How to Live Well with Chronic Pain and Illness

by Toni Bernhard

  Recognize it.

  Label it.

  Investigate it.

  Let it be.

  Although I’ll use the “Hawaii incident” as an example, I encourage you to explore this practice by bringing to mind something in your life about which you’re feeling envy or resentment, or both. It could be related solely to your health, but it could also be a friend who’s in a new romantic relationship, a coworker who got a promotion, a family member who’s rolling in cash, or an acquaintance who always seems carefree and happy. As you read what follows, try applying the four steps to your specific situation.

  Recognize it.

  It may seem as if recognizing the presence of a stressful emotion would be easy, but it can be a challenge. One reason is that we can be so focused on the object of whatever emotions are present that we mistakenly believe that the unease we’re experiencing is caused by that object. In my situation, I was so focused on the object of my envy and resentment — Kari being in Hawaii instead of me — that when I saw her photo of Kauai, I thought the photo itself was the source of my unhappiness. It wasn’t until I pointedly asked myself “What am I feeling?” and “What emotions are present?” that I recognized that the suffering I was experiencing wasn’t being imposed on me from the outside but was in my own mind in the form of envy and resentment.

  Another reason it took me a while to recognize that envy and resentment were present is that I love Kari; this kept me from seeing that she could still be a trigger for painful emotions on my part. As Buddhist teacher Jack Kornfield likes to say, “The mind has no shame.” In my experience, he’s right. The mind is going to think and feel what it’s going to think and feel, even if we wish it wouldn’t!

  Recognizing the presence of a stressful emotion is a mindfulness skill. It requires paying caring attention to what we’re feeling. Caring attention is attention without judgment, which includes not judging our “shameless” minds. If we’re busy blaming ourselves for being unhappy, it becomes virtually impossible to unearth the stressful emotions that lie beneath that unhappiness — in this case, envy and resentment.

  Label it.

  The purpose of labeling an emotion is to hold it in awareness so that we can investigate it. Once again, a nonjudgmental attitude is essential. Stressful emotions can be fertile ground for judging ourselves negatively. Many of us think we shouldn’t feel certain emotions because they aren’t appropriate and reflect poorly on us. However, everyone experiences his or her share of unpleasant and painful emotions.

  As soon as I realized that envy and resentment had arisen over Kari’s trip, my inner critic was ready to pounce. I immediately started judging myself negatively for feeling this way about someone for whom I care deeply. As if envy and resentment weren’t unpleasant enough, now I’d added another layer of suffering in the form of blaming myself for feeling these two emotions in the first place. It was only through nonjudgmental labeling that I was able to quiet the inner critic.

  The best way to label an emotion nonjudgmentally is to regard it as an uninvited guest. Think of it this way: you didn’t invite it over, yet neither will you push the door closed in its face. The Buddha often used the phrase “I see you” to label a mental state. I picture him saying it in a friendly, even teasing, tone. Here’s how I labeled the emotions I was feeling about Kari’s trip:

  My old friend envy has arisen.

  Feeling resentment too.

  I see you, envy and resentment.

  Investigate it.

  Investigating a stressful emotion keeps it from intensifying because it’s no longer just sitting in our minds, brewing.

  Holding the envy and resentment without judgment in my awareness, I started investigating them by paying attention to how they felt in my body. Pleasant? Unpleasant? Definitely the latter. I could even feel some muscles contracting. I also noticed that I was breathing more shallowly than usual. I took a deep breath and made a conscious effort to relax my body. That alone eased my distress a bit.

  Then I looked at my mind. When I’m suffering due to a painful emotion, I can almost always trace it back to an unfulfilled longing or desire. Here, the desire wasn’t hard to pinpoint: I wanted to go to Hawaii, and this wanting was more than a preference. My longing to go was so strong that I was experiencing it as a need: “I need to go to Hawaii,” I was telling myself. No wonder I was miserable!

