe out, we release that suffering and offer others whatever measure of kindness, compassion, and peace of mind we have to give. It’s a counterintuitive practice, which is why the Buddhist nun and teacher Pema Chödrön says that tonglen reverses ego’s logic.

  Tonglen practice was brought to Tibet from India in the eleventh century as part of a group of teachings known as the “seven points of mind training,” a collection of fifty-nine “slogans” for practicing the path of compassion. The practice of tonglen is described in this slogan: train in taking and sending alternately; put them on the breath.

  Those two phrases don’t give us a lot of guidance, b
ut for hundreds of years this slogan, along with the other fifty-eight, has been a favorite subject for commentary by Tibetan masters who flesh out the meaning of each slogan. Tonglen, literally translated as “giving and receiving,” has become “Breathe in the suffering of others; breathe out thoughts of kindness, compassion, and peace.” We are, in effect, breathing out the sublime states of mind introduced in earlier chapters.

  I had learned tonglen practice before getting sick, but I didn’t use it very often. Now it’s one of my principal compassion practices. My bond with tonglen occurred on the first day I returned to work, six months after getting sick in Paris.

  Like everyone else around me, I couldn’t believe I wasn’t well enough to continue with my profession, at least on a part-time basis. So a half-hour before my scheduled class, Tony dropped me off at the front door of the law school. It was the second week of January 2002. I took the elevator up one floor to my office. I was to teach Marital Property to second- and third-year students. As soon as I sat down in my office chair, I knew I was too sick to be there. I began to panic, so I lay down on a couch in the office. Unexpectedly, my thoughts turned to the millions of people who must go to work every day even though they’re chronically ill. I realized that many of these people were in a worse position than I was — if they didn’t go to work, they wouldn’t be able to pay the rent or buy food for their families.

  I’d been in the workforce for dozens of years but had never before thought about people being forced to work while not feeling well. As I was contemplating this, I began to breathe in their suffering, which, as a chronically ill person myself, now included my own suffering. Then I breathed out what kindness, compassion, and peace of mind I had to give. To my surprise, the panic subsided and was replaced with a feeling of deep connection to all these people. Even more astonishing was the realization that, as sick and in pain as I was at that moment and as preoccupied as I was about the task awaiting me in less than ten minutes, I was still able to send some thoughts of kindness, compassion, and peace to others on the out-breath.

  A few minutes later, I arose from the couch, took a chair with me, and, for the first time in twenty years, taught a class while sitting down. For the next two and a half years of part-time teaching, I used tonglen in my office, followed by adrenaline in the classroom, to get me through the workweek. Only Tony saw the devastating effect that continuing to work had on me as I went straight from the car to the bed and stayed there until the next class I had to teach. When I think of those years, tonglen and that couch in my office are inseparable in my mind. I don’t know how I would have survived without both.

  Inspired by what had happened that first day back at work, I began to use tonglen all the time. I’d use it while waiting for the results of medical tests related to my ongoing illness. It took me out of my small world — out of exclusive focus on my illness — and connected me with all the people caught up in the medical system who were anxiously waiting to hear the results of tests. It never failed to amaze me that no matter how worried I was, there were always some good wishes, some compassion, and some serenity inside me to send out to others in the same situation. Finding our own storehouse of kindness and compassion is the wonder of tonglen practice. Gradually, the fear over my test results diminished and I was able to wait with equanimity to see what the world had in store for me next. And, of course, some years later, I relied on tonglen to help me cope with the anxiety of waiting for test results related to the breast cancer.

  I love that tonglen is a two-for-one compassion practice. The formal instruction is to breathe in the suffering of others and breathe out thoughts of kindness, compassion, and peace. But the effect of repeated practice is that we connect with our own suffering, anguish, stress, and discomfort. So as we breathe in the suffering of someone who is in the midst of a similar struggle, we are also breathing in our own suffering over that struggle as well. As we breathe out whatever measure of kindness, compassion, and peace of mind we have to give, we are offering those sublime states to ourselves, too. All beings are included.

  A day did come when I reached my limit with tonglen. I tried the practice on Thanksgiving Day, two and a half years after I got sick, while lying in my bedroom and listening to the sound of my family chatting and laughing in the front of the house. I tried breathing in the sadness and sorrow of all the people who were in the same house as their family on Thanksgiving but weren’t well enough to join the festivities. It was too much; I couldn’t hold everyone’s suffering without crying. So I cried.

