I love you, but I cannot keep you from feeling disappointed and sad.
I hope that along with your sorrows, you’re able to experience joy.
May you find peace and well-being in the midst of your difficult circumstances.
40
Lessons for the Healthy from the Land of the Sick
Everything has been figured out, except how to live.
— JEAN-PAUL SARTRE
PEOPLE WHO ARE in good health can learn a lot by paying attention to those who are chronically ill. I still hope to regain my health. Should that day come, the lessons I’ve learned in the land of the sick will accompany me to the land of the healthy.
Expanding your thinking beyond your personal problems helps you accept the life you have.
I used to think that I’d been singled out because of this illness, as if the world were being unfair to me personally. This gave rise to anger and resentment. Over the years, I’ve learned the value of going beyond this narrow self-focused thinking. I haven’t been singled out; in every household on the planet, in every generation, in every era throughout history, people have experienced unexpected upheavals in their lives. Expanding my thinking in this way has helped me accept my life as it is.
If I recover my health, I’m determined to maintain this broader perspective. My life — just like everyone else’s — will be a mixture of pleasant and unpleasant experiences, successes and disappointments, joys and sorrows.
Your identity need not be tied to a job title.
When illness forced me to spend my days in the bedroom instead of the classroom, I continued to think of myself as a law professor long after it was clear that this was no longer in the cards for me. I clung to that identity as if it were a life raft, repeating to myself over and over in a panic, “If I’m not a law professor, who am I?”
One day, out of a combination of frustration and exhaustion, I let go of the label “law professor” and the identity that went along with it. To my surprise and relief, I felt liberated, as if I’d put down a heavy load. This left me free to create a new life for myself. Now I look for fulfillment in a broader range of interests and activities, without the need to call myself something that’s important-sounding.
Whether you’re healthy or not, I hope you won’t limit your identity to a job title. Doing so may keep you from exploring the abundance of life’s possibilities and lead you to believe that your fulfillment is dependent on what you do for a living.
Dwelling on the past and worrying about the future are recipes for stress and anxiety.
I’m not suggesting that you can’t learn from the past or that skillful planning for the future isn’t worthwhile, but it’s wise to be mindful that this type of thinking can become unproductive. For many years after becoming ill, I spent most of my days stuck in regret about a life I could no longer lead or lost in worry about a life I couldn’t predict with any degree of certainty. I was miserable.
Then I remembered a book I’d read in the early 1990s: Present Moment, Wonderful Moment by Thich Nhat Hanh. In it, he wrote:
When we settle into the present moment, we can see beauties and wonders right before our eyes — a newborn baby, the sun rising in the sky.
Encouraged by his words, I began to practice staying in the present moment. I devised an exercise I call “drop it.” It’s an alternative practice to the four-step approach I’ve discussed in previous chapters. If it suits you, use it! Here’s how it works.
When you become aware that you’re stuck in regret about the past, or that you’re overcome with worry about what the future holds, gently but firmly say, “Drop it.” Then immediately direct your attention to some current sensory input. It could be something you see or smell. It could be the physical sensation of your feet on the ground or of your breath coming in and out of your body. Dropping a stressful train of thought about the past or the future and relaxing into the present moment is a relief. And adding a slight smile can bring with it a sense of peace and well-being.
Note that there are two parts to this practice. First, saying “drop it,” and then, turning your attention to a sensory experience in the present moment. It’s important not to forget that second part. Without it, you’re just barking a command at yourself; if you’re like me, ordering yourself not to think or feel something makes those very thoughts or feelings stick like glue in your mind. That’s why, after saying “drop it,” it’s important to turn your attention to something else in your field of awareness.
Those who are healthy can also benefit from “drop it” practice. After all, no one is likely to make it through the day without his or her mind hosting a stressful thought or two about the past:
“I should have been more chatty at lunch instead of sitting there like a dunce.”
“I shouldn’t have stayed so long at my friend’s house; I’m sure I wore out my welcome.”
Notice how thoughts about the past often contain self-critical “shoulds” and “shouldn’ts.” These serve only to make you feel inadequate, as if you’re not living up to some ideal standard of behavior, but those standards tend to be unrealistically high. Who is ever 100 percent satisfied with everything he or she said at a social function? No one I’ve ever met. Who is able to perfectly calculate how long to stay at someone’s house? No one. Dwelling on the past and adding a negative self-judgment into the mix only add stress and anxiety to life.
You’re also unlikely to have made it this far in your day without your mind hosting a stressful thought or two about the future.
I faced this head-on in the fall of 2014 when I suddenly found myself waiting for the results of seven medical tests in a three-week period. Understandably, at times, I felt anxious and worried. I made matters worse, however, when I began spinning stressful stories about the future even though I could not possibly know what it had in store for me. It amazed me how this mental chatter ranged from the embarrassingly trivial (how will I keep up my Facebook posts if I have to be hospitalized?) to serious considerations (how will this impact my family?).
