The Impermanence of Everything and the Preciousness of Life

In Part 1 of his book, The Five Invitations, Frank Ostaseski discusses his first invitation and principle for living, “Don’t Wait”.  Frank, as founder of a hospice and end-of-life carer, has cared for more than a thousand patients during their dying process and death.  In this first part of his book, he highlights the impermanence of everything and the preciousness of each moment of living.   

Frank has been a companion to the deepest grief of friends and relatives of the dying and experienced a depth of vicarious grief that is difficult to conceive – it’s as if the collective grief of others had beset him and brought him to his knees, both physically and metaphorically.  Fortuitously, he was a colleague and friend of Elizabeth Kübler-Ross at the time who supported him in his grief and his work as an end-of-life carer.  Elizabeth developed the classic concept of the five stages of dealing with death and loss in her book On Death and Dying and was also the author of Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss.

The impermanence of everything

If nothing else, the Coronavirus reinforces the impermanence of everything through its pervasive impact on every facet of our daily lives – our home, work location, transportation, schooling and education, shopping, spending, entertainment, health, finances, sport and our very daily interactions and movements.  The on-off nature and varying intensity of imposed restrictions serve to reinforce this message of the changeability of everything.  In these challenging times, we are called to adapt to the unpredictability of our work, our changing home arrangements, the extreme challenge to our health and welfare, and the uncertainty of our income and overall finances.

Without the pandemic, we can still become aware of impermanence – the birth and death cycle for humans, animals and nature.   Relationships end, animals are killed and eaten by other animals in the endless pursuit of food and survival and leaves fall off trees to become life-giving compost for new plant growth.  

The impermanence of everything was brought home to me by two recent incidents.  The first was the disturbing story of a nurse killed suddenly in our city while cycling to work.  Her husband indicated that their day started as normal with a coffee and breakfast together but ended tragically when the nurse was only metres away from her work at the hospital.

The second experience of impermanence occurred when I was walking along the foreshore of Moreton Bay near our home.  I was watching the small fish full of life darting back and forth in the marina when a fast-moving bird dived into the water and retrieved one of the fish for its food – only to be followed by other birds dive-bombing the school of little fish. 

The preciousness of life

Frank describes the process of dying as a “stripping away” of everything including our sense of “self” – our sense of who we think we are and should be, all our roles such as husband/wife, partner, parent, neighbour.  We lose our professional identity, our personal orientation, e.g. as a “people person” and our comparative self-assessment such as well-off or impoverished and successful or an abject failure.  Frank reinforces his view of the inadequacy of the medical model to explain the breadth and depth of the “stripping away” at death.  He maintains that in dying everything is released/dissolved – “the gross physical elements of the body, thoughts, perceptions, feelings, conditioning all dissolving”.  Frank asserts that what is left to discover is “something more elemental and connective” that constitutes the real essence of human nature.

Our awareness of impermanence, accentuated by illness, can lead to anxiety or a readiness to appreciate and savour the preciousness of life, of our relationships and of nature.   Through appreciating the pervasiveness of impermanence, we can more readily accept change and more willingly give up our attachments – the things that we hold onto to define our self and our worth.   This is where meditation can help us both in fully living and preparing for dying and death.

The “Don’t Wait” principle reminds us of the certainty of death and the uncertainty of the timing of our death – that it will happen, but we don’t know when or how.  This principle encourages us to value every moment we are alive and to savour what we have in life and the experiences of living.  Frank’s heart attack reinforced this message for him – his sense of self and perception of himself as the “strong one” helping everyone else in need was completely undone.  He encourages us to be curious about ourselves and our preferences/attitudes/ biases and to work at letting go of the identities that we have become attached to.

 Frank maintains that “softening around these identities, we will feel less constraint, more immediacy and presence”.  I am learning the profound truth of this statement through softening my identification with being a “good” tennis player who never or rarely makes mistakes.  Instead of wallowing in negative self-evaluation, I am beginning to enjoy the freedom of progressively loosening this unsustainable identification as I grow older and less physically able.

Reflection

Frank’s book would have to be the easiest and most-engrossing personal development book I have had the privilege to read, and, at the same time, the most profound.  As someone who has had a deep interest in, and knowledge of, his subject, he can communicate his ideas in simple language and practical illustrations.  Each paragraph contains exquisite morsels of wisdom and the book is replete with moving but brief stories that impress indelibly – so, even if you don’t remember the exact wording of his principles, you certainly remember the stories that illustrate them.  Frank’s writing reflects the calmness, humility and depth of insight and wisdom that is evident in his many conversations and podcast interviews about the process of dying and “The Five Invitations”.

“Don’t Wait” is a challenging principle but Coronavirus has forced us to stop, reassess and protect ourselves and others.  It has been the catalyst for incredible acts of courage and kindness – by our health professionals and people from all walks of life.  The Pandemic Kindness group on Facebook©, with over half a million members, is but one of many efforts to encourage and support random acts of kindness in these challenging times.

The “Don’t Wait” principle incorporates many invitations to create change in our lives.  As we grow in mindfulness through meditation and reflection, we can become increasingly aware of our attachments (including to harmful self-narratives) and progressively develop the discipline and self-regulation to create real change in our lives to live with more appreciation, thoughtfulness, kindness and compassion.  We can learn to savour every moment of our life and everything that it entails.

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Image by christels from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Understanding the Message and Wisdom of Difficult Emotions

In a recent interview podcast, Tami Simon of Sounds True recorded a conversation with Karla McLaren, author of The Language of Emotions: What Your Feelings are Trying to Tell You.   The interview covered a range of emotions and the message and wisdom that lie beneath each one.  Karla’s primary focus was on emphasizing that emotions are not good or bad but serve to help us in various ways to change our situation and/or our behaviour.  In her view, emotions are a hidden source of wisdom that we should listen to rather than seek to control or dismiss.  Karla noted that people often deflect their attention from difficult emotions and try to displace them with “happier” experiences – thus missing the message of emotions.