  But four years later, in similar circumstances, the practice was tremendously helpful to me. It was a measure of how tonglen had slowly worked its magic. My second grandchild, Camden Bodhi, was born in September 2007, and I planned a welcoming party for her that, as it turned out, I could not attend. When I set the plan in motion in the spring, I was halfway through a yearlong experimental antiviral treatment that appeared to be working. But six months later, on the day of the party, I was too sick to take the hour-long trip to Berkeley. I lay in bed that day thinking about friends and family who had gathered to celebrate my granddaughter’s birth, and I was overcome with sorrow.

  First I tried empathetic joy — feeling good about all the fun everyone was having at the celebration. It helped, but I continued to feel sad and disheartened by my inability to attend, by thoughts about the good time I was missing, and by the feeling that I had let others down. So I turned to tonglen. I breathed in the suffering of all those who were unable to be with their families on special days of celebration. As I did this, I was aware I was breathing in my own sadness and sorrow, but unlike that Thanksgiving Day, I was able to hold the suffering — to care for it — without feeling overcome by it. I then breathed out thoughts of kindness, compassion, and peace for them and for myself. The connection I felt with all those people was powerful and moving.

  If you feel hesitant to try tonglen for fear that breathing in other people’s suffering could overwhelm you, you’re not alone. Here’s the response given by the eco-philosopher and Buddhist scholar Joanna Macy when that very concern was raised at a Spirit Rock workshop. First she reassured the woman asking the question that her capacity to hold others’ suffering was greater than she imagined. Then she said, “If you really could alleviate all the suffering in the world by breathing it in, wouldn’t you?”

  Of course, this is a hypothetical ideal and so is not a realistic assessment of the effect of practicing tonglen. Indeed, at times we may cry in response to breathing in the suffering in the world, but these are tears of compassion — a perfectly appropriate response. And those moments when we can hold the suffering of the world on the in-breath and breathe out whatever kindness, compassion, and peace of mind we have to give are like turning straw into gold.

  12

  With Our Thoughts We Make the World

  AN APPRECIATION OF BYRON KATIE

  In our everyday life, our thinking is 99 percent self-centered. “Why do I have suffering? Why do I have trouble?”

  — SHUNRYU SUZUKI

  SEVERAL YEARS BEFORE I became chronically ill, I attended a retreat in Northern California led by Ayya Khema. In it, she gave a talk on the nature of thought. According to my notes, she said at one point: “Thoughts are just there, like the air around us. They arise but are arbitrary and not reliable. Most of them are just rubbish, but we believe them anyway.”

  I took her words to heart and, before getting sick, had become quite adept at applying this teaching. Especially while in formal meditation, I could watch a thought arise in the mind, treat it as impersonal energy, and let it pass through. I knew I couldn’t control the content of thoughts that arose, but I also knew it wasn’t the content that led to suffering. Suffering arose when I “believed” the thought — when I believed it was a valid reflection of reality. I knew, for example, that the thought “My Torts class won’t go well today” didn’t mean that the class wouldn’t be just fine. Believing a thought is another way of saying that we’re cling
ing to it, continuing to go round and round on the wheel of suffering.

  By the time the Parisian Flu hit, I had a good understanding of the nature of thoughts and the circumstances under which they gave rise to suffering. But put me in the sickbed all day and suddenly my thoughts seemed anything but impersonal. As for Ayya Khema’s statement that thoughts are arbitrary and not reliable, I now believed every one of them held the force of Absolute Truth:

  “I’ll never feel joy again.”

  “No doctor wants to treat me.”

  “All my friends have abandoned me.”

  “I’ve ruined Tony’s life.”

  Thoughts and suffering were now marching hand in hand in my life.

  Feeling overwhelmed by this barrage of stressful thoughts, I turned to the Buddha for help. His words as recorded in a small book called the Dhammapada came to mind: “With our thoughts we make the world.”

  With my thoughts I had made a world of suffering to live in. And the thoughts had a stranglehold on me because I believed they were true — that I was ruining Tony’s life, that I wouldn’t feel joy again. In confronting the suffering that my thoughts were causing, I was helped by an inspiring teacher named Byron Katie. Katie, as everyone calls her, encourages us to question the validity of our stressful thoughts. I highly recommend her books and her website. Using what she calls “The Work,” or “inquiry,” she sets forth a five-step method for revealing the suffering that follows when we believe our thoughts. Along with the Buddha’s teachings, Byron Katie’s inquiry has been the most powerful tool I’ve found to help with the challenges of being chronically ill.