My job as a psychologist is not what probably comes to mind when you think of psychotherapy. For a good chunk of each day, I spend time with people in the hospital dealing with a cancer diagnosis. Most have just had what will turn out to be life-saving surgery or chemotherapy. But many of my inpatients are hospitalized because their health is too precarious for them to be home.
It was one of those days in the hospital.
It seemed like every room I walked into had some heavy things going on. Big decisions to make. Incredible questions to answer. Uncertain futures to predict.
There was the overall feeling-- life is slipping away too quickly, time is running out. Mind is clear, body is failing. Relationships are being torn apart too soon. There are still dreams of memories to be made.
It doesn't seem fair.
As a health care provider, the known path is to build a wall. Don't get too close. Don't get to personal. Don't feel their fears, don't fall into their arms. As an old book once dictated, "always remember, you're not the patient". Mutter some line about hope and positive thinking and quickly leave the room. It's "them", we are "us".
That doesn't seem to help.
The supposedly riskier path is the uncharted territory-- at least in health care-- of the open heart. Let's step into this darkest part of this cave, together. The person I am with is too sick and weak, perhaps also overwhelmed by pain, to navigate it alone. Here, we can use the light I can shine to illuminate these dark walls, scatter the scary shadows. Let's feel out the path, together.
Into this space of light in darkness, unexpected things begin to happen. Time seems to stop, even for a moment. When you come out of a conversation in which you've had a wall up around your heart, time seems to be going too fast. But that wall isn't just for the patient, it very quickly takes over your life. It amplifies this sense of powerlessness in the face of suffering.
It seeks to perpetuate itself. It seeks out unhealthy coping to numb the natural state of existential terror that is life. Alcohol, junk food, tuning out instead of turning on the experience of life and relationships.
The open heart that allows the light of compassion to shine-- into that space, time become irrelevant. Life feels deeper because it's being deeply felt. Coming out of these conversations feels like connecting to something much, much larger than just another person. It feels like tapping into something much grander, something cosmic.
I suspect this is what Martin Buber was referring to as "I and Thou". It's a sacred space, even if God doesn't feel present or caring. This is the opening that brings healing.
It also seeks to perpetuate itself. But this is about turning on to life. Light seeks light.
Once ignited sufficiently, the light of compassion seeks to keep itself burning. For me, this is the motivation to wake up early, meditate for an hour, work out. Keep that light lit. I might not know why I will need it on any given day, but it needs to stay lit.
The darkness is all around all of us. If we don't ignite the light within, the darkness will take over.
Showing posts with label #compassion. Show all posts
Showing posts with label #compassion. Show all posts
Thursday, January 28, 2016
Wednesday, May 27, 2015
Thoughts on compassionate health care
Recently, I heard a fantastic story on the radio about how one of the leading medical schools in the country is allowing a growing percentage of humanities majors into medical school. My first reaction was one of gratitude that a training facility for medical and health care professionals sees the potential of well rounded human beings being even better health care practitioners. My second reaction was self-reflection.
I didn't go to medical school. I always wanted to be a psychologist. For 17 years now, I've been living out my dream of doing just that, but in the setting of cancer care. I've probably seen many thousands of people, treated hundreds of family members for grief. I didn't set out to do this.
And I learned very little of how to do it in my formal graduate education.
As an undergraduate, I had the incredible luck of attending one of the most eccentric colleges in the country, the University of California at Santa Cruz. Set high above the Pacific Ocean on the edge of a redwood forest, it was an idyllic locale for inner and outer exploration. I planned on being a psychology major. Unfortunately, it seemed at least half the student body had the same idea. The pre-requisite classes were just too crowded. I couldn't get in. It seemed that if I wanted to do the psychology major route, it would probably require an extra year.
Back then, I was allowed to do an independent major. So I put together my own curriculum and syllabus and major requirements over the course of an angst filled weekend during my sophomore year. I recruited three of some of my favorite faculty members to serve on the committee. The major-- I called it Psychology of Self-- was a mix of explorations into transcultural identity, mysticism and hermeneutics. Most of my classes were one-on-one, a professor, assigned study text and me meeting weekly. One particular highlight was a meticulous study of Exodus 3:1 using Martin Buber's I and Thou as a sort of decoder ring.