Emotions hold a huge amount of energy

In her book, The Language of Emotions, Karla highlights the huge amount of energy that is stored in emotions, especially those that we label as “bad”.   The unproductive ways to deal with these emotions (and the energy stored within them) is either to suppress or repress them.  Suppression involves consciously distracting ourselves from the discomfort of these emotions and trying to meet the unrealistic ideal of an “always happy” person.  It can be okay as a short-term solution, but if the emotion (e.g. anger) remains unaddressed then it can lead to dysfunctional and harmful behaviour as we express our emotions in an unhelpful way.  

Repression, on the other hand, involves unconscious avoidance of emotions (a response partly conditioned by our upbringing and our perceptions of other people’s views).   The energy stored in repressed emotions can manifest itself in a depleted immune system and physical symptoms such as muscle pain and fatigue as well as the associated increased risk of serious illness such as cardiovascular disease.  You can see the negative impact of repressed emotions such as anger  operating in the workplace when someone at work blasts you for something that was a very minor mistake – you cop an “emotional dump” that is a response completely disproportionate to the nature of your error (but that manifests the accumulated energy of a repressed emotion).

Emotions are not good or bad

By naming difficult emotions as “bad”, we perpetuate our reluctance to face them and understand their message and wisdom.  Instead we increase our motivation to suppress or repress them because we fear what others might think, even if we express them in an entirely appropriate way.  Karla suggests too that when we label some emotions as “good” we are potentially setting ourselves up for disappointment or negative self-evaluation – because we perceive that we don’t feel as positive as others expect or express our good emotions in a way expected by others.

According to Karla, what lies behind calling emotions “bad” or “good” is an “attribution error” – we erroneously blame our emotions for the precipitating situation or trigger.   Our difficult emotions do not create our problems (like the health and economic impacts of the Coronavirus) – they exist to help us deal with our problems and difficult situations, if only we would listen to the message they convey.

Understanding the message and wisdom of difficult emotions

The first task is to name your feelings in a fine-grained way or what Susan David calls developing a granular description of your feelings.  This involves avoiding generalisations such as “I feel upset” and being more precise about the feelings involved such as anger, fear or anxiety.  Until you can name and compassionately accept your difficult emotions, you will be unable to understand what they are telling you.

According to Karla, each emotion has its own message.  For example, depression arising from a specific situation reduces your energy and slows you down so that you can see when something is not right, and you need to change the situation.  Karla maintains that depression “removes energy when we are going in the wrong way to do the wrong things for the wrong reason”.   On the other hand, anger helps you to establish boundaries (e.g. constant interruptions or intrusions into your personal space) and fear helps you to get really focused on the present moment and to draw on your insight and intuition to address the trigger for your fear.

Karla maintains that the current challenging times of the Coronavirus is resulting in people experiencing dyads or triads of emotions – she sees, for example, evidence of people simultaneously experiencing sadness, depression and grief.  In her view, sadness in this context is a message to let go of something that no longer works or applies (e.g. working in a workplace during pandemic restrictions) and grief is a natural emotion when you have lost someone or something – it is about taking the time to grieve and allowing for the fact that grief is experienced and expressed differently by different people and its expression changes over time.

Effective ways to draw on the message and wisdom of emotions

Karla emphasised the importance of being grounded when you attempt to deal with difficult emotions.  In her interview podcast with Tami Simon, she described a process based on deep breathing and sighing and complete focus on the present moment and your bodily sensations.  She suggested, for instance, that you feel the sensation of your bottom on the seat and your feet on the floor and listen to the sounds that surround you.

In her book, The Language of Emotions, Karla provides many experiential exercises to draw out the wisdom hidden in a wide range of emotions including anger, fear, jealousy and shame.  Through these exercises you can gain emotional fluency in dealing with your own and others’ emotions.  Karla stresses the importance of understanding a particular emotion and being able to differentiate it from other emotions, e.g. differentiating between sadness and grief.  This clarity about the nature of a particular emotion enables you to identify practices to understand and act on the message and wisdom inherent in the emotion.  She provides an alphabetical list of emotions and links to relevant blog posts on her website as well as videos on different emotions on her YouTube© playlist.

Another strategy that Karla mentioned is that of “conscious questioning” which she describes in detail in her latest book, Embracing Anxiety: How to Access the Genius of This Vital Emotion.  In the interview podcast, Karla provided an example of this process that can be used in relation to panic.  For example, you can ask yourself, “What is the basis of my fear and the likelihood that what I fear will happen?” or “Can I avoid the situation that has the potential to harm me and is making me fearful?”  In the latter case, you might put off a visit to a food store at a busy time for fear of contamination from the Coronavirus.  Panic can help us to realise a potentially dangerous situation and enable us to take action to avoid the situation.   If your panic is chronic and not situational, other approaches such as managing your morning panic attack might help.

Reflection

Karla draws on her own life experience of dealing with her difficult emotions as well as a lifetime of research into emotions, their manifestation and effective ways of dealing with them.  As we grow in mindfulness and understanding through experiential exercises, reflection, conscious questioning and meditation we can access the messages and wisdom hidden in our emotions and develop emotional fluency.  Through these mindfulness practices we can safely negotiate difficult emotions and restore our equilibrium in any situation.