During those difficult weeks, I relied heavily on “drop it” practice and on tonglen. When I became aware that I was lost in worst-case scenarios about the future, I gently but firmly said, “drop it.” Then I immediately turned my attention to something that was going on in the present moment. Sometimes I saw, as Thich Nhat Hanh said, beauties and wonders right before my eyes.
I also practiced tonglen (which is discussed in detail in earlier chapters) by breathing in the worry and anxiety of everyone everywhere who was waiting for test results and breathing out — to them and to myself — all the compassion and serenity I could summon up. This helped me feel connected to the millions of people who were in my same situation. This special bond helped me accept with equanimity that, although waiting for test results is definitely one of life’s unpleasant experiences, it’s one that almost everyone must endure at one time or another in life. The best we can do is try to keep our attention in the present moment and call on our storehouse of patience and compassion.
I’m grateful that I had “drop it” and tonglen as practices to help me through those challenging weeks. Maybe you’re in good health and are waiting for the results of a different kind of test: an entry exam for a job, for example. You need not be chronically ill to benefit from practices that help stem worry and anxiety.
Taking “I,” me,” and “mine” out of your thinking can keep you from treating unpleasant physical and emotional states as permanent features of who you are.
In chapter 24, “The Uncertainty of It All,” I wrote about the practice of reformulating your thoughts by taking out self-referential terms, such as “I,” “me,” and “mine.” To do this, you treat how you’re feeling at the moment as being the result of the temporary coming together of causes and conditions in your life, as opposed to being due to some permanent quality of yourself.
This perspective can benefit everyone, including those in good health. Here’s an example of how I’v
e used this practice.
Because I’m home almost all the time, often by myself, I decided in the spring of 2014 to bring new life into the house. We got a puppy and named her Scout. My husband drove to pick her up when she was twelve weeks old. Because the drive was too long for me, our friend Richard was kind enough to accompany him.
While they were on the road, I lay down for my nap. My plan was to be in as good shape as possible when Scout arrived. But I couldn’t sleep. In fact, I couldn’t even rest. Unexpectedly, I was overcome with anxiety about what was about to happen. “I can’t believe how anxious I am,” I thought. The anxiety then triggered an avalanche of stressful stories: “Will I be able to adequately exercise a puppy? Who will train her? How will I ensure a quiet environment for my nap and for sleep at night?”
As I lay there, it became clear that this so-called nap was making matters worse, because lying still in the quiet had become fertile ground for generating these stressful stories. After about a half hour, I decided to try the practice of taking self-referential terms out of my thinking. (Note that all of the stressful thoughts contained the word “I” in them!) And so instead of thinking “I can’t believe how anxious I am,” I changed it to “Anxiety is happening” and “Anxiety is present.” Then I took a moment to explore how anxiety felt — in both my body and my mind.
First, I noticed that my body was tense and that the muscles in my neck were particularly tight. Then I reflected on how several causes and conditions had come together at this moment in time to create the anxiety I was experiencing: the uncertainty of the demands that a new puppy would bring; the unpredictability of my illness from day-to-day; the fact that this was the very day my husband was picking her up; my determination that this nap would put me in good shape to greet her. As I reflected on this, I kept repeating “Anxiety is happening” and “Anxiety is present.” There was no need to identify with this anxiety as an intrinsic quality of who I was. It just happened to be what was going on at the moment.
The result of reformulating my thinking in this way was that the anxiety lost its oppressive feel and the tension in my body relaxed. A feeling of spaciousness arose in which the anxiety was nothing more than a fluid emotional state — coming and going, arising and passing — as opposed to being a permanent feature of this person Toni Bernhard. I thought, “Yes, anxiety is present; that’s okay. Just let it be.” As I lay on my bed, the anxiety eventually gave way to a pleasant feeling of curiosity; instead of feeling anxious, I was suddenly interested in seeing how life with Scout would unfold.
This perspective — that what happens in life is the result of causes and conditions that are ever-changing, out of your control, and need not be taken personally — is helpful in a broad range of settings. It was another practice I relied on during the three weeks I spent waiting for test results. When worry and anxiety arose, I worked on describing them without the use of self-referential terms. And so I’d say “Worry is happening” or “Anxiety is present.” Doing this kept me from identifying with what I was feeling, and that made it easier for the worry and anxiety to lift and blow away — over and over again.
Whether you’re chronically ill or not, I hope you’ll try this practice. It can help you “go with the flow,” instead of treating an unpleasant physical or emotional state as a permanent feature of who you are.
Less is more.
Before I got sick, I was an accumulator. My life was filled with stuff: unopened books and magazines that sat unread; CDs; jewelry; knickknacks and trinkets; clothing and all its accessories (shoes, belts, scarves). Since becoming sick, I’ve learned that less is more. As a result, if someone admires something, unless it’s a special item that I’m saving for my children or grandchildren, I give it away. So be careful if you come to my house; if you say you like something, odds are, it’s about to be yours.
I love to give things away. I have less but I feel as if I have more, because I have the satisfaction of knowing that I’ve made someone happy and that something that was once mine will now be put to better use. If I woke up tomorrow morning with my health restored, I wouldn’t change this behavior. It carries with it a newfound sense of freedom.