Every week for 9 weeks, my professor and I studied the scriptural text word by word using the transcending flow of I and Thou to understand the interaction and interplay of human and divine. We travelled through a spiritual landscape populated by personal experience and individualized quest for meaning. Weeks were spent contemplating "Moses, take off thy sandals from thy feet, for the ground upon which you stand is holy ground." Where did the voice come from? Was it referring to only that spot on the mountain? What is holy? What is holy ground?
I can't convey all that went on in those conversations. The point of it was that each of us has to answer those questions for ourselves.
As I sit with a patient who is newly diagnosed with a curable disease, or told they only have a short time to live, or with a family member whose only companion now is the absence of a loved one, I realize so much of what I do is still in that tiny room, sipping mint tea with a scholar of the Hebrew holy books, contemplating the mysteries of the spiritual and the mundane.
Neither of us knew in those conversations that it would lead to comfort for the sick and dying in a most literal sense 25 years later. None of this was done with foresight. Yet without the freedom to let my mind and spirit wander in that misty forest campus, I don't think I could do much of what I do today half as well as I hope I am doing.
I realize that in order to provide compassionate care to those who need a companion to be present as the mysteries of suffering, illness, pain and death unfold, the companion needs to travel some of this territory on their own. This isn't taught in graduate training programs nor in medical schools. It's the realm of the humanities. Supposedly unpopular and unlucrative majors like English literature, philosophy, religious studies may offer keys to unlocking our health care system. They offer the path forward towards breathing humanity into the health care system, of restoring medical care into a healing art and allowing healers to have genuine, intimate contact with patients.
And a way for healers to heal themselves from the burdens of care delivery.
Clearly, there is no substitute for competent, evidence-based care. But there is also no substitute for a curious, compassionate person providing that care who has spent as much of their lives living as well as studying.
I didn't go to medical school. I always wanted to be a psychologist. For 17 years now, I've been living out my dream of doing just that, but in the setting of cancer care. I've probably seen many thousands of people, treated hundreds of family members for grief. I didn't set out to do this.
And I learned very little of how to do it in my formal graduate education.
As an undergraduate, I had the incredible luck of attending one of the most eccentric colleges in the country, the University of California at Santa Cruz. Set high above the Pacific Ocean on the edge of a redwood forest, it was an idyllic locale for inner and outer exploration. I planned on being a psychology major. Unfortunately, it seemed at least half the student body had the same idea. The pre-requisite classes were just too crowded. I couldn't get in. It seemed that if I wanted to do the psychology major route, it would probably require an extra year.
Back then, I was allowed to do an independent major. So I put together my own curriculum and syllabus and major requirements over the course of an angst filled weekend during my sophomore year. I recruited three of some of my favorite faculty members to serve on the committee. The major-- I called it Psychology of Self-- was a mix of explorations into transcultural identity, mysticism and hermeneutics. Most of my classes were one-on-one, a professor, assigned study text and me meeting weekly. One particular highlight was a meticulous study of Exodus 3:1 using Martin Buber's I and Thou as a sort of decoder ring.
Every week for 9 weeks, my professor and I studied the scriptural text word by word using the transcending flow of I and Thou to understand the interaction and interplay of human and divine. We travelled through a spiritual landscape populated by personal experience and individualized quest for meaning. Weeks were spent contemplating "Moses, take off thy sandals from thy feet, for the ground upon which you stand is holy ground." Where did the voice come from? Was it referring to only that spot on the mountain? What is holy? What is holy ground?
I can't convey all that went on in those conversations. The point of it was that each of us has to answer those questions for ourselves.
As I sit with a patient who is newly diagnosed with a curable disease, or told they only have a short time to live, or with a family member whose only companion now is the absence of a loved one, I realize so much of what I do is still in that tiny room, sipping mint tea with a scholar of the Hebrew holy books, contemplating the mysteries of the spiritual and the mundane.
Neither of us knew in those conversations that it would lead to comfort for the sick and dying in a most literal sense 25 years later. None of this was done with foresight. Yet without the freedom to let my mind and spirit wander in that misty forest campus, I don't think I could do much of what I do today half as well as I hope I am doing.
