Friday, 20 January 2017
Mind Choice Blog No6. The chronic illness roller coaster - depression
Mind Choice Blog No6
The chronic illness roller coaster - depression
It wasn’t cancer this time but the ride is not dissimilar. When I was diagnosed with cancer 11 years ago I initially had no physical symptoms other than losing my voice (cancer of the larynx) and after the initial shock, I felt a tremendous energy and felt more alive than I had done for years. Although saying that, I could still be floored at times thinking of my little son and whether I would live to see him grow up. With this illness, an autoimmune condition causing vasculitis and nerve damage, I was initially so physically ill it was more a matter of just getting through each day. But that’s just the beginning of any chronic illness then come the stages of loss identified by Elizabeth Kubler-Ross of denial, anger, depression, bargaining and acceptance. Not really experienced as stages but emotions that come and go in no particular order and like a roller coaster gradually lose strength and impact.
Sadness, anger, fear, anxiety – often our habitual reaction to these emotions is resistance, we push them away which drives our thinking and behavior. We may try to distract ourselves by getting busy or we worry and ruminate over things. For example, angry thoughts about why the doctor didn’t diagnose us earlier or fear and uncertainty about illness and the future. We may find ourselves searching for answers on the internet or getting caught up in frightening thoughts about the future rather than being with what’s actually present. But, these normal, human habitual tactics of avoidance or elaboration fuel the feelings and emotions, so it becomes a vicious cycle as seen below. Tension is part of the body’s fight-flight response to stress and in this state of readiness to run or fight, there is no energy for healing.
The Cycle of Suffering
What we learn in mindfulness is that as soon as we notice this happening, whether that is immediately or after some time, is to drop into the body and notice what we are actually experiencing. We may become aware of tension, holding and resistance and can simply bring awareness to this and breath with it, allowing it to soften on the outbreath, maybe even saying the words “softening, opening’ to ourselves or hold it gently in awareness. We may become aware of sensations in the throat, chest or belly and experience feelings of sadness or fear and hold this too in awareness, a compassionate, friendly awareness that allows what is already there to be experienced. Sometimes, we can be surprised at what is really beneath it all and at how quickly it passes, if we allow it to be fully experienced rather than pushed away.
For example, not so long ago I found myself feeling anger towards my GP, this is what I wrote in my journal:-
“Noticing angry thoughts towards my GP. Why didn't you listen over the last few years when I complained about xxx and xxxx? Noticing these angry thoughts, I realise I don't want to carry anger so I drop into my body and there is a big well of sadness. I am finding it difficult today, the pain, the confusion with medication and reordering, the confusion over my diagnosis and now some problem with my blood test results necessitating an emergency call with the doctor. I feel sad and alone.”
How surely gravity’s law,
strong as an ocean current,
takes hold of even the strongest thing
and pulls it toward the heart of the world.
each stone, blossom, child –
is held in place.
Only we, in our arrogance,
push out beyond what we belong to
for some empty freedom.
If we surrendered
to earth’s intelligence
we could rise up rooted, like trees.
Instead we entangle ourselves
in knots of our own making
and struggle, lonely and confused.
So, like children, we begin again
to learn from the things,
because they are in God’s heart;
they have never left him.
This is what the things teach us:
patiently trusting our heaviness.
Even a bird has to do that
before he can fly.
-Rainer Maria Rilke
from the Book of Hours 11, 16 translated by Anita Burrows and Joanna May
However painful these feelings maybe I can feel the physical sensations in my body, I am alive, whereas with depression it feels more akin to flat lining, shut off from everything, my body and life itself. I find it a challenging state to be in. I don’t remember depression when I was living with a diagnosis of cancer but the months before Christmas I was stuck in depression or more of a ‘fed-up’ state and it felt like getting through a murky, horrid, unending, lifeless stuckness. I was dragging myself around, getting through the day and then just wanting to blank out in front of the TV. Perhaps this state was an avoidance of underlying painful feelings. I tried to open to it, to let it be, to not take it personally but it was difficult and I did begin to catch myself in “I am depressed, I am boring, I am bored with my life, why do I feel like this’? I did my best to notice these thoughts and just let them pass rather than getting caught on the old hooks. I even had little reminders from teachers I revere on post it notes to remind me, like this one from Pema Chodron:-
“Learning how to observe our experience in a friendly way rather than identifying with it, resisting it or rejecting it”
I was reducing the steroids and the pain killers that I am on and my mood state may have been due to this. My lovely acupuncturist said “I am giving you heart for what you are going through, be kind to yourself”. It is something we do need reminding of, okay this is a difficult time but we can bring kindness to ourselves, it’s alright for a while to curl up in front of the fire or TV and remember that this too will pass. It has been a difficult year, I have also been grieving the loss of my beloved dachshund, Saxon, who was like a first child to me. Here we are getting prepared for a sponsored walk for Yes to Life back in January 2008.