  Further investigation revealed that I’d been linking going to Hawaii with my very ability to be happy. This had me spinning an unrealistic story that was intensifying the envy and resentment: “I need to go to Hawaii in order to feel happy again.” Absurd as this may sound, I’d convinced myself that this was true. Like most people, I’d been conditioned from childhood to believe that getting what I wanted in life would bring me sustained and lasting happiness.

  I’ve worked hard to undo this harmful conditioning. Even so, I can still fall prey to it when an intense desire clouds my ability to see that minds are as changeable as everything else in the world. What we want today isn’t necessarily what we’ll want tomorrow. A desire fulfilled soon gives way to a new desire — going to Tahiti perhaps? Reflecting on this helped me see the absurdity of believing that going to Hawaii would solve all my problems.

  My investigation also revealed that the envy and resentment had me feeling possessive about Hawaii. If I couldn’t go there, I didn’t want anyone else to either. This generated another stressful story: “It’s my Hawaii. Kari and her family are in my Hawaii.” I know that sounds childish, but it’s what was going on in my mind. When I became aware of this possessiveness, a slight smile came to my face, and I shook my head at the mind’s seemingly infinite ability to derail our attempts to be at peace with our lives, however that life is unfolding at the moment.

  Further investigation finally allowed me to shed light on the source of my resentment. Recall that resentment is the bitter feeling that arises when we believe we’re not getting what we want because we think we’ve been treated unfairly by someone or some thing. I didn’t feel unfairly treated by Kari, but I did feel unfairly treated by life. This gave rise to a third stressful story: “It’s not fair that I’m sick and can’t go where I want to, when I want to.”

  Bringing into conscious awareness the stories that are triggered by stressful emotions makes it possible to examine the faulty assumptions that underlie those stories. When I questioned the validity of my three stories, I saw that none of them had any basis in fact:

  “I need to go to Hawaii in order to feel happy again.” — Not true.

  “Kari and her family are in my Hawaii.” — I don’t own Hawaii!

  “It’s not fair that I’m sick.” — All bodies are subject to illness at one time or another in life.

  The insights gained from investigating a stressful emotion — noticing how it feels physically, looking for the desire that underlies it, questioning the validity of the stories we tell ourselves about it — is likely to have already weakened its tight-fisted grip on us. Then we can move on to the next step.

  Let it be.

  When we command ourselves to let go of a painful emotion, we open ourselves to self-blame if we fail in our efforts. In addition, the emotion may actually intensify because we’re adding aversion to what we’re feeling. So rather than trying to push an unpleasant emotion out of our minds by telling ourselves “Let it go, let it go,” I suggest the more compassionate “Let it be.”

  To let envy and resentment be, it helps to reflect on how they’re not built-in qualities of who we are. There’s no reason to take on the identity of “I’m an envious person” or “I’m a resentful person.” Envy and resentment are simply emotions that have momentarily arisen as a result of past and current conditions in our lives.

  Reflecting on my past conditioning, I realized that the envy and resentment I was feeling stemmed from the strong affection I’d developed for Hawaii at a time in my life when I was particularly vulnerable and needy. Remembering how unhappy I was after my father died became
the catalyst for evoking compassion for myself.

  Cultivating compassion is the kindest and most skillful way to let it be, no matter what stressful or painful emotion we’re experiencing. I recommend silently or softly speaking kindly to yourself by finding words that specifically address your suffering. Here’s how I spoke to myself with compassion: “It’s hard not to be able to go to Hawaii when it’s such a special place for me”; “I’m sad that I can’t feel happy for Kari at this moment.” Speaking in this way eased my suffering because it gave me permission to be present for how I was feeling.

  As self-compassion deepens, the door to equanimity opens. A mind that is equanimous engages the full range of human emotions without negative self-judgment and with an even temper and a peaceful heart, knowing that, like all mental states, emotions are subject to the law of impermanence.