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Image by Anemone123 from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Living in the Light of the Lessons from Death and Dying

Frank Ostaseski in an interview with Rheanna Hoffmann about death and the process of dying, mentioned his book based on his experiences of being with a thousand people as they died.  His book, The Five Invitations: Discover What Death Can Teach Us About Living Life Fully, provides five principles or guides for living life with integrity, meaningfully and in alignment with our true purpose.  Frank was the co-founder and director of a thousand-bed hospice, so his book is based on lived experiences and real stories of how people faced death, as well as the distillation of the “wisdom of death” from these deeply personal and moving experiences.

Frank maintains that death is the “silent teacher”, imparting understanding and wisdom about how we should live.  He expounds his ideas and principles in a number of recorded podcast interviews, including What Can Death Teach Us About Living Mindfully. His recoded talk at Google focused on his book through the theme, Inviting the Wisdom of Death Into Life.   A succinct explanation of the principles in his book, which he describes as “invitations to living”, is provided in his 26-minute edited interview with Steve Heilig of Palouse Mindfulness.

The five invitations to living learned from the dying

Frank emphasises that these invitations to living have been taught to him by the dying and by compassionately helping many hundreds of people with the process of dying.   Understanding the following five principles and putting them into practice enables us to live life fully and mindfully:

  1. Don’t wait – we assume that life will go on as it always has, that our health, wealth and relationships will persist into the future.  If nothing else, the Coronavirus should disabuse us of this belief and the associated perceptions.  There is a tendency to put off changing the way we live because of this belief in continuity.  However, living is precarious, nothing is certain.  We can become absorbed in the busyness of life and put off any change – avoiding the need to slow down and really experience life and relationships.  We can spend so much of the day planning our next activity or sequence of events. Frank maintains that we are reticent to fully “step into life” – “waiting for the next moment in life, we miss the present”.  Frank urges us not to wait till our death to find out the lessons of dying.
  2. Welcome everything, push nothing away – whether it’s grief, loneliness, boredom or suffering, there is a lesson to learn if we don’t push away the feelings, emotions and thoughts that pervade our life.  Frank suggests that we should welcome grief and fear and difficult feelings because these “moments” of discomfort are pivotal in our life for developing sustainable personal change, if we fully face them.  He spoke of the grief he experienced working with the dying and how he adopted meditation, bodywork (the touch of a practitioner on a source of physical pain in his body) and holding and rocking newly born babies (a life-affirming activity) as a way to face the full emotional, physical and mental experience of grief – it’s as if he ritually experienced the life cycle of birth, living and dying as a way to manage his overwhelming grief.  
  3. Bring your whole self to the experience – Frank made the point that in his work with the dying, the part of him that was most helpful was his vulnerability and helplessness because it acted as an “empathetic bridge to their experience”.  These “weaknesses” became his strengths and enabled him to be fully present to them, to be-with-them.  He has stated previously that authentic presence and compassionate listening are healing and supportive of people’s transition in both the challenges of living and of the dying process.  He asserts that none of us is perfect but that we can bring our whole self to whatever we are experiencing – leaving no part of our self out of the interaction.
  4. Find a place of rest in the middle of things – we can find a place to rest amidst the turmoil and tenuousness of life and despite overwhelming emotions that beset us.  The “place of rest” could be a breathing exercise, a ritual, mindfulness practice or reconnecting with nature.  Finding such a “place” is critical as a self-care approach for healthcare professional, particularly in these challenging times. Rheanna Hoffmann, who volunteered to work in the Emergency Department of a New York Hospital during the height of the Coronavirus, stated that this principle, explained in Franks’ book, helped her deal with the exhaustion, grief and overwhelm she experienced in helping suffering and dying patients while working under unimaginably difficult conditions. Frank also recounts the story of how he helped a woman to find a place of rest who was dying and experiencing extreme difficulty breathing, a struggle to breathe exacerbated by fear.  He asked her, “Would you like to struggle a little less?”  He then helped her to put her attention to the gap/pause in her breathing and began to pace her by breathing in and out with her.  He reports that “fear left her face” and she died peacefully.  Frank pointed out that none of the conditions had changed for her (including difficulty with breathing), only her relationship to her experience of dying.
  5. Cultivate a don’t know mind – this is not designed to encourage ignorance.  Frank quoted a Zen saying, “Ignorance is not just ‘not knowing something’ but the right thing”.  Ignorance is knowing the wrong thing and insisting on its truth and universality.  The principle is not about accumulating information (the “what”) but cultivating a mind that is “open, receptive and full of wonder” – a mind that is curious and pursues the truth and understanding in everything.  Frank suggested that we should talk with our children about death and, in the process, learn from them (not tell them).  He recounts his experience as a Director of a pre-school when he organised for the children involved to go and collect dead things in the woods nearby.  He marvels at the insight of the children and their perceptiveness.  They had been discussing the theme of endings becoming beginnings, e.g. a caterpillar becoming a butterfly, when a four-year old girl said, “I think the leaves on the trees are very, very generous – they fall and make room for new leaves”.  Frank maintains that a “don’t know mind” is fluid and flexible and “infused with a deep interest to know” and to know what is true right now.

Reflection

Frank’s approach to fully facing all that life presents (both discomfort and joy) is in alignment with Jon Kabat-Zinn’s concept of Full Catastrophe Living and Frank’s personal process for handling his grief accords with Deepak Chopra’s recommendation that we adopt a ritual to symbolise our release from the stranglehold of grief.

Frank epitomises in his life and work what he advocates through his talks and video podcasts.  He pursues a life that is meaningful and purposeful.  For example, in addition to his book and public presentations sharing his knowledge and experience of the dying process and its lessons, he has established a creative approach to educating end-of-life carers through the Metta Institute.  His words and actions manifest a life of integrity, compassion and wisdom.