I was very fortunate to go on a week’s silent retreat in early December which was exactly what I needed as it turned out. It was with teachers I love and admire, Vidyamala Birch who set up Breathworks and Colette Power. The first morning Colette led a meditation bringing loving kindness towards the difficult. It was something like – we all suffer, we avoid, avoid, avoid and then end up in overwhelm. Can we be present with the difficult and the painful like when we are with a friend who is suffering. We know what to do, to listen, to be there, to try to understand and empathize to know what we might offer for comfort – touch hand on the heart or belly where we feel emotions, words ‘Clare its okay, you’re alright. After this 30 minute practice we then went into the main temple for a long silent sit. As soon as we started in silence, sadness flowed out of and through me and I felt immense compassion and gratitude toward the teachers I have been guided by – Thich Nhat Hanh, Pema Chodron, Tara Brach, Vidyamala.
So, maybe I had been supressing, pushing away and ignoring painful feelings which had led to a sense of dullness, in my practice and my life, because I was shutting off part of my experience. I needed the guidance of these teachers to bring a delicate, receptive and focused awareness to my experience and to “imbue the breath with tenderness”. Many of us over-effort to gain insight or have a better experience and here I was learning about soft effort. I noticed that what arose in my meditation practice, hardly seemed to want to be seen, it comes, I focus my attention on it and it disappears just as quickly. It’s like a scared child coming into a room, if you pay attention to it, it runs out but if you hold a kind, gentle space it may feel safe to enter. Again the words of Pema Chodron ring in my head – “let go of the idea of fruition”. Reflecting back, maybe my formal practice during this time had been focusing on the pain and tension in my chest and wanting to soften and open to the feeling but in an over-effortful way, wanting to release feelings, wanting to change my experience rather than accepting it as it was.
Our sorrows and wounds are only healed when we touch them with compassion
Towards the end of the retreat, we practised loving kindness meditations when you bring to mind a friend, remembering times together and times you have supported each other and all the struggles or anxieties they may have and send them good wishes. Then come back to yourself and send the same good wishes, compassionate feelings toward yourself. Then broadening out to include people around you, in your home and community and out beyond into the country and the world. This can be a very powerful practice and certainly my experience was just that – I felt the pain and suffering of the refugees and people in prison and hospitals. What I found interesting was that I then began experiencing joy and aliveness. Maybe I had really shut myself off in my own small world of “my suffering” – my story of feeling low and feeling shame and coming off steroids etc etc. The isolating container of the “story of me”. The practice opened me back out to feel the joy of being alive and connection with others.
The mind is its own place, and of itself can make a heaven of hell, a hell of heaven.
- Milton, Paradise Lost
So here’s what I need to remember and maybe these are good tips for life and for the start of 2017. We are going to travel the rollercoaster but by being aware of the experience we can ride it rather than be thrown about by it.
1. Compassion, compassion, compassion – When you notice it is a difficult moment, bring your attention into the body – are you aware of any tension in your shoulders or back, how’s your breathing? This is a moment of suffering, what’s in your experience (thoughts, feelings, sensations) being curious as to what’s here, maybe placing a hand on your heart or where you are feeling pain or tension and acknowledging whatever is there and holding it in loving awareness.
2. Connection – remembering that everyone struggles and suffers in their lives and that there are likely to be many people suffering in the same way. You are not alone. Keep yourself open to feeling connected maybe even by ensuring that you see your friends and family rather than cocooning yourself.
3. Cultivation of good experiences - it can be really beneficial to us, in practice and daily life, to take in the good and to build inner resources so that we can cope when life is difficult. So when we notice a pleasant or enjoyable moment, to really savour it and allow it time to be felt and to settle into the body whether it’s feeling relaxed, feeling cared about, feeling grateful or any other positive experience.
The Laughing Heart (Charles Bukowski)
Your life is your life, don’t let it be clubbed into dank submission.
Be on the watch. There are ways out.
There is a light somewhere.
It may not be much light but it beats the darkness.
Be on the watch.
The gods will offer you chances.
Know them. take them.
You can’t beat death but you can beat death in life, sometimes.
And the more often you learn to do it, the more light there will be.
Your life is your life.
Know it while you have it.
You are marvellous the gods wait to delight in you.