  Wrapped in a cloak of compassion and steadied by equanimity, I patiently waited. Sure enough, the envy and resentment eventually weakened and passed out of my mind, leaving me feeling happy again for my friend and free to look for ways to enjoy life despite my limitations. Yes, it’s true that I can no longer travel to my paradise, but as Tibetan Buddhist teacher Pema Chödrön so wisely reminds us: “It isn’t the things that happen to us in our lives that cause us to suffer. It’s how we relate to the things that happen to us that causes us to suffer.”

  It takes practice to learn to work skillfully with envy and resentment — or with any painful emotion. Be content to take baby steps. When you first try this four-step approach, don’t be discouraged if you sometimes get lost or it feels like a muddle to you. Just take a deep breath and try again. We can go from suffering to not-suffering over and over again, so be patient. Patience is an act of self-compassion, and I hope you’ll undertake this four-step approach in that spirit.

  32

  Slow Down and Savor Life

  Climb Mount Fuji, O snail, but slowly, slowly.

  — ISSA

  IN THE EARLY 1990s, I discovered the value of slowing down.

  At the time, I drove an ’85 Ford LTD, nicknamed the Big White Boat by my children and their friends. I never liked driving on the freeway, even though I had to do it a lot. I’d hang out in the middle lane except when I wanted to pass a car. Then I’d pull into the left lane to get around it.

  One day, I found myself driving in the far right lane. I noticed that the feeling-tone of the freeway experience was different. I felt more relaxed and was enjoying the scenery around me. I discovered that if I stayed in that lane and stuck to the speed limit, I wouldn’t have to worry about passing cars, because they were going as slowly as I was. And no one was riding my bumper, since it was acceptable to go the speed limit in the far right lane. From that day forward, when on the freeway, it was “life in the slow lane” for me — that is, until chronic illness took me off the roadways for the most part.

  It’s just as well that I don’t drive on freeways anymore, because my strategy would no longer work. Today, most people exceed the speed limit even in the slow lane. In addition, traffic has increased to the point that I’d have to constantly be dodging cars merging onto the freeway from onramps — and so even in the slow lane, I wouldn’t have the opportunity to admire the scenery. But it was a great idea while it lasted.

  Since becoming chronically ill, I’ve taken that “slow lane” mentality and consciously applied it to other activities. Doing so helps me become more aware of what I’m doing and of everything around me, so I can appreciate and enjoy each moment of my life as it is, illness included. Additionally, slowing down can ease my symptoms.

  This chapter explores some ways to ease back on the metaphorical throttle.

  Double the time you think it will take to complete a task.

  Even before I became chronically ill, I rarely completed a task in the time I’d allotted for it. (There must be some obscure cosmic law at work here.) This used to be a source of irritation and stress in my life. My to-do list was always so long that whenever a particular task took longer than I’d anticipated, it increased the pressure I felt to get through the rest of the list by the end of the day. As a result, I’d pick up the pace and move even faster. Now that I’m sick, I can’t pick up the pace. In fact, I need to slow down. And so I’ve resolved to double the time I think it will take to complete a task.

  Here’s an example of how this works. I have a raised asparagus fern bed outside my front door. Periodically, the ferns spill over onto the walkway and I need to cut them back. When I assess the task, I estimate it will take twenty minutes at most, so I double the allotted time. Forty minutes is longer than I can physically work at this task at one time, so I cut back half the ferns on one day and the other half on the next.

  Sure, the box looks odd for twenty-four hours — like half of a buzz cut — but no one seems to notice. And the benefits for me are well-worth it; I spare myself an exacerbation of symptoms, and by going more slowly and spreading the job over two days, I truly enjoy it — not once, but twice!

  Become mindful of when you’re multitasking and try to limit yourself to one activity.

  Zen teachers like to say, “When eating, only eat. When resting, only rest. When thinking, only think.” If you’re like me, you may have such a strong multitasking habit that you’re often not even aware that you’re engaged in multiple tasks. A few years ago, I committed to breaking this habit because multitasking exacerbates my symptoms. First, I had to work on becoming mindful of what I was doing because unless I consciously paid attention, I was almost always unaware that I was doing more than one thing at a time. I’d be surfing the web while talking on the phone or editing some writing while trying to follow a movie on TV or composing an email while listening to an audiobook and eating a snack!