Steve Heilig, the person who interviewed Frank in one of the video podcasts mentioned above, has also found a way to live a life full of meaning and purpose.  One of his many mindfulness endeavours has been to collect resources and permissions from leading mindfulness practitioners, including Jon Kabat-Zinn, to enable him to provide a free, 8-week, online course in Mindfulness-Based Stress Reduction (MBSR).

As we grow in mindfulness, by employing the five principles that Frank espouses, we can live our lives more fully and expansively and truly aligned to our energy and purpose.  We can find our expansiveness and spaciousness which Frank evidenced with people who were dying – their capacity to find the personal resources to face their fear and death despite their belief that the challenge was beyond them.   We can also become a calming presence to others who are experiencing difficulties as we progressively overcome our own reactivity. If we develop the discipline of the daily practice of meditation, we can live in the light of the lessons of dying and death.

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Image by mostafa meraji from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Healing Grief through Compassion and Love

Frank Ostaseski was recently interviewed during the 2020 Mindfulness & Compassion Global Summit by Rheanna Hoffmann on the topic, Grief and the Healing Power of Love and Compassion.  With so many deaths worldwide from the Coronavirus (410,000 at the time of writing), the issue of grief and its manifestations becomes increasingly prevalent.   Frank is the cofounder of the Zen Hospice Project (now called The Zen Caregiving Project) and founder of the Metta Institute designed to provide creative education in the art of “mindful and compassionate end-of-life care”.

Healthcare professionals may not have lost loved ones through the virus, but they can experience grief too with the loss of patients that they have been caring for – this is in addition to other stressors that challenge their resilience.  In his interview responses, Frank explained the nature of grief and the power of compassion and love to heal people who have experienced profound grief.

The nature of grief

Frank who has supported more than 1,000 people in the process of dying maintains that grief is not a single point but a process – an evolving process of “loss, losing and loosening”.  There is the initial shock of the loss that can result in physical collapse and total disorientation.  Shock impacts people differentially – some people may experience numbness, there is no “one way”.   Beyond the initial shock of the loss, is a process of “losing”, where in the midst of other things an overwhelming sense of loss returns accompanied by strong emotional and physical symptoms.  “Losing” can persist for many years and eventually become an intermittent event.  In the meantime, the process of “loosening” commences with progressive release of the hold that grief has over a person.

People grieve in different ways – some withdraw and have a strong desire to be alone with their grief, others experience tears and crying uncontrollably, while still others may take out their grief by aggression and violence (such as is occurring in the riots in America in relation to the Black Lives Matter movement).  Grief and our response may be aggravated in challenging times such as the pandemic where everyone is experiencing a form of “emotional inflammation”.

Frank maintains that grief has many faces, e.g. anger, rage, sadness, depression, fear and even regret.  He also suggests that grief results not just from the sense of loss of a loved one but also from the associated lost opportunities – a young life cut off in their prime, a missed opportunity to reconcile with a loved one, a lost chance to say goodbye or to be physically present with someone as they were dying.   For people exposed to dying and death as a result of the Coronavirus, there can be a collective grief brought on by the lost opportunity to save lives, as well as the lost opportunity of the lives lost.

Healing grief through love and compassion

The starting point for being able to show compassion towards the people experiencing grief is having an understanding of the nature of grief and its many forms of expression. It is important not to add to the stress of people who are grieving by communicating expectations of how their grief should be expressed.  Grieving is a very personal process and requires compassionate attending and listening, not the projection of personal preference.

Pema Chödrön discusses ”compassionate abiding” in our own grief and suffering as the pathway to expressing compassion for others.  Frank suggests that we need to “metabolize” our own fear and suffering by facing it fully, experiencing it in our body, mind and heart and converting it to compassion for others.  He maintains that when we can explore our own experience through self-observation and self-inquiry we can “build an empathetic bridge to other people’s experience”.  Otherwise we can be working out of our own distress and needs rather than the needs of others who are grieving.  Without this level of self-intimacy we can appear dishonest or disingenuous to others we are trying to help in their grief.

Frank explained that he has difficulty expressing self-compassion but has developed a number of processes that enable him to express compassion for others.  Each night before going to sleep, he focuses on the suffering of others – those who might be suffering through loneliness, those experiencing grief or those who are caring for others who are dying.  Through this process he feels love and warmth towards others and the emergence of his “innate compassion” that is broad and deep enough to absorb or dissolve his own experience of suffering.   In the morning, with his hand on his heart, he asks himself, “What would love have me do today?”

Reflection

Self-intimacy is a key to genuine compassion towards others who are grieving.  Compassion and love help to heal grief because they involve abiding fully with someone who is experiencing grief, not trying to fix them.  Our very presence, uncontaminated by unrealistic expectations of the other person, can be a source of healing just as “listening generously” can be.   As we grow in mindfulness, we can develop self-intimacy, calmness and peace and be better able to be present to and compassionate towards others.

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Image by Gordon Johnson from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Self-Care for Healthcare Professionals

Dr. Reena Kotecha presented at the 2020 Mindfulness & Compassion Global Summit on the topic of self-care for healthcare professionals.  Reena highlighted the irony of healthcare professionals caring for everyone but themselves and, in the process, suffering pain, disillusionment and burnout.  She shared her own story of depression, mental illness and suicidal thoughts resulting from working as a young doctor in an emergency department in a hospital.  She was drowning in self-doubt, suffering anxiety about the future and trying to cope with her present level of stress symptoms such as palpitations and sleeplessness.  Reena found her way out of the dark hole of depression through meditation.

