Docsplainin' -- it's what I do

Docsplainin'--it's what I do.
After all, I'm a doc, aren't I?



Showing posts with label Mindfulness. Show all posts
Showing posts with label Mindfulness. Show all posts

Monday, June 10, 2013

Think With Your Whole Body

We like, in Western society at least, to think of our mental or spiritual selves as "me" and our embodied selves as separate, an "it". One effect of that is that we get out of touch with what's going on with and in our bodies, and wander off in our minds--into the future, the past, or some parallel universe that is neither past nor future, but which is certainly not here or now either. And the primary effect of that, I have found, is bodily neglect and abuse along with a good deal of unnecessary tension and stress. 

But what if we treated our minds and bodies as the unified experience that they are? What if we thought of our minds as one with our bodies, and rested and fed it like the organism it is? What if we treated our bodies like part of our minds and attended to what it was telling us about our selves and the world all of the time? Our bodies are powerful sources of constant streams of information and wisdom, and when we only think with the frontal lobes, we're only using a fraction of the potential available to us. 

Next time you are, say, eating breakfast, and notice that your mind is wandering, try bringing it back. Take a nice, normal breath in and attend to it -- really attend to it. Notice what it feels like coming in -- how the air feels passing over your upper lip, into your nostrils, down your throat. Notice the rise of your chest. Can you scent your breakfast? Taste it? Bet you hadn't even noticed your breakfast while you were doing all that wool-gathering!

When you breathe out gently, slowly, naturally, also notice what that's like. Then, what do you see? If you are like me, you might have been completely blind for some time to the look of the morning sun slanting through the trees in your yard, or to activity of animals or people around you. What have you not been hearing that you can become aware of now?  The refrigerator humming? The dog's toenails on the kitchen linoleum? Or perhaps you were numb to the warmth of the mug in your hands, the feel of the chair under your butt or your elbows on the table.

And as you do all this, notice how your body relaxes. I'll bet where your mind was before wasn't fun. You were missing someone or something from the past, regretting something you had done or failed to do, planning your workday, or worrying about something in the future that might not even come to pass. And your body was responding by becoming tense. (All that tension, over time, besides not being much fun is rough on your health.) You may find that 99 times out of 100 when you check in using this technique, your mind was yelling that the sky is falling but when you listen to your body it will tell you that right this two seconds it's actually all quite good. 

And while you were in that place that is neither here nor now, you may have neglected to notice that your body was stiffening in its current position and needed to adjust, or that you were tired, or cold, or needed to pee. That kind of neglect leads to abuse. We don't rest our bodies, or feed us, or clothe us warmly enough, or move ourselves around to keep limber and strong. Or if we do feed ourselves, we eat stuff we don't even enjoy because we're not paying attention to what we have a taste for or when we're full. We put ourselves and leave ourselves in situations we don't like, with people who are not good for us, in the meantime bypassing or at least not fully attending to good relationships and pleasurable activities because we are trying to think our way through life with our frontal lobes and ignoring what our bodies are telling us. We're where we think we should be, doing what we think we should, and we've doped that out with a fraction of the data we need to make genuinely good decisions.

It's a really powerful skill, thinking with your whole body. And although the daily practice of sitting meditation or yoga helps you get better at it, neither is absolutely necessary. You can do it any time you notice that you are all in your head and someplace else: Just take a nice, normal, gentle breath in, following it, and then let it out, again simply being aware of it. And then become mindful of the rest of your body as well. Mindful -- as in, fill your mind with this and kind of let all the thinking activity go for a minute. What's your belly doing, saying? Your feet? Your hands? Your skin? and so forth until you have developed an awareness of all of your senses and parts and systems. Hold all of that in your mind at the same time for a bit. If you do it often during the day, you'll find it becoming more natural to do more of the time. 

Try it. You'll like it.
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Monday, April 1, 2013

Fat and your health

This is an odd little piece that doesn't have anything to do with anything other than that these two stories have been on my mind a lot lately.

Some time ago I read an article on ethics that took a dying man to task for not making arrangements for his practice, not telling his colleagues and clients he was sick, continuing to work after he was probably no longer competent to, etc. The writer never addressed what to me was the most poignant part of the whole story, that as he lost more and more weight, becoming thinner and thinner as he dwindled away to nothing, his colleagues congratulated him and told him how wonderful he looked. Only in our culture would drastic weight loss not be an alarm signal that something was drastically wrong. But nobody in his practice, apparently, ever thought to ask him if he were ill. My heart aches when I imagine how each of those well-meaning compliments must have only increased his isolation, and what a lonely death his must have been in the end.

