More than mindfulness

I have practiced mindfulness meditation for almost 20 years. I started practicing mindfulness meditation way back in 1994, after reading the Vietnamese Zen master Thich Nhat Hanh’s book, Being Peace.

Between 1994 and 2000, my sister and I gave each other Thich Nhat Hanh’s books, and we tried to apply his teachings on mindfulness to our lives. In 2000, my sister and I went on a retreat at Plum Village, the monastery where Thich Nhat Hanh lives and teaches. We were there for several weeks, and our experiences there were life-changing. I’ve written about the retreat in my post: Trying out Zen medicine.

I credit mindfulness meditation with helping me to become healthy again after years of struggling with debilitating flares of inflammatory bowel disease. With mindfulness, I learned to listen to my body and to my intuition in ways that supported my physical and mental health. I also learned how to relate to strong emotions, even if they still take me for a roller-coaster ride at times. Importantly, during some of the most difficult times of my life, I felt the support of the Sangha, the community of mindfulness practitioners.

I am something of a poster-child for how mindfulness can help people to experience less stress, less illness and more joy and freedom in life. But I want to be clear — especially with the upsurge of mindfulness as a panacea for just about every ailment in modern life — it wasn’t just mindfulness that helped me. More

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The meaning of pain

The other night I started to have extreme pain in my abdomen. I couldn’t find a comfortable sitting or lying position and walking was out of the question. I knew that I was not having labor contractions because those are short-lived and I was experiencing near-constant pain. I started to wonder if the pain meant something terrible was happening in my uterus, for example, if my placenta was becoming detached. And then I decided to clear my mind of what the pain could “mean” and to really focus on my body.

With mindful attention, I felt that the pain was not in my uterus, it seemed to be behind my uterus. I decided to experiment with more positions, including some Yoga poses. When I went on my hands and knees, I felt immediate relief, and then the cause of the pain was clear to me. A lot of gas was caught in my squished and shortened intestines (my colon was surgically removed in 2002). I remembered that I’ve felt similar pain during colonoscopy procedures in which air is pumped into the intestines (to ensure the scope does not puncture them). (I usually choose not to be sedated during these procedures.)

I had to temporarily let go of my drive to make meaning of the pain in order to discover the actual cause of my pain, and subsequent relief.
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Accepting the challenges we’d rather avoid

“A further sign of health is that we don’t become undone by fear and trembling, but we take it as a message that it’s time to stop struggling and look directly at what’s threatening us.” ~ Pema Chödrön

“The cave you fear to enter holds the treasure you seek.” ~ Joseph Campbell

It’s December 31st and I have decided on but one aspiration for the New Year: to see difficult feelings and situations as opportunities to learn about myself and go beyond my comfort zone; in other words, to grow.

It’s easier to stay in the comfort zone and distract myself with projects and leisure activities, and yet I know that staying in the comfort zone of distractions and self-delusion contributes to a sense of complacency, of doing the same things again and again and expecting different results (the definition of insanity for some people).

No matter how much I might wish for things to be otherwise, there will always be challenges in my life. I will give birth to a baby boy in 2012. There’s no easy way to deliver a baby or to adjust to being a new parent. And pregnancy has not been easy since I’ve had symphysis pubis dysfunction and restless leg syndrome among other pregnancy-related ailments.

For many women, pregnancy is the first major physical challenge they face in their lives. For me, pregnancy is the first major physical challenge that I willingly chose to undergo. After years of living with chronic illness and pain, I have developed a “toolbox” of coping strategies, learned to navigate medical systems, and learned to advocate for myself. I know where to find credible medical information on the Internet. I know how to make sense of contradictory medical opinions. And I know how to take care of myself when I feel like crap. So I’m applying what I learned from living with Crohn’s colitis and chronic pain, but pregnancy still challenges me.
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The one thing I like about pain

Just to be clear, I’m not a masochist or a sadist or anything like that. I curse as much as the next guy/gal when I have high levels of pain. But I also see that pain has a redeeming feature: it pushes me to shut off the never-ending discourse in my mind and listen to my body, if only for seconds at a time.

When last I wrote, I was sick with a chest cold. It took a month for my body to fight that dreadful cold virus, and I thank my lucky stars I didn’t get bronchitis. I wrote that I couldn’t take any meds for the cold virus. Now here is the reason:

I’m pregnant!