She highlighted the stresses that healthcare professionals are experiencing in these challenging times of the Coronavirus.  Reena spoke of frontline healthcare workers who had to move out of home to protect their family and/or elderly parents, of the sadness and grief they experienced with the death of patients, of the frustration of having inadequate resources (such as personal protective equipment) and of their fear for their own safety in terms of the impact of their work on their mental and physical health.  Frontline professionals experience the intensity and immediacy of Coronavirus-related stress and emotional inflammation as a result of the risks to the life of their patients and their own life.

Barriers to healthcare professionals seeking help

Reena emphasised that healthcare professionals not only tended to overlook caring for themselves but also failed to seek help for their mental welfare when they really needed it.  She spoke of the barriers that stop healthcare workers from seeking professional support (some of which she experienced herself):

  • Training focus – all the focus of their training is on how to care for others, very little of the training is focused on caring for themselves or how to seek professional help for themselves
  • Priority focus – healthcare professionals are singularly focused on caring for others and they fail to give priority to their own mental and emotional health that would actually enable them to care for others more effectively and in a more sustainable way.  As Reena points out, healthcare professionals are much more comfortable and more proficient in the role of caregiver than that of “care-taker”.
  • Career focus – healthcare professionals become concerned about what others, including management, would think of them if they admitted to not coping and experiencing some form of mental illness (which still carries its own stigma).  They can be concerned about how others will judge them and what impact this would have on their career.
  • Expectations focus – the community has highlighted the heroic efforts of the frontline healthcare workers but this brings with it an unrealistic set of expectations that they are all strong and courageous, free from normal human emotions of fear, anxiety and self-doubts and the resultant experience of depression with its concomitant impacts of inertia, exhaustion, reticence and lack of energy.  In the light of this community expectation set, they are reluctant to admit to “weakness and fragility”.

Young healthcare professionals may begin their career with an unerring focus on their patients, giving priority to their caregiver role and ignoring their own needs.  They may feel really uncomfortable about being seen as “needy” or becoming a “care-taker”.  Professionalism is interpreted by them as being strong and efficient, able to cope with any situation.  Gradually, however, the singular focus on patients begins to take its toll and is compounded by the fact that no matter how hard or fast they work, demand continues to outpace resources and capacity.  They begin to experience stress, fatigue and sleeplessness.  Despite these signs of not coping they push on – driven by their own expectations and the perceived expectations of others, including the “worshipping” community.  Burnout results when the gap between what they are putting in and their intrinsic satisfaction with their work widens to the point where they lose belief in the value of what they are doing – burnout occurs on the physical, emotional and spiritual levels.

Mindfulness as self-care for healthcare professionals

Self-care for healthcare professionals is a lifetime passion for Reena, partly generated by her own early professional experience but also reinforced by the healthcare workers who seek her help and support during these highly stressful times.  She is the founder of Mindful Medics – an 8 week course for healthcare professionals incorporating mindfulness, emotional intelligence, neuroscience and positive psychology. Participants in the course have experienced significant benefits for their mental and physical health as well as in their overall personal and professional lives.

Reena is also a highly recognised public speaker on the topic of her lived experience.  For example she presented at the Happiness and Its Causes Conference in 2018 on the topic, Personal Story: Healthcare Starts with Self-Care.   In her Summit presentation, Reena provided a gratitude meditation designed to focus on appreciation for what we have in the present to displace a focus on a disturbing past or anticipatory anxiety about the future.  There is so much that we can be grateful for and savour in our life – nature and our environment, the development of our children, our achievements and rewards and the space of being alone

Reena in an article, titled I am grateful…, recommends strongly that we develop a constant practice of expressing gratitude for the simple things that we have in our lives and highlights the neuroscience research that supports the benefits of gratitude for mental health and wellbeing.

Reflection

It is important to express compassion for others, especially healthcare professionals and those directly impacted by the Coronavirus.  However, we have to recognise the enormous stress healthcare workers are experiencing in these challenging times and be more aware of not adding to that burden by perpetuating the expectation that they, individually and collectively, can cope with any challenge at no cost to themselves.  We can also offer our support for people like Reena who are helping healthcare professionals to develop mindfulness as a means of self-care.  The Mindful Healthcare Speaker Series is one ongoing event that we can support.

As we grow in mindfulness by focusing on self-care through mindfulness practices and gratitude meditation, we can become more conscious of what we are thinking and feeling and be better able to appreciate the present moment and all it has to offer in terms of overall wellness and happiness.  Mindfulness enables us to identify our barriers and expectations, acknowledge when we need help, develop strategies to cope more effectively and progressively build our resilience.

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Image by Petya Georgieva from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Building Resilience through Compassion Towards Others

In a previous post, I discussed Pema Chödrön’s ideas of developing resilience through self-compassion by “compassionate abiding” in our own pain and suffering during these challenging times of the pandemic.  This entails abiding in, or dropping into, the full depth of our painful experience through our bodily sensations and conscious breathing.  As we undertake slow, conscious breathing we hold our suffering with self-kindness and warmth.  Lulu & Mischka in their mantra meditation, Warriors of Light, remind us to “breathe into our hearts” because breath is our chariot enabling us to face the unknown and stand on our own.

In her interview podcast with Tami Simon of Sounds True, Pema extended the concept of compassionate abiding by moving beyond self-compassion to compassion towards others.  She maintained that embracing the pain and suffering of others particularly in these times, when everyone is suffering in one form or another, contributes to our resilience – we realise we are not alone and we are able to move beyond self-absorption and “panic storylines” to extending kindness to others.