I realize that in order to provide compassionate care to those who need a companion to be present as the mysteries of suffering, illness, pain and death unfold, the companion needs to travel some of this territory on their own. This isn't taught in graduate training programs nor in medical schools. It's the realm of the humanities. Supposedly unpopular and unlucrative majors like English literature, philosophy, religious studies may offer keys to unlocking our health care system. They offer the path forward towards breathing humanity into the health care system, of restoring medical care into a healing art and allowing healers to have genuine, intimate contact with patients.
And a way for healers to heal themselves from the burdens of care delivery.
Clearly, there is no substitute for competent, evidence-based care. But there is also no substitute for a curious, compassionate person providing that care who has spent as much of their lives living as well as studying.
Sunday, August 24, 2014
Meditation: The Inside Scoop
The most common reason people give to be unable to meditate is to say "I can't turn my mind off". For some reason, there's this assumption that meditation requires the supernatural ability to clear the mind in order to be performed. This is absolute rubbish.
Everything we do requires practice. If the prerequisite or goal of meditation practice was to empty the mind, the best meditation teachers would be those who could perform lobotomies. I can assure you this isn't the case.
I've maintained a daily meditation practice for about 18 years. I thought I'd share with you all some of what happens when I sit down to meditate to assure you that a quiet mind is in no way a requirement for a meditation practice. The following took place in an idyllic location while on vacation in Catalunya a couple of weeks ago. I sat down one afternoon while everyone else in the house was gone to watch my breath. I assumed the meditation posture, and focused my mind on counting my exhalations, one at a time, while allowing my mind to unfurl.
"What a beautiful spot. I can't believe how blue the sea and sky are. I should have sat down to meditate a while ago.
It reminds me of what I thought of earlier, once you decide to sit down to meditate, everything outside of the sitting session is resistance. How long have I had this meditation practice? I used to say 16 years, but I think it's 18. Wow. Mind still very much on.
This spot is high up. I'm pretty sure it will survive the ice caps melting. Who knows how many feet that will be. I hope it's gradual, although that one researcher said it's more likely to be sudden and catastrophic. Those methane reserves in Siberia are being released, that's really bad. It will all come down to timing. I hope we're all together when it happens. I can't imagine the drive out of south Florida. What will I take? Glad I backed up the hard drive and put it in a Ziploc in my office. That's going to be a crazy traffic jam. We'll have to head north. I hope I can get a job in another state easily. I wonder if the flood will bring down the global economic system.
Wow, that's the most uncomfortable tangent. I hate that topic. Government is so broken. Taken over by demonic forces. Ancient forces that brought down Rome, too. So evil the way the way they're treating the earth.
Why all the judgement? Meditation is about love, after all. Ok, let's think about love. Let's send love to the politicians and greedy oil executives.
Wow, what a nice spot to sit. I can't believe how relaxing this is. Seems like a bubble while the rest of the world turns to shit. So many dead in Gaza, Syria.
Breath tight. Release the belly. There. The most helpful thing is always to release the belly. Got to remember that. Love the chattering parts of the mind. How many parts of my mind are there? Wait, who's keeping track? Is that part of the mind, too, or something outside of it. Does mind emerge? I'm really appreciating that emergent hypothesis. I wonder if I can incorporate that into the Toronto workshop somehow. The slides are all done. Those used to make me so much more nervous.
The run this morning was awesome. I wish we had mountains and trails in Florida like that. Makes me miss living in California. I don't think my Achilles' tendon can take two runs a day, but I would love to if I could. I wish I had run more in my late twenties. Grad school sucked for that stuff.
Soften the belly.
Oh wait, that was a shimmering moment. Love that. Let's do it again.
Nope. But that was nice.
Ah, it happened again.
Hmmm. I hit my goal. But I want to keep going. Ok, another 49 breaths. I hope I have time. Is there anything else I should be doing?
Oh, nevermind, this is nice. 'The Buddha's enlightenment is vast, it encompasses all experience'. He's been here, each moment is a footprint of his enlightenment.
If only people knew how much chatter remains, even with meditation practice, they'd be less intimidated. I should totally blog out this session. "
So what's your experience like?
Everything we do requires practice. If the prerequisite or goal of meditation practice was to empty the mind, the best meditation teachers would be those who could perform lobotomies. I can assure you this isn't the case.
