How to Live Well with Chronic Pain and Illness Page 6

  In fact, I try to cultivate friendliness toward those chatterers — to enjoy how they’re enjoying each other’s company. After all, what’s another minute or two in line? If, like me, you have trouble standing for long, you can look for something to lean on or take a wide stance with your legs so you’re better balanced. Sometimes I bring a cane.

  My point is that, yes, your first choice may be to institute a “no traffic jam on the freeway” rule and a “no chatting at the checkout counter” directive, but most of the time in life, we don’t get our first choice. When this happens, if the alternatives are to get upset and angry, or to find a way to make the experience enjoyable, or at least tolerable — I know which one feels better to me.

  Let’s move to those unrealistic expectations regarding the mastery of a new skill. Investigating your impatience is likely to reveal that your assumption that you should immediately become competent partially stems from your cultural conditioning to hurry, hurry, hurry, no matter what you’re doing. If you were to make a conscious effort to be patient and proceed more slowly, not only might you enjoy yourself more, but you’re likely to do a better job of mastering the skill in question.

  Finally, there’s that out-of-touch-with-reality expectation that you should be able to control what goes on in your mind. Instead of getting impatient (that is, angry or upset) about unwelcome thoughts and emotions, you can work on holding them more lightly — sometimes even with a wry smile as you reflect on your mind’s seemingly nonstop unruliness. Doing this is a compassionate response to what arises in the mind.

  Let it be.

  The odds are good that at this point in your investigation, you’re well on your way to transforming impatience into patience. Then you can take the last step in the four-step approach: letting impatience be.

  Transforming painful and stressful emotions takes practice and… patience! In one of the first Buddhist books I ever read, Mindfulness in Plain English, Bhante Gunaratana says this about the mind:

  [Sometime] you will come face to face with the sudden and shocking realization that you are completely crazy. Your mind is a shrieking, gibbering madhouse on wheels barreling pell-mell down the hill, utterly out of control and hopeless. No problem.

  I love this quotation for two reasons. First, I find it reassuring to know that I’m not alone in having a shrieking, gibbering, madhouse on wheels for a mind. Second, Bhante says, “No problem.” I take “no problem” to mean that I can learn to be patient with this “crazy” mind. If I’m still feeling impatient after I’ve investigated what’s going on, I let it be by calmly accepting the presence of impatience, knowing that, with time, conditions will change… and so will my mind.

  I hope you’ll practice being patient. Learning how to be patient has helped me find a measure of peace with being chronically ill. It’s the peace of mind that comes with accepting, without aversion, that delays, difficulties, and annoyances will inevitably be among life’s experiences. I still do get impatient sometimes. When this happens, I try to remember to be patient with my impatience. That’s the compassionate way to treat our inability to always respond the way we wish we could.

  9

  Cultivating Kindness

  People will forget what you said, people will forget what you did, but people will never forget how you made them feel.

  — MAYA ANGELOU

  KINDNESS IS ONE of my favorite words. I associate it with the phrase in kind — that is, “in the same way” — meaning that when we’re being kind, we’re treating others in the same way we hope they’ll treat us. When I think of the people in my life whom I like to be around the most, the one quality they share is that they’re kind. They may be high-powered professionals; they may be utility workers in my neighborhood. The quality they share — and that I treasure — is kindness. I treasure it because what Maya Angelou said is true: I never forget how they made me feel.

  Kindness is a universal form of communication. All it asks of us is that we be friendly, caring, and considerate. Many years ago, as a favor to a friend, my husband and I spent an afternoon visiting her mother who was alone in San Francisco. Our friend’s mother was from Argentina and spoke no English. We spoke no Spanish. She made us tea and showed us some pictures. We responded with smiles. Beyond that, the only means of communication available to us was kindness. There were long periods of time when the three of us simply sat, looking at each other with friendliness and care. It was a rich and fulfilling experience. Whenever I recall that afternoon, I see her kind face, and a warm feeling arises in my heart.

  Kindness is a quality of mind that we can cultivate toward ourselves, as well as others. Many of us struggle to treat ourselves kindly. Having been conditioned throughout our lives to hold ourselves to impossible standards, we’ve become our own harshest critics. If you’re quick to direct negative judgment at yourself, pause for a moment and imagine how it would feel if you spent the entire day being friendly, caring, and considerate to yourself.

  If you can imagine it, you can do it. No matter how deeply ingrained your conditioning, you can change. As noted in chapter 5, the Buddha taught — and modern neuroscientists are confirming — that the mind is flexible and changeable. This means that, in the same way that you can change how you respond to the Want Monster, you can learn to be friendly, caring, and considerate to yourself.

  To begin cultivating kindness, it’s helpful to see what others have said about it. Here’s a collection of quotations, followed by my reflections.

  My religion is very simple. My religion is kindness.

  — THE FOURTEENTH DALAI LAMA

  Although the words “kindness” and “compassion” are often used interchangeably, there’s a difference between them. Compassion arises when we reach out to help a person who is suffering and unhappy. By contrast, kindness is the simple act of being friendly, caring, and considerate toward those we meet, whether they’re suffering or not. In my book How to Wake Up, I describe what I call friendliness practice.