Pain and suffering: a doorway to compassion for others

In these challenging times of the Coronavirus, we can be very sure that there are millions of people around the world who are experiencing suffering like we are.  People are experiencing all forms of loss – of loved ones, their jobs, their business incomes, their health, their financial security or their homes.  They may have become physically disconnected from their workplaces, their family and their friends, even stranded in a foreign country because of international travel restrictions.  They could be healthcare professionals working on the frontline and/or living away from their families for a number of months to protect their loved ones from cross-infection.  We can be very confident that there are people around the world who are feeling pain and suffering like we are.

Pema argues that abiding with compassion in our own pain and suffering is the doorway opening us to compassion towards others.  In experiencing fully our own suffering, not denying its intensity or pervasiveness, we develop a deep sense of connection with others who are also suffering at this time.  Pema spoke of the principle of Tonglen, a Tibetan word meaning “taking in and sending out” – taking in our own experience of pain and suffering and sending out desire for relief for others.  She suggests that once we become grounded in our own suffering (this may take 10-20 minutes), we can take in the suffering of others.  On our in-breath we can imagine others who are experiencing similar pain and suffering and on our out-breath, wish them relief and insight to enable them to move beyond their own discomfort, distress, grief or loneliness.  Connectedness and resilience lie in this mutual experiencing.

Pema maintains that we do not have to confine this compassion towards others to a time of extreme challenge, we can use our pain and suffering as the doorway to compassion and connectedness at other times.  We may be experiencing distress because a family member is suffering from Alzheimer’s or feeling panic and anxiety because someone we are carer for is experiencing the black dog of depression.  At these times, we can drop into conscious breathing, embracing our distress and anxiety with kindness, and gradually move beyond this abiding self-compassion to compassion towards others who are experiencing the intensity of our own emotions. 

Reflection

I think that Pema’s profound insight into compassionate abiding opens the way to develop self-compassion, compassion towards others and personal resilience.  As we grow in mindfulness through conscious breathing and extending relief to others, we can move beyond our self-destructive narratives, restore our inner equilibrium and peace, and develop the resilience to not only survive these challenging times but also be able to extend help and support to others. 

Compassion towards others can be expressed in many ways even in these times of social distancing – the virtual choir of women physicians singing “Rise Again” is but one example of many where people are moving beyond their own overwhelming challenges and distress to reach out to others.

Pema provides multiple resources including her many books, her free e-book titled, 5 Teachings of Pema Chödrön  and her online course, Freedom to Love, which expands on the principles and practice of compassionate abiding.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Mindfulness and Resilience in Challenging Times

The Awake Network and Mindful.org have collaborated to provide a free resource for healthcare professionals in the form of The Mindful Healthcare Speaker Series.  Jon Kabat-Zinn speaking on Mindfulness and Resilience in Challenging Times was the first in the series of six speakers.   While Jon is not an MD, he has a PhD in Medicine and focuses on mindfulness in medication, healthcare and society.

Jon and host, Dr. Reena Kotecha, spoke of the enormity of the challenges facing everyone with the advent of the Coronavirus and especially the frontline healthcare professionals who, in many instances, lack adequate resources and training to deal with the magnitude of this pandemic.  They spoke of the trauma experienced by these healthcare professionals who are witnessing the suffering and death of so many people.  Reena spoke of one frontline female doctor who had to move out of home to live in a hotel for three months to protect her mother who was suffering from cancer. 

A truly disturbing event was the suicide death of Dr. Lorna M. Breen, an emergency center doctor, who continually witnessed the very worst of the impact of the Coronavirus on people, including people dying at the hospital before they could be removed from the ambulance.   Her heroic efforts to save people through her frontline medical work contributed to her own death.  Jon reiterated that mindfulness does not lessen the enormity of the physical and mental health impact of the pandemic on the lives of healthcare professionals but emphasised that mindfulness acts as a ballast to provide stability in the face of the turbulent winds created by the pandemic.

Mindfulness as ballast for stability

Jon referred to the 25 years of quality scientific research that showed the benefits of mindfulness, extending to positively altering the structure of the brain, increasing functional connectivity (e.g. of the mind-body connection) and enhancing neuroplasticity.   Neuroscientist Richard Davidson co-authored a book, Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body, and demonstrated the powerful effect mindfulness had on building resilience.

Jon spoke of “full catastrophe living” and emphasised that it is truly human to experience fear, anxiety and grief.  He argued that mental health is enhanced by feeling and accepting everything we experience, rather than denying its existence or intensity.  He stated that no matter how emotionally rending our circumstances are we can find refuge in mindfulness, by being “in the present moment, moment by moment”.  In this way, we are better able to recover from the “trauma” of the present reality and to do so without total depletion of ourselves.   

Mindfulness as awareness

Jon maintained that “we are not our narrative” – we are not our negative self-talk that diminishes us and depletes our energy in the face of life challenges.  He argues that our life is “one seamless whole” – our mind, body, thoughts and emotions.  In his view, our breath serves as the integrating factor and energy force.  Awareness of our breath in the present moment enables us “to get out of the wind” and “to recalibrate, recover and respond instead of reacting”.  To reinforce this message, he provided a guided meditation during his presentation focused on the breath for about ten minutes (at the 30-minute mark).

Jon maintained that awareness of our breath can enable us to be fully awake to what is going on inside us and to be more deeply connected to others.  He argued that we don’t have to achieve a particular goal – to become more or better – in his view, “we are already okay”.  In these challenging times, what is needed to help ourselves and others we interact with is to be authentically present, without a “mask” (metaphorically speaking), but with openness and vulnerability. 

Reflection

Jon highlighted the importance of trusting our “human creativity” when confronted with the need to help people who are stressed out by the pandemic.  As we grow in mindfulness through mindful breathing, we not only build our resilience in managing our personal challenges but also “modulate the tendency to put self ahead of everyone else” – we can diminish our self-absorption and self-doubt.  He maintained that awareness of our breathing reinforces our ecological connectedness.  