  I’ve been surprised at how much time and discipline it’s taking for me to change. My goal is to limit myself to one activity at a time. I’ve even felt mild anxiety arise at times when I do this; I take it as a sign of just how deeply ingrained this multitasking habit is. But in those moments when I’m only doing one thing, I’ve noticed that being fully engaged in the activity allows me to enjoy and savor it, much more than if it were competing for attention with two or three other things.

  Experiment with performing tasks in slow motion.

  I recommend trying this with a variety of activities: getting dressed, brushing your teeth, cooking a meal, doing the dishes, surfing the internet. Slow yourself down by about 25 percent. As with cutting back on multitasking, you may find this difficult to do. When I try it, if I’m not vigilant, I slowly start moving faster and faster until I’m back to my normal speed.

  Moving in slow motion doesn’t just help with symptom relief. I’ve also discovered that several tasks I hadn’t liked before became both interesting and enjoyable. How many times have you washed the dishes without paying any attention to what you’re doing? The answer for me: countless. Slowing the task down by 25 percent grounds me in the present moment so that I can enjoy the physical sensation of the warm suds on my hands and the sight of shiny clean plates and silverware as I rinse them off.

  Stimulate your parasympathetic nervous system.

  Two branches of the autonomic nervous system — which regulates many bodily systems without our conscious direction — are the sympathetic nervous system and the parasympathetic nervous system.

  When the sympathetic nervous system is aroused, it puts you on high alert, often called the “fight-or-flight” response. The sympathetic nervous system is necessary to your survival because it enables you to respond quickly when there’s a threat. In contrast, when the parasympathetic nervous system is aroused, it produces a feeling of relaxation and calm in the mind and the body.

  The two systems work together; as one becomes more active, the other becomes less active. But they can get out of balance. Many people live in a constant state of high alert — or sympathetic nervous system arousal — even though there’s no immediate threat. Three recognized causes for this are our fast-pace
d, never-enough-time-to-do-everything lifestyle; sensory overload (exacerbated by multitasking); and the media’s distorted but relentless suggestion that danger lurks around every corner.

  When the sympathetic nervous system is in a state of constant arousal, the parasympathetic nervous system — the one that produces a calm and relaxed state — is underactive. By stimulating the parasympathetic nervous system, you can restore the balance and, with that balance restored, you naturally slow down your pace of life.

  The following techniques for stimulating the parasympathetic nervous system are adapted from Rick Hanson’s excellent book Buddha’s Brain. You can try these just about anywhere, anytime.

  Breathe from your diaphragm. This stimulates the parasympathetic nervous system because it slows down your breathing. If you put your hand on your stomach and it rises up and down slightly as you breathe, you know you’re diaphragm breathing. (This is why it’s sometimes called abdominal breathing.)

  Combine diaphragm breathing with mindfulness. Gently rest your attention on whatever is happening in the present moment. If your sympathetic nervous system is in a constant state of arousal, mindfulness helps restore the proper balance between the sympathetic and parasympathetic systems by increasing the activity of the latter. This creates a feeling of calm and relaxation.

  Use imagery to stimulate the parasympathetic nervous system. Visualize yourself in a peaceful place, such as a mountain stream, a forest, or a secluded beach. Engage all your senses in this imagery — sights, sounds, the feel of the breeze on your face.

  Lightly run one or two fingers over your lips. Parasympathetic fibers are spread throughout your lips, so touching them stimulates the parasympathetic nervous system. I was skeptical of this until I tried it. Now it’s my go-to practice for immediately calming my mind and body. Once I’m calm, I slow down naturally.

  Mindfulness and slowing down are wonderfully reciprocal because each one facilitates the arising of the other. Being mindfully aware of our present-moment experience makes it easier to remember to slow down. And the more we slow down, the more mindfully aware we become of what life is offering us at the moment. Even if that offering is not exactly what we wish it would be, we can work on savoring it anyway as part of the full range of life’s experiences.