Clean is better than neat.
My house isn’t neat, but it’s relatively clean. The limitations imposed by my illness have forced me to choose between the two because I can’t manage both; I can have neat, or I can have clean. I’ve chosen clean. This means that if I wipe down a refrigerator shelf, I feel good about it, even though I know its contents will still be in disarray when I’m done. When I do laundry, if I’ve managed to get the sheets and some detergent into the washer, I consider it a job well done even if the sheets emerge from the dryer only to be casually shoved onto a shelf (clean but not neat!) until I need them.
Rushing to judgment about others can lead to painful misunderstandings.
When I got sick, I rushed to judgment about friends who didn’t keep in touch. I assumed they no longer cared about me. As I’ve written about in earlier chapters, most of my assumptions were way off base. I could have saved myself a lot of suffering if I’d kept that Don’t-Know Mind I wrote about in chapter 21. As Korean Zen teacher Seung Sahn said, “If you keep a don’t-know mind, then your mind is clear like space and clear like a mirror.”
Whether in good health or not, we’re all experts at clouding our minds with stressful stories about other people — stories in which we impute motives and intentions that more often than not have no basis in fact. In truth, we don’t know what’s happening in another person’s life unless we inquire about it. Yes, it may be time to let a relationship go and move on, but before doing so, consider asking yourself whether you’ve rushed to judgment without checking out what might really be going on.
Paying attention to your body’s needs is of utmost importance.
Before I got sick, I lived mostly in my mind. I thought of my body and mind as separate and disconnected. Like most people, I’d been taught “mind over matter,” as if the body were a slave to the mind, carrying out its directives. As a result of that belief, I ignored my body when it sent me signals that would have been beneficial to me, such as to slow down or to get more sleep. Being chronically ill has made me more conscious of the interconnectedness of mind and body. I can feel, for example, how emotions are felt in the body and how mental stress can exacerbate physical symptoms.
Should I regain my health, I’ll stay embodied — I’ll stay in body. I’ll listen to what it’s saying to me, and I’ll remember to appreciate what an extraordinary organism it is. Even when I’m struggling mightily with this illness, my heart keeps beating, my blood keeps circulating, my lungs keep taking in oxygen.
The body may be the most wondrous instrument in the world, but it’s also fragile.
When I saw people on television stranded in the heat and humidity on the cement freeway overpasses in New Orleans after the levees broke, I thought, “I would not survive in that situation.” When I see pictures of Sudanese refugees walking days on end to find food and water, I think, “They would have had to leave me behind.” It’s a sobering thought and not, I believe, one that people who are healthy realize is the case.
Illness is the great equalizer.
My health care provider serves the indigent in several counties. When I have an appointment, I share the waiting room with the homeless and the affluent. People graciously give up their chairs to others in need. People admire each other’s children. They engage in friendly small talk. We know we’re in this together.
When you’re chronically ill, barriers fall. Illness and pain don’t care about your background or your life circumstances: whether you’re financially secure or struggling to pay the rent, whether you have an advanced degree or a high school diploma, whether you have plenty of support from others or are utterly alone. Should I regain my health, I’ll never lose sight of the fact that, underneath the trappings of society and our particular life circumstances, we’re all equals on the path of life.
&nb
sp; Being kind to yourself is the best medicine.
As I’ve written about several times in this book, when I first became chronically ill, I was not kind to myself. I thought my body had betrayed me. I thought my mind was weak because I couldn’t will myself back to health. My inner critic was in full voice. It took several years, but I finally learned to treat myself with kindness and compassion.
Once I began speaking to myself in a caring voice, I realized how much I could have benefitted from this supportive self-talk before I got sick. In my early years of teaching, I felt inadequate in the classroom. I judged myself harshly even though I worked as hard as I could to be a good professor. I wish I’d known to say to myself something like “Such a dedicated teacher, working so hard to do the best for my students.”
Healthy or not, no one’s life is without bumps in the road. When the going gets rough, instead of blaming yourself for your difficulties, try to see them as an inevitable part of the human experience. Then take a big dose of that best of medicines: self-compassion. It will heal your mind and bring you a measure of peace no matter what your circumstances.
Cosmically, there’s no difference between weekdays and weekends, or between regular days and holidays.
It’s just sunrise, sunset, sunrise, sunset. Treasure and enjoy.
VIII. Last But Not Least
41
True Confessions
Waking up to who you are requires letting go of who you imagine yourself to be.
— ALAN WATTS
WHETHER HEALTHY OR not, all of us face the challenge at some point in our lives of letting go of who we imagine ourselves to be. With chronic illness, however, that challenge may be thrust upon us before we’re prepared for it — indeed before we even see it coming. Waking up to who we are requires honesty and courage. Although these confessions — some lighthearted, some not — are personal, I offer them on behalf of everyone who is chronically ill.
How to Live Well with Chronic Pain and Illness Page 24