  Here’s how it works. When I leave the house, I resolve to be friendly to everyone I see, including people I don’t know. I look at each person who comes into view and silently say “May you have a lovely day” or “I hope this day will be fun for you.” I wish for them whatever feels natural to me at the moment. When I first look at someone, if a negative judgment begins to arise (it’s amazing how easily we can judge people we don’t even know), I immediately direct a friendly thought toward that person. Invariably, the judgment disappears.

  I devised this practice so that I could turn being kind into a habit — or, as the Dalai Lama put it, into my religion.

  Tenderness and kindness are not signs of weakness and despair, but manifestations of strength and resolution.

  — KAHLIL GIBRAN

  Kindness to another person, even if we only offer a heartfelt smile, takes us out of being preoccupied with our own lives. We spend a good part of our time lost in our personal stories. They may be about the past or about some imagined future, or they may even be a running commentary about what’s going on in the present. It takes strength and resolution to drop our self-focused thinking and turn our attention to how we might make another person’s day a bit brighter.

  Kindness is within our power even when fondness is not.

  — SAMUEL JOHNSON

  This reminds me of a quotation from the Buddha that is often misstated this way: “Hatred does not cease by hatred, but only by love.” The written record of his teaching, however, indicates that he put it this way: “Hatred does not cease by hatred, but only by nonhatred.” To me, this second version is more realistic. There are some people whom I find hard to love. Nevertheless, I’ve come to realize that when I direct hatred at them, I’m the one who suffers. So I cultivate nonhatred for them. In other words, I cultivate kindness.

  To do this, I start by recognizing that we’re not so different. Like me, they want to be happy and free from suffering. It’s true that I may not want to hang out with them; even so
, being friendly, caring, and considerate toward them turns out to be an act of kindness, not just toward them but toward me too, because harboring thoughts of hatred and ill-will always make me feel bad.

  I’ve always depended on the kindness of strangers.

  — BLANCHE IN TENNESSEE WILLIAMS’S A Streetcar Named Desire

  In the context of Williams’s play, Blanche’s comment is sad and heartbreaking. But when I unexpectedly found myself surrounded by strangers during the traumatic years when my husband was taking me from medical facility to medical facility in a desperate attempt to find a diagnosis for my illness, I came to depend on the kindness of strangers to help get me through emotionally — a fellow patient in the waiting room who gave me a friendly smile, a lab technician who cared about my comfort. Their behavior, in turn, helped teach me to be kind to strangers.

  Kindness can become its own motive.

  We are made kind by being kind.

  — ERIC HOFFER

  This quotation echoes another of the Buddha’s teachings — how our actions become the inclination of our minds. Both the Buddha and Hoffer are saying that each act of kindness strengthens our inclination to be kind again. We’re planting a behavioral seed that can grow into a habit. I like to think of it as building a kindness muscle.

  Be kind to people whether they deserve your kindness or not.

  If your kindness reaches the deserving, good for you; if your kindness reaches the undeserving, take joy in your compassion.

  — JAMES FADIMAN AND ROBERT FRAGER

  As kindness becomes a habit, we stop engaging in the mental gymnastics of making sure that someone really and truly deserves our kindness before we dole it out. Wouldn’t it feel great if kindness became our natural response to others as we made our way through life? I know it would feel great to me.

  No act of kindness, no matter how small, is ever wasted.

  — AESOP

  Another saying attributed to the Buddha expresses a similar theme: “Drop by drop is the water pot filled. Likewise, the wise man, gathering it little by little, fills himself with good.” In other words, every drop counts, so don’t stop being kind just because you can’t fill that water pot with a power hose!

  Here’s another quotation that sounds this same theme:

  Do your little bit of good where you are; it’s those little bits of good put together that overwhelm the world.

  — DESMOND TUTU

  I’ll let Henry James have the final words on cultivating kindness:

  Three things in human life are important: the first is to be kind; the second is to be kind; and the third is to be kind.

  II. Mindfulness: Potent Medicine for Easing the Symptoms of Chronic Illness

  10

  Mindfulness Can Ease Physical Suffering by Easing Mental Suffering

  Nothing in life is to be feared, it is only to be understood.

  — MARIE CURIE

  MINDFULNESS IS the practice of turning your attention with care to your experience of the moment. With care means paying attention with kindness, friendliness, and compassion. Without that element of care, it’s easy to resist any attempt to become aware of what’s going on in your mind and in your body, particularly if what’s going on is not pleasant.

  Let’s face it, the present moment is not always a pleasant moment. If you have a migraine or if you’re in a serious disagreement with someone at a medical clinic, being in the moment is not a joyful experience. In other words, mindfulness is not necessarily synonymous with joy. That said, paying caring attention to physical discomfort and to mental stress can help you make peace with your life as it is at the moment.