I've maintained a daily meditation practice for about 18 years. I thought I'd share with you all some of what happens when I sit down to meditate to assure you that a quiet mind is in no way a requirement for a meditation practice. The following took place in an idyllic location while on vacation in Catalunya a couple of weeks ago. I sat down one afternoon while everyone else in the house was gone to watch my breath. I assumed the meditation posture, and focused my mind on counting my exhalations, one at a time, while allowing my mind to unfurl.
"What a beautiful spot. I can't believe how blue the sea and sky are. I should have sat down to meditate a while ago.
It reminds me of what I thought of earlier, once you decide to sit down to meditate, everything outside of the sitting session is resistance. How long have I had this meditation practice? I used to say 16 years, but I think it's 18. Wow. Mind still very much on.
This spot is high up. I'm pretty sure it will survive the ice caps melting. Who knows how many feet that will be. I hope it's gradual, although that one researcher said it's more likely to be sudden and catastrophic. Those methane reserves in Siberia are being released, that's really bad. It will all come down to timing. I hope we're all together when it happens. I can't imagine the drive out of south Florida. What will I take? Glad I backed up the hard drive and put it in a Ziploc in my office. That's going to be a crazy traffic jam. We'll have to head north. I hope I can get a job in another state easily. I wonder if the flood will bring down the global economic system.
Wow, that's the most uncomfortable tangent. I hate that topic. Government is so broken. Taken over by demonic forces. Ancient forces that brought down Rome, too. So evil the way the way they're treating the earth.
Why all the judgement? Meditation is about love, after all. Ok, let's think about love. Let's send love to the politicians and greedy oil executives.
Wow, what a nice spot to sit. I can't believe how relaxing this is. Seems like a bubble while the rest of the world turns to shit. So many dead in Gaza, Syria.
Breath tight. Release the belly. There. The most helpful thing is always to release the belly. Got to remember that. Love the chattering parts of the mind. How many parts of my mind are there? Wait, who's keeping track? Is that part of the mind, too, or something outside of it. Does mind emerge? I'm really appreciating that emergent hypothesis. I wonder if I can incorporate that into the Toronto workshop somehow. The slides are all done. Those used to make me so much more nervous.
The run this morning was awesome. I wish we had mountains and trails in Florida like that. Makes me miss living in California. I don't think my Achilles' tendon can take two runs a day, but I would love to if I could. I wish I had run more in my late twenties. Grad school sucked for that stuff.
Soften the belly.
Oh wait, that was a shimmering moment. Love that. Let's do it again.
Nope. But that was nice.
Ah, it happened again.
Hmmm. I hit my goal. But I want to keep going. Ok, another 49 breaths. I hope I have time. Is there anything else I should be doing?
Oh, nevermind, this is nice. 'The Buddha's enlightenment is vast, it encompasses all experience'. He's been here, each moment is a footprint of his enlightenment.
If only people knew how much chatter remains, even with meditation practice, they'd be less intimidated. I should totally blog out this session. "
So what's your experience like?
Sunday, July 20, 2014
Filling the World with Compassion
Pictures coming out of Gaza and the news of MH17 being shot out of the sky has made this a very difficult week to be a human. Our world seems to be run by people obsessed with power, and we are subject to their whims. So quickly, we become mobilized to take sides-- the one we are on is legitimate, righteous and those other people are wrong, even evil.
But does this actually help the situation?
I'm inclined to believe that it only perpetuates the horrors we feel overwhelmed by. I recall reading years ago, I don't know the exact source or context, a quote by Mahatma Gandhi. In it, he says something to the effect of "the purpose of non-violence is the genuine wish to improve your enemy, not destroy him."
Improve your enemy.
This is not the Art of War, it's the Art of Compassion.
Sure, some say this is naive, it's not how the world works.
Oh really?
I think it's the only what it can work.
It's impossible to think of a single geo-political conflict currently raging without having to first go back dozens, hundreds, even thousands of years. Taking sides seems to not be a very effective solution.
The alternative-- compassion-- will never be supported by power. Dominance requires a group mentality that preys on our most primal herding instincts. Compassion is equalizing, decentralizing. It threatens power consolidation.
Does this mean we should throw flowers at Hamas, or give group hugs to the IDF?
No. What it means is that we should all try and practice compassion wherever we are.
Try and be nice to the person who brings you your food or who comes to fix your cable TV.
Smile at the next person who is helping you in a store.