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Image by Jill Wellington from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

How to Be Open to Change

Diana Winston recently provided a guided meditation on Opening to Change as part of the weekly meditation podcasts provided by MARC, UCLA.  Diana pointed out that change has always been a part of our life – both internally and externally.  We have constantly experienced change in the form of changes to our bodily sensations, our thoughts, emotions and body form.  We have experienced constant change in our environment (local and global) – our economic, political, social, financial, legal and climatic environment.  We can just think of the ever-changing nature of social media or the weather to remind us of the numerous changes that we experience daily.

Disruptive change brought on by the Coronavirus

The Coronavirus has created a disruptive change that is unprecedented in its magnitude and impacts.  We are finding that every dimension of our lives has been disrupted.  How we work and where we work has changed and for some people this means a loss of job and income.  Our financial situation is changing constantly as the new reality sets in, with businesses closing or going into lockdown, the share market fluctuating erratically, and customers prevented from visiting stores, cafes and restaurants.

Local, interstate and international travel has been severely constricted.  There have been significant restrictions on our daily lives – our movement, hygiene practices and access to resources have been mandated by Government (employing emergency powers).  Our interactions are changing as we have to adopt social distancing and social isolation – so people avoid rather than connect, people even cross the road to create distance as we approach them.

There are new limitations on who we can meet with, and the nature, duration and location of our meetings.  We are often forced to connect online, instead of face-to-face and to experience the exhaustion of this new mode of contact when adopted on a constant basis.  Everything seems to be turned upside down, even our perception of what day it is.  Bernard Salt, social commentator and demographer, coined the term “Lockdown Befuddlement Syndrome (LBS)” to describe our inability to remember what day it is  – a condition he attributes to the “loss of reference points” which served to fix the time of day and the day of the week for us (Weekend Australian Magazine, 16-17 May 2020, p. 28).

It is natural then for us to experience stress and resistance when we encounter total disruption and uncertainty.  It is also natural for us to experience the very real fear of viral contamination when going to the shops, being in enclosed public transport or lifts or just walking down the street. 

Previously, we have discussed various issues that impact our openness to change – our immunity to change, the need for emotional agility and the different survival strategies that individuals adopt.  Diana offers a guided meditation to help us to be more open to change whatever our habituated response is.  She suggests that, through mindfulness practice, we can turn the current “breakdown” in our life to the potential of a “breakthrough”. 

Guided meditation on openness to change

There are several steps in the guided meditation offered by Diana:

  • Physical grounding – sitting, lying or standing comfortably with eyes closed or downwardly focused.
  • Body scan – feeling your feet on the floor or ground, breathing into points of stiffness or pain, opening to your bodily sensations as they are at the moment.   Diana also suggests some form of movement to loosen your muscles, e.g. move your neck from side to side, stretch your arms and legs.
  • Emotional scan – getting in touch with your feelings at the moment and naming your feelings, without self-censure or self-evaluation (everyone experiences a range of emotions when faced with extreme uncertainty and threats to their sense of security).  It also involves confronting the experience of boredom and how it negatively impacts your life.
  • Mind scan – being open to your thoughts and what occupies your mind, exploring your preoccupation with the lost opportunities of the past and/or the uncertainty of the future.
  • Mindful breathing – sense your breathing (the in-breath, out-breath and the gap between), adopting deep breathing to tap into your life force.
  • Tune into sounds – open your awareness to sounds in the room and externally, without interpretation or emotional response.
  • Decide on an anchor – what will help you return to your focus when your mind wanders and you lose focus?  Your anchor could be a specific form of breathing, a bodily sensation, attention to sounds or any other signal to return your attention back to your desired focus.
  • Exploring your approach to present changes in your life – once you are in touch with how you are holistically experiencing your current reality, you can ask yourself a series of questions:
    • What aspects of your changed life are you adapting to well?
    • What positive responses have you employed, how have your enriched your daily routine?
    • What has slipped from your earlier resolve and practice, have you lost the discipline of a daily routine?
    • How could you improve your responses to your changed life and environment?
    • Are your expectations realistic, given your present environment?
    • What single positive behavioural change will you adopt?

Reflection

There are numerous examples, locally and globally, of individuals, communities and businesses adapting in a positive way to the experience of our current, constrained existence.  Parents are spending more time with their children; people working from home are valuing their home environment and enjoying increased productivity; businesses are adapting to a take-away or online environment; consultants, trainers and teachers are successfully converting to an online-teaching environment; people are learning new skills, including how to make bread; many people are exercising more and/or spending more time in nature and the open air.

Individuals and communities are working together to offer free nutritious meals to frontline health workers; businesses are adapting manufacturing processes to produce sanitisers, ventilators and protective gear; and musicians and artists are providing free shows online to brighten people’s lives and raise funds to fight the Coronavirus.   Everywhere you look, you can see examples of the resilience and generosity of the human spirit.

Diana askes us, “How can we channel what we have learned [in this crisis] to create a new existence?”  She maintains that as we grow in mindfulness we can move beyond our self-limitations and negative self-talk to access our inner strength, resilience and creativity.  We can move beyond our self-absorption to a sense of gratitude, self-compassion and compassion towards others.