The other story I have for you today is of a woman who had a tumor growing in her belly. It went undiagnosed for a long time because everybody--including her weight loss doctor--assumed it was because she was fat. She'd even complained at the weight loss clinic that no matter how much she dieted, no matter how much weight she lost, her belly wasn't shrinking. It was uncomfortable. It finally got so big that it was about to burst, as I understand it, but it wasn't until she started throwing up green bile that she went to the local Emergency Department. Surgery to remove it nearly cost her her colon, and complications from surgery to repair that almost cost her her life. It did all together cost her 15 months off work, so sick she was unable to walk around her own house. 

Only in our culture could we be so out of touch with our own bodies. 

As I wrote this, Zemanta threw up article after article, photo after photo for me to select from to illustrate my stories or to link to. Every one of them was about diets--most for useless junk like green coffee. Not one article, not one graphic raised concerns about weight loss being a sign of illness. Not one. And yet among wild animals and human cultures of the past, that's universally what it was. A nice, healthy layer of fat has always been a sign of plenty, and of well-being. Bears put on fat before they hibernate. Hummingbirds put on weight before they migrate. Old horsemen used to talk about 'good keepers', that is, horses that could maintain their weight.

But beyond that, I suspect that prior to the last 50 years or so, we've been in better touch with our own bodies. Surely people are born knowing how to eat--half a million years of evolution would have seen to that--but over the last half-century we've let the "experts" and the diet industry tell us what, how, and when we should eat. Signals that should come from within now get ignored in favor of arbitrary directions from without. It's no surprise that few of us know when we're hungry any more, never mind what for, or when we're satisfied. And it would not surprise me if that, in turn, led us to be out of touch with other internal signals, from signals that we are getting tired and need to rest to signals that we might be getting sick. 

If that is so, then might not mindful eating be the start of a path back to a lot more mindfulness, toward getting to know many aspects of our internal experience, and perhaps even a step toward approaching others' experiences free of erroneous assumptions about weight and diet?
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Sunday, March 3, 2013

On Gratitude

joy!
joy! (Photo credit: atomicity)
I always feel funny talking to clients about gratitude, although I do it often. I worry that it sounds Pollyanna-ish, that flying in the face of their very real (and often truly insurmountable) difficulties, I am, in effect, advising them to whistle past the graveyard. I suspect that the only reason I'm able to do it is that I try to practice "an attitude of gratitude" myself and I know that it works. 

There are all sorts of How-To instructions out there. One of my favorites is Kathleen Adams's Pockets of Joy.  The expression comes from her childhood, when her mother would be emptying the pockets of her jeans before throwing them in the wash. There were always in them the cool things that kids collect during an adventurous day outside--pretty rocks, dead bugs and the like. And her mother would remark that she must have had another wonderful day, because she had her "pockets of joy" again. Adams advises journaling three things every day that you have in your Pockets of Joy. Sometimes when we think we've had a tough day, we can surprise ourselves, discovering that we actually had a pretty amazing one, too. And if we can hold those two views in our minds at once, we can feel better about ourselves and our days.

I've learned that there are dozens of things, often tiny ones, that we can be grateful for in any moment of a given day--or night. I may be lying awake anxious and frustrated because I'm not sleeping, worrying about the day gone by or the day to come, but I can be grateful that I have my nice warm waterbed with my nice soft sheets to lie and worry in. I can be grateful for a roof over my head, and central heating and air, and the dog at the foot of the bed and the partner by my side. And if I focus on those, then lying awake at 2 a.m. can actually become a pleasant experience.  

In a recent post on Tiny Buddha, guest blogger Alexandra Hope Flood advised listing things in your head that you are grateful for from your day as you lie in bed waiting to fall asleep every night. And in the morning, she says, while you're brushing your teeth, list ten things that you are grateful for to start your day. If you're having trouble thinking of anything, begin with having teeth to brush, and being able to stand there and brush them. From there, I might go on to being grateful for meaningful work to do, and a place to go and do it in.

I like that one, and I'm going to start prescribing it.  

The practice applies to far more serious problem states, too, than a little insomnia. Are you sick? injured? possibly even dying? Still. As Jon Kabat Zinn says in Full Catastrophe Living, "as long as you are breathing, there is more right with you than wrong with you, even if you are sick or troubled or in pain and things in your life feel dark and out of control." So start your gratitude list with the fact that you are breathing, if you can't think of anything else. And while you're at it you can send a smile, as Thich Nhat Hanh advises, to every body part that's working. This is something you can practice at any time throughout your day. Right now, for example, you can smile to your eyes that they see these letters, and to that part of your brain that comprehends the words. Smile to your eyelids that blink, to your tear ducts that moisturize, and to your lashes that keep junk out of your eyes. And then direct your attention back to your breathing. Put a half-smile on your face as you do, on the principle that "neurons that fire together wire together," to paraphrase Hebb. In this way, over time, you develop a habit of being happy.