Be courteous driving in rush-hour traffic.
Reach out to that person you've been meaning to check in on.
When compassion in every day life become second-nature, it becomes reinforced in how we see the world. We cringe when our leaders ask us to turn it off in nationalist double-speak.
Maybe, just maybe, each of these individual acts of compassion can gradually fill the bucket that seems so empty in our world today.
But does this actually help the situation?
I'm inclined to believe that it only perpetuates the horrors we feel overwhelmed by. I recall reading years ago, I don't know the exact source or context, a quote by Mahatma Gandhi. In it, he says something to the effect of "the purpose of non-violence is the genuine wish to improve your enemy, not destroy him."
Improve your enemy.
This is not the Art of War, it's the Art of Compassion.
Sure, some say this is naive, it's not how the world works.
Oh really?
I think it's the only what it can work.
It's impossible to think of a single geo-political conflict currently raging without having to first go back dozens, hundreds, even thousands of years. Taking sides seems to not be a very effective solution.
The alternative-- compassion-- will never be supported by power. Dominance requires a group mentality that preys on our most primal herding instincts. Compassion is equalizing, decentralizing. It threatens power consolidation.
Does this mean we should throw flowers at Hamas, or give group hugs to the IDF?
No. What it means is that we should all try and practice compassion wherever we are.
Try and be nice to the person who brings you your food or who comes to fix your cable TV.
Smile at the next person who is helping you in a store.
Be courteous driving in rush-hour traffic.
Reach out to that person you've been meaning to check in on.
When compassion in every day life become second-nature, it becomes reinforced in how we see the world. We cringe when our leaders ask us to turn it off in nationalist double-speak.
Maybe, just maybe, each of these individual acts of compassion can gradually fill the bucket that seems so empty in our world today.
Tuesday, December 10, 2013
Seven Tips from the Edge
For the past 15 years, several hours of each work day for me involves seeing the world from the perspective of someone who is dying. I don't know exactly how it is or what it is in me that chose to do this for a living, but I feel very strongly it's a big part of what I was put on this planet to do with the life I have.
It's not for everyone to do, and I don't think it makes me all that special. I can assure you that when my car makes a funny noise, I'm clueless as to what to do about it and glad that there's a mechanic who is doing what he or she was put on this planet to do, and fix my car. I can't do that. That makes the mechanic way more special to me. I need my car.
I've written elsewhere that recently for an 18 month stretch, I knew a steady stream of 2 or 3 people who died every week. I knew some of these people for days, others for years. That streak got interrupted for a few weeks, but seems to have returned in its brutal predictability.
Being in such close and regular contact with death, of having people gravely ill, dying, frozen in fear or radiating peace, them and their loved ones asking me what this whole gig we call existence is about... Roshi Joan Halifax refers to this space as an "edge state", way out on the horizon where the known and the unknown meet. I believe this horizon is what the existentialists refer to as "absurdity", the quest for relevance and meaning in an otherwise indifferent world that cares little for our individual existence.
Out on this edge of absurdity, I've had these flashes of insight lately as I go about my day that the whole gig is a giant inkblot. We see patterns where there maybe are none, we see images where they may be only empty space, we impose rules where chaos reigns, we see connection when we are really flying alone by the seat of our pants. And it's probably okay to do that.
Our intelligence and capacity for insight gives us choices in what patterns we see, what decisions we make, which rules of the game we choose to abide by. For many of us, religion saves us time and effort, offering us a template of guidance. For many of us, we find our own way.
For all of us, I think the most important facts to keep in mind are these:
1) None of us are fully in control of anything, no matter how much power, wealth, fame or status we accumulate. Pink Floyd sang it best years ago, "all the iron turns to rust, all the proud men turn to dust."
2) The whole inkblot nature of reality does not make violent or mean behavior acceptable. On the contrary, we should treat each other, and all life, lovingly, as we would lost and scared children that showed up at our door. That's really what we all are-- lost animals trying to find our way into the comfort of each other.
3) We waste a lot of energy doing stupid things to keep the crushing absurdity of being alive out of sight. Rather than focus on self-destructive vices like gambling and drugs to indulge our insatiable appetites for fleeting pleasures, we should bear mindful witness to fleeting moments of awe that surround us every day that go un-noticed. We're often too lost in our internal chatter to notice awe, to the point where we often can't dwell in awe.