  Making peace starts with gently acknowledging what’s going on: “My poor head is hurting” or “Disagreeing with this person does not feel good, but it’s what’s happening right now, so I’ll see it through as calmly as I can.” The alternative to acknowledging your experience is to turn away from it in aversion. This tends to make matters worse by increasing your dissatisfaction and frustration with your circumstances as they are. So always try to bring an attitude of self-compassion to your mindfulness practice.

  Mindfulness can be practiced inside or outside of meditation. Here’s the basic practice: stop for a few seconds and, with an attitude of care for yourself and for how you’re feeling, take three or four conscious breaths, paying attention to the physical sensation of the breath as it comes in and goes out of your body. The sensation of the breath is a good anchor, because it’s a sensation that’s always taking place in the present moment. With practice, you can learn to keep your attention on your experience of the moment by using this simple conscious breathing technique. The more you practice, the easier it becomes.

  In the next three chapters, I invite you to explore how mindfulness practice can help ease the physical discomfort that accompanies chronic pain and illness.

  The Three Components of Physical Discomfort

  It may surprise you to learn that physical discomfort is not just the result of what’s going on in your body. It has three components:

  The unpleasant physical sensation itself (pain, aching muscles, fatigue).

  Your emotional reaction to that discomfort (frustration, irritation, fear).

  The thoughts that are related to the first two components. These are the stress-filled stories you tell yourself — and then believe without question — such as “This pain will never go away.”

  Note that two of the three components that make up your experience of physical discomfort are mental in origin. These two mental components are often referred to as “mental suffering.” They can make your physical discomfort worse because mental reactions are responded to and felt in the body.

  This chapter explores the second and third components of physical discomfort: stressful emotions and stressful thought patterns. It covers how mindfulness of these two components can keep physical symptoms from becoming worse. The next chapter describes several mindfulness practices that address physical discomfort itself. The last chapter in this section contains instructions for practicing mindfulness meditation.

  Stressful Emotions

  When physical symptoms are intense, your mind can feel like a muddy blur. This makes it difficult to identify what emotions are present in your mind at the moment. With caring attentiveness, however, the “mud” can settle, making it possible to identify those emotions: “I’m frustrated”; “Irritation is present”; “This is what fear feels like.”

  To help that mud settle, follow the basic instructions for mindfulness practice: with an attitude of care for yourself and for how you’re feeling, take several conscious breaths, turning your attention to the physical sensation of the breath as it comes in and goes out of your body. Now, also observe what emotions are present in your mind. This is one of the most beneficial functions of mindfulness: it helps you identify what’s going on in your mind, such as frustration, irritation, or fear.

  Mindfulness also helps you respond skillfully to those emotions. This can ease both your mental and physical suffering. Here’s how this works. Once you recognize the presence of a stressful emotion, there are two ways to respond. You can respond with aversion or you can respond with acceptance. Let’s look at the first choice.

  When you react with aversion to a stressful emotion, you’re resisting what’s going on in your mind. It’s as if you’re saying to the emotion, “Go away!” You may even mount a militant battle against the emotion by trying to force it out of your mind. This kind of response increases your mental suffering because aversion to the presence of an emotion almost always has the effect of intensifying it. In addition, now you’re dealing with two stressful emotions: frustration and aversion to the frustration; irritation and aversion to the irritation; fear and aversion to the fear.

  Aversion to what’s present in your mind is also likely to increase your physical suffering because stressful emotions trigger physical reactions in the body. For example, if you’re in physical pain, you may respond by
getting irritated. This emotional reaction can lead to tightening the muscles that surround the point of pain. The result is an increase in your overall pain load. Other common physical reactions to stressful emotions are heart racing, agitation, nausea, and fatigue.

  The alternative to responding with aversion is to respond with acceptance. As Marie Curie said in the epigraph that begins this chapter: “Nothing in life is to be feared, it is only to be understood.” Sticking with the example of feeling irritated at physical pain, the way to understand and accept what’s going on in your mind is to gently acknowledge that irritation is present, and then incline your mind toward kindness and compassion for yourself. After all, who doesn’t get irritated at pain sometimes?

  Once you begin to treat yourself with kindness, you can calmly and gently begin to examine the actual physical discomfort. That’s the subject of the next chapter. Suffice it to say here that a physical sensation is not the solid block of discomfort that you might think it is. Physical discomfort is made up of multiple sensations that are constantly changing. This reflection can help you remember that your frustration is impermanent too. It arose, and it will pass. This recognition alone can keep it from intensifying, which will, of course, ease your mental suffering and, perhaps, your physical suffering too.

  Stressful Thought Patterns

  Unpleasant physical sensations and the stressful emotions that accompany them tend to trigger stressful thought patterns — full-blown stories about your life that have little or no basis in fact. Some typical stressful thoughts that accompany physical discomfort are “This pain will never go away” and “I’ll never feel well enough to leave the house again.”

  You may not even stop there. You might keep spinning these stories until you’re telling yourself “I’ve ruined my partner’s life” or “No one cares about my pain.” As with stressful emotions, stressful thought patterns tend to trigger physical reactions in the body, such as a racing heart and tightening muscles.