Bernard Salt asks the Australian community:

What learnings, skills, adaptations, re­imagined values can we, should we, take forward in the recovery process to build an even better Australia in the months and the years ahead?  (The Australian, Monday 18 May 2020)

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Image by Jess Foami from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Reduce Emotional Inflammation with Reconnection to Nature

Tami Simon recently interviewed psychiatrist Dr. Lise Van Susteren on Emotional Inflammation as part of the Insights at the Edge podcast series.  Lise drew on her newly published book co-authored with Stacey Colino, Emotional Inflammation: Discover Your Triggers and Reclaim Your Equilibrium During Anxious Times.  While the book was written before the onset of the Coronavirus, it is made even more relevant in these times of the global dislocation caused by the pandemic.  Lise maintains that emotional inflammation existing before the outbreak of the Coronavirus has been aggravated by the virus and its flow-on effects such as anxiety and grief and the unnatural states of social isolation and social distancing.

Prior to the onset of the Coronavirus, people were experiencing emotional inflammation as a result of our global and local environments impacted by climate change, gun violence, racial and refugee discrimination, economic disparity and turbulent economic conditions.  Lise acknowledged that the pre-existent emotional inflammation has been exacerbated by the advent of the Coronavirus.

She described out current conditions as a “fraught inflamed time” and encouraged us to be kind to ourselves and others as we work our way through the many challenges confronting us on a daily basis.  Lise maintained that individuals will deal with the challenges in different ways, e.g. some will keep themselves busy and get engaged with community work such as The Care Army, while others will use the time to retreat, read and reflect and/or listen to encouraging and inspiring podcasts.

Loss of connection to nature

I have previously discussed the impact of  the “nature-deficit disorder” and the loss of connection to nature and its healing powers.  Lise, who is a renowned climate change activist, argues that much of our emotional inflammation is caused by a loss of harmony with nature and its natural energy flows.  We have not only devastated our ecosystems (and the “immune system of the environment”) but also lost our capacity to be attuned to nature and its tranquillity and timelessness.

We have become time-poor, impatient, intolerant and stressed by the pressures that surround us and, increasingly, by the technologically paced character of our lives.  We refer to “slow mail” and “running out of time” on a consistent basis as our communications have increased in speed, simultaneously with increased expectations about response times and constant exposure to information overload – we are drowning in information and unrealistic expectations.

Lise is a firm believer that our ecology impacts our biology and she bases her assertions on sound scientific evidence.  She is at pains to point out that climate change has a devastating effect on our physical and mental health, a perspective reinforced by the American Psychiatric Association (APA).  Our physical and mental health is intimately linked to our connectedness to others and to nature.  Connection is a deeply felt need and frustration of this connection leads to physical and mental illness, including depression, ill-health and anxiety.

Reflection

Emotional inflammation is strongly associated with disconnection from nature.  Reconnection with, and respect for, nature can bring many health benefits and reduce the enervating effects of this “fraught inflamed time”.   Mindfulness practices involving breathing can help us to become better attuned to nature and more at peace with ourselves and others.  Nature is a rich source of healing and time spent being mindful in nature can assist us to develop the equanimity and creativity we need to navigate the unprecedented challenges of our time.  As we grow in mindfulness through meditation on nature, mindfulness practices and reflection on our way of living, we can begin to realise the critical role that nature plays in our health and wellbeing.

Peter Doherty, Nobel Prize winner for his work on infectious diseases, suggests, like Lise, that there are opportunities to be taken, and real lessons to be learned, from the current challenges of the Coronavirus:

We need to take this opportunity to rethink how we live in the world, what’s of value to us and start to look at what is really important. (Interview quoted in the Australian Financial Review, 9-10 May 2020, p.37).

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Self-Compassion in Times of Uncertainty and the Coronavirus

There are many people offering ways to manage anxiety and fear in these times of uncertainty brought on by the global Coronavirus.  Psychologist Rick Hanson, for example,  provides multiple online mindfulness resources including the Wise Brain Bulletin.  In the latest issue (Volume 14.2), Kristin Neff and Chris Germer offer 10 self-compassion practices for self-management during this time of the pandemic.  Self-compassion is about being compassionate towards ourselves despite our mistakes, deficiencies and perceived weaknesses.  It takes time and effort to build self-compassion, particularly if we are used to negative self-talk, berating ourselves for our mistakes or constantly comparing ourselves to others (and coming up short in our own estimation).

Elsewhere, Kristin provides a video explanation of the concept of self-compassion, discusses the three components of self-compassion and offers exercises on how to develop each of these.  She also offers a range of guided meditations and exercises on the website for the  Center for Mindful Self-Compassion.   Kristin and Chris are co-developers of the Mindful Self-Compassion (MSP) Program designed for those who want to explore more fully the richness of this mindfulness approach.  They are very well qualified to teach mindfulness and compassion (for ourselves and others).

Additional Approaches to developing self-compassion

There are multiple resources and exercises available to help you build self-compassion.  Some that are very accessible and easy to use are:

  • Compassionate body scan: a 20-minute progressive body scan that focuses attention on different parts of the body and treats each part of the body with kind awareness and tension release.  The guided body scan is offered in separate audio recordings by both Kristin and Chris.
  • Mood tracking: an essential element in building the self-awareness necessary for developing self-compassion and improved mental health.  There are many mood tracker apps that help you identify your triggers and enable you to gain control over your emotional responses.  Steve Scott provides a review of the 14 best mood tracker apps available today.  These apps provide a ready means of tracking stimuli and your responses in terms of moods/feelings.

Reflection

Self-compassion is the antidote to negative self-evaluation, just as gratitude and savouring what we have reduces competitive comparison and envy.  As we grow in mindfulness and self-compassion through meditation, mindfulness practices/exercises and reflection on the triggers that precipitate our strong emotional responses, we can progressively develop self-intimacy and the self-regulation necessary to identify our negative triggers and control our responses.

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Image by Stephen Cruickshank from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.