4) Respect the body. See #3. Our choices should nurture our meat suits, not destroy them. We don't have our body for as long as we would like. It begins to age and fall apart just when you're getting used to it. Don't grease the wheels towards achiness.
5) Find what soothes you that is healthy, and what soothes those around you that is healthy. Create opportunities for soothing regularly. We're all lost children, we want security blankets. There's nothing wrong with that.
6) Structure the ambiguity of our absurd existence with self-disciplined progress towards goals. Exercise, meditation, healthy eating and sleep hygiene form a powerhouse of security and inner resources to ride through waves of suffering and anxiety. I've written about this extensively in my books. You actually have to do these things, though, not just read about them.
7) Live a life that others would want to grieve. This sounds strange to our pleasure driven society, but grief is often a sign that you got close to people, that people got close to you. Grief is healthy, and it's essential. Live a life that people would want to celebrate after you leave. You might not know how to do it now, but if you embrace absurdity with love, you're probably going to find out how.
It's not for everyone to do, and I don't think it makes me all that special. I can assure you that when my car makes a funny noise, I'm clueless as to what to do about it and glad that there's a mechanic who is doing what he or she was put on this planet to do, and fix my car. I can't do that. That makes the mechanic way more special to me. I need my car.
I've written elsewhere that recently for an 18 month stretch, I knew a steady stream of 2 or 3 people who died every week. I knew some of these people for days, others for years. That streak got interrupted for a few weeks, but seems to have returned in its brutal predictability.
Being in such close and regular contact with death, of having people gravely ill, dying, frozen in fear or radiating peace, them and their loved ones asking me what this whole gig we call existence is about... Roshi Joan Halifax refers to this space as an "edge state", way out on the horizon where the known and the unknown meet. I believe this horizon is what the existentialists refer to as "absurdity", the quest for relevance and meaning in an otherwise indifferent world that cares little for our individual existence.
Out on this edge of absurdity, I've had these flashes of insight lately as I go about my day that the whole gig is a giant inkblot. We see patterns where there maybe are none, we see images where they may be only empty space, we impose rules where chaos reigns, we see connection when we are really flying alone by the seat of our pants. And it's probably okay to do that.
Our intelligence and capacity for insight gives us choices in what patterns we see, what decisions we make, which rules of the game we choose to abide by. For many of us, religion saves us time and effort, offering us a template of guidance. For many of us, we find our own way.
For all of us, I think the most important facts to keep in mind are these:
1) None of us are fully in control of anything, no matter how much power, wealth, fame or status we accumulate. Pink Floyd sang it best years ago, "all the iron turns to rust, all the proud men turn to dust."
2) The whole inkblot nature of reality does not make violent or mean behavior acceptable. On the contrary, we should treat each other, and all life, lovingly, as we would lost and scared children that showed up at our door. That's really what we all are-- lost animals trying to find our way into the comfort of each other.
3) We waste a lot of energy doing stupid things to keep the crushing absurdity of being alive out of sight. Rather than focus on self-destructive vices like gambling and drugs to indulge our insatiable appetites for fleeting pleasures, we should bear mindful witness to fleeting moments of awe that surround us every day that go un-noticed. We're often too lost in our internal chatter to notice awe, to the point where we often can't dwell in awe.
4) Respect the body. See #3. Our choices should nurture our meat suits, not destroy them. We don't have our body for as long as we would like. It begins to age and fall apart just when you're getting used to it. Don't grease the wheels towards achiness.
5) Find what soothes you that is healthy, and what soothes those around you that is healthy. Create opportunities for soothing regularly. We're all lost children, we want security blankets. There's nothing wrong with that.
6) Structure the ambiguity of our absurd existence with self-disciplined progress towards goals. Exercise, meditation, healthy eating and sleep hygiene form a powerhouse of security and inner resources to ride through waves of suffering and anxiety. I've written about this extensively in my books. You actually have to do these things, though, not just read about them.
7) Live a life that others would want to grieve. This sounds strange to our pleasure driven society, but grief is often a sign that you got close to people, that people got close to you. Grief is healthy, and it's essential. Live a life that people would want to celebrate after you leave. You might not know how to do it now, but if you embrace absurdity with love, you're probably going to find out how.
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