Today marks five months exactly that I have been on the journey of being pregnant. It is a wonderful and challenging journey. It seems that just about every week I have another pregnancy-related ailment with which to contend. About a month ago I started to have a lot of pain in my butt. It was keeping me from getting a good night’s sleep and the intensity had me almost in tears. I suspected it could be sacroiliac joint dysfunction so I visited my physical therapist. She confirmed my suspicion and gave me some tips for reducing the pain: walking like Charlie Chaplin, sleeping with three (yes three) pillows between my knees, and sitting with my knees far apart. Within a few days, the pain subsided substantially, and I am really thankful for that, but I’m also thankful for being highly attuned to my body because of the pain.

How often do we really sink into the everyday sensations of sitting, standing, walking, and rolling in or out of bed? I have practiced mindfulness meditation for over a decade and yet I am often not present to the minute sensations that occur while I’m carrying out these basic movements. When the sacroiliac joint pain was intense, I was fully aware of every slight feeling involved in each movement: lifting a foot, the shift of weight from one foot to the other, balancing, swinging my legs off the bed and touching the soles of my feet to the floor, and the “apex” of sitting in which I let go and trust that the couch or chair would support my bottom. How often do I take these movements for granted?
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Befriending anxiety

Before I had a chronic illness the situations in my life that triggered the most anxiety were going on dates, difficulties in relationships, and taking academic exams. Back in those days, one of my closest friends in college used to call me “the Big Easy” (and no, I was not promiscuous!). I was really easygoing and it took a lot to unnerve me.  Starting at the age of 24, chronic illness and pain altered my nervous system in a way that made me much more susceptible to chronic anxiety.

The first time chronic anxiety hit me hard was in 1999, about a year after I had first been diagnosed with inflammatory bowel disease (IBD). I re-washed dishes after they had been through the dishwasher because I was scared that there might be some bacteria left on the dishes that would trigger another flare. I knew that my fears were irrational and yet it was so difficult to stop my behaviors. So I sought help from a counselor.

The counselor helped me see that I was trying desperately to control my circumstances. The flares of IBD that I had experienced scared me and I wanted to prevent them in any way possible. But my mind had made the error of thinking that doing things like rewashing dishes would somehow protect me from future flares of IBD. The corticosteroids that I took during that time did not help as they exacerbated every emotion I felt and made me jumpy.

In 2000, I visited Plum Village, a Buddhist monastery and meditation practice center in the south of France. You can read about my experience here. It was there that I experienced a deep sense of inner peace and learned some wonderful techniques for coping with my anxiety. The practice of mindfulness meditation helped me to see my fears more clearly. I saw how much I feared losing control, and one day I wrote the following in my journal:

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Living with uncertainty

Earlier this week I went to my doctor to have my moles checked out. It had been three years since a doctor looked at them. I explained to the doc that I am at high-risk for melanoma cancer because:

1) I lived in Florida during my teenage years and got so burned that my face looked like it had been microwaved,

2) I was on immunosuppressant medicines for 13 years, and

3) My maternal grandparents both had moles that became cancerous, though the moles were removed early (level 1 or 2).

My doctor looked at my back and then asked me to wait as he wanted to consult with a colleague. Some 15 minutes later (good thing I brought a book) she came in and looked at the moles then asked me how long I had had a particularly  large one.

“Många år” (many years) I said in Swedish. She assured me it was fine then. My doctor said that he couldn’t remove all the moles that all of his patients had. We just have to live with some uncertainty. I told him I knew lots about living with uncertainty.

I’ve lived with uncertainty for so long that coping with a long-standing sense of uncertainty has become a part of my way of life. In the five or so years after I was diagnosed with inflammatory bowel disease (1998) I tried to control everything that I could to maintain some semblance of security. I did not want to get sick again so I washed dishes twice or washed my hands many, many times. I don’t like labels, but you could say it was probably some version of obsessive compulsive disorder (OCD).

It took many years of mindfulness practice, therapy and self-awareness to loosen some of the habit patterns that I developed during the years that my illness was most severe (see the article I wrote: Is Your Need for Control Out of Control?). The illness almost killed me and triggered an enormous amount of suffering and I never wanted to go through that again. Strangely enough, I handled acute episodes of illness quite well, even when I was hospitalized and not allowed to eat for weeks at a time.

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What to do with severe pain

We all get it at least once, except for those rare individuals who are born without the capacity to feel pain. Those people tend to die young because they don’t get important messages from their bodies. There are folks who get pain once in a great while, maybe they get an infection or burn themselves on a hot stove. There are folks that experience flares of pain from various health conditions, be it an old injury or a chronic disease. And there are also folks who live with pain almost every day. Pain becomes blended in with their every day experiences of life.

I’ve experienced all three categories and fortunately I only experience pain once in a while these days. When I feel pain, I have different strategies for dealing with it and I choose my strategy based on the level of pain.

If the pain is severe–a level of 7, 8, 9, or 10 out of 10–I mostly choose the following core strategies:
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