Gratitude is one way I deploy Wood's Rule #4, and its corollary, #5. Focusing on what you can be grateful for in the moment is a mindfulness practice that is the perfect antidote to worry about what is not happening now, may never happen, in fact, and which, in any case, you can do nothing about right now. 

Now mind you, I'm not saying not to worry, period. That would be Pollyanna-ish. And it wouldn't do any good to try, because we're hard-wired for worry. I mean, think about it: The Pollyannas of the savannahs would have been eaten by sabre-toothed tigers before they ever got old enough to reproduce. What I am saying is that we are all so good at worrying that it tends to crowd other things out. We lose sight of the big picture. Cultivating an attitude of gratitude is just remembering to add our assets to our bottom line before we hit "Print" on the balance sheet of life. No matter what else is going on in my day, right now it's spitting snow, the birds are mobbing the feeders outside my window, my dog is lying beside my chair, and I am writing. There are problems, yes, and I am happy. No reason both can't be true for you, too. As one client said recently, "That's the power of 'and'."

When you are in a seriously foul mood, I think it's best to make a written list.  I advise people to use their journals for this, because you can look back over your  lists when you are making the cognitive error of thinking, "Oh, this has been such a bad week!" or some such. Read your lists and it will give you a more balanced perspective. Don't limit your list to a prescribed number, but keep writing until you run out of steam. It's ok to repeat things from previous lists: The dog and the sky and my mate go on nearly every list. And you can list the same thing multiple times from various points in time or points of view on the same list: Mine might, for example, include the way my dog's silky coat feels under my hand, the warmth of her body curled up next to mine during our afternoon nap, and something cute she did this morning, all on one day's list. I guarantee your mood will be improved when you're done, if only by a few percentage points. And that's good. At least while you are writing this list, you definitely feel better. So if nothing else, you've given yourself a break for five, or ten, or fifteen minutes from your unhappiness, and those breaks are essential for all of us. One thing we are often guilty of as humans is 100% thinking, as in "This is a bad day." Stopping and making a list proves to us that no day is 100% bad, including this one.

So hop to it. Unhappy? Get out your pen and paper!
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Saturday, March 13, 2010

#7: Patience is a virtue

Patient ContemplationImage by 1Sock via Flickr
Patients occasionally (okay, frequently) express impatience with their progress in therapy. Impatient with themselves, they become impatient with me for not fixing them faster. And they worry that perhaps I am impatient with them for not doing more, better, faster than they actually are. 

Wood's Rule #7: Patience is a virtue

Because cultivating this virtue helps you "cease contributing to your own suffering and confusion and perhaps to that of others", Jon Kabat-Zinn1 describes patience as a "fundamental ethical attitude" (1994, p. 48).

"From the perspective of patience," Kabat-Zinn writes, "things happen because[emphasis added] other things happen" (p. 48). You get sober, whether sooner or later, because you got drunk. The teenager you've brought to me for therapy will develop maturity and judgment (eventually) precisely because he has been immature and impetuous. For that matter, we can only learn patience who began our journey with impatience.

And if that is true, then it is also true that
what will come next will be determined in large measure by how we are now. This is helpful to keep in mind when we get. . . frustrated, impatient, and angry in our lives (p. 50). 
What will being impatient and irritable right now this two seconds create in our next few minutes, days, weeks, or months? Years down the road, what quality of life will all this rushing around and crankiness have produced for us?

So I would remind my patients to, in Kabat-Zinn's words,
. . . [remember] that things unfold in their own time. The seasons cannot be hurried. Spring comes, the grass grows by itself. Being in a hurry usually doesn't help, and it can create a great deal of suffering--sometimes in us, sometimes in those who have to be around us (p. 48).
It's how I think of you when you are struggling, when you have hit a wall. I know that I cannot make a flower bloom, or control its form and color when it does. All I can do is make sure to plant it where it receives enough sunshine (but not too much); then I must water and fertilize it (but not too much). It grows on its own, in its own time and in its own way. And so will you, dear, so will you.

Kabat-Zinn closes this chapter, poetically titled "The Bloom of the Present Moment", with a quote from Lao-Tzu:
Do you have the patience to wait
till your mud settles and the water is clear?
Can you remain unmoving
till the right action arises by itself
                            -from the Tao-te-Ching 
If I allow myself to become impatient in session, then I act before my mud has settled. It is not likely that anything that I do will come out of right mindfulness or right understanding. To the contrary, it is highly likely that I will do something to make your journey harder, or longer. And that would be unethical.
 

1. Kabat-Zinn, Jon (1994). Wherever you go there you are: Mindfulness meditation in everyday life, pp. 47-51. Hyperion: New York.
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