WillSpirit!

Where Will meets Spirit
∞ Love, Clarity, Balance, Peace, & Bliss ∞

A science, mental health and spirituality blog written by a physician.








  • Red_Exclamation_DotDisclaimer
    • Dear Visitors:
      Although I trained and practiced as a physician, my background does not include formal instruction in psychiatry beyond basic medical education. This journal presents ideas about treatment philosophy, but must not be considered therapeutic advice. Abrupt changes in one's psychiatric medications can trigger profound cognitive, emotional, and physical symptoms, including suicidal thoughts and actions. Consequently, pharmaceutical agents should not be increased or decreased without supervision by a mental health clinician.

    • ON THE OTHER HAND, your brain belongs to you, and your opinion counts. If you decide that changing your medication regimen will serve your best interest, then I believe your providers have an obligation to help you try to achieve your goals. I want everyone to be educated about their options, and do what will be most helpful for themselves. No one should feel pushed around by dogmatic and/or limited viewpoints, whether those of psychiatrists, anti-psychiatry advocates, or myself.


The Teaching of Survival

It’s funny how just when Western healthcare had almost completely alienated me, it saved my life. Having studied a holistic tradition (Chinese medicine) to a certain depth, my portrayals of conventional medicine had become dominated by the shortcomings of its clinical care: overly technological, narrowly focused, insufficiently personal. It seemed obvious that healing requires more human touch and less electronic gadgetry. Just six days ago I railed against modern inpatient treatment (see Hospital, Heal Thyself).

And then…

It turns out a ligament occluded my celiac artery, which supplies many abdominal organs. This led to enlargement of vessels around my pancreas, one of which became so thin and weakened that it bled. During a four-hour procedure, an interventional radiologist embolized this aneurysm to prevent further bleeding. But the hematoma remains in place, where it has totally blocked my small intestine. Since no food can get through my digestive tract, the doctors ordered a semi-permanent venous access and started IV feedings two nights ago. Without nutrients dripping directly into my bloodstream, I probably wouldn’t survive long enough to permit my intestine to reopen. And if the problem doesn’t correct itself with time, I’ll need surgery. My life is likely to continue, but only because of modern medical techniques.

So it appears I need to soften my stance against contemporary biomedicine. To remain contemptuous would be hypocritical and ungrateful.

I still see problems, of course. More artwork, nicer paint jobs, some soothing music, fewer computer screens, and more patient contact would all be nice. On the other hand, technology does demand we tolerate a bit of depersonalization and indignity.

This became clearest as I rested on a rigid radiology table during my procedure. After the third hour my bladder was so full that the discomfort made it difficult for me to remain still. The team members, who had already shaved my groin to my slight embarrassment, now placed a plastic urinal between my legs and dropped my appendage into it. While five people watched impatiently (four of them women) I was commanded to pee into the bottle. Can you imagine how difficult that felt? I tried very hard, which was of course the wrong approach. A nurse placed my fingers in a cup of warm water, but nothing flowed. Finally, I had to endure the dreaded Foley catheter, the fear of which was a large part of the reason I was so desperate to urinate on my own. As they inserted the tube, it hurt just about exactly as much as I’d expected. I felt mortified by the entire experience, though at least I managed to lighten the mood with a small joke about my situation.

Although the process involved pain and a dose of humiliation, the angiographic procedure clarified a confusing clinical problem. It cured me of my aneurysm. Yes, attempting to micturate publicly under duress felt embarrassing, but I don’t see how the awkwardness could have been avoided. Three of the staff were scrubbed and gowned, so they couldn’t leave the bedside. One was monitoring the equipment and the other dealt with positioning the bottle relative to my anatomy. It was dehumanizing but unavoidable.

There are trade-offs in life. Although I resist viewing the body as a device, it does have mechanisms that can fail, and which can be corrected by technological procedures. This requires a team of health care workers, lots of machinery, and sometimes compromise of modesty. But if the alternative is death, why complain?

Over and over in the course of writing this blog I’ve found myself modifying earlier narrow views with later expanded ones. These days a popular buzzword is integrative healthcare. It suggests that we can combine the best of technological and traditional healing. I suppose it’s our most promising option, as difficult as it might be to achieve. It would also be the equivalent of clinical medicine maximally enlarging its range and acceptance.

Unfortunately, we are in an era of diminishing resources, so integral approaches will need to be developed on the cheap. Yet that may be a good thing. It might force us to trim the waste of natural resources that is so rampant in hospitals. It might reduce the use of expensive and ineffective medications. It might result in fewer unnecessary procedures.

As always, life is teaching me to extend my awareness, soften my criticisms, and increase my thankfulness. This illness has been painful, frustrating, and discouraging, but it has aided my maturation. I now remember the tremendous power of a health system I’d nearly rejected. I recognize that although there are many insensitive hospital workers, there are also legions who are dedicated and compassionate. I better understand that you sometimes need to sacrifice dignity and comfort in service of survival. It’s been a tutorial, finally, in letting go of rigid demands.

I’m seeing, once again, that learning to be flexible and open-hearted in the face of fate’s trials is the ultimate lesson and reward of living. Adopting levity helps too, as in joking while trying to ‘produce’ under trying circumstances. It never hurts to milk a little humor from humiliation. Life is, after all, at turns both sublime and ridiculous.

Thanks to modern medicine, my life will go on despite this setback, and perhaps I will be wiser, jollier, and suppler from here on out.

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The Teaching of Survival was published on February 3rd, 2012 . 11 comments






The Third Dart

Pain, illness, fear, and hunger make clear thinking difficult. They undermine efforts to behave well toward others. These effects have become obvious to me in this hospital bed, where I’ve hung out for seven days without eating, feeling pain ranging from mild cramping to agonizing pressure, and suffering with ongoing nausea that at one point morphed into twelve hours of retching.

To my chagrin, I’ve seen myself act more selfishly and distractedly than usual. When visitors arrive I sometimes talk about my dilemma non-stop, whereas other times I stare blankly without truly hearing what they say about their own trials. I try to remain focused on the needs of others, but it’s hard.

As never before, I understand how maturity and effectiveness can be undermined by adverse states of body-mind. But I’m trying to cut myself some slack and simply review the effects of starvation and pain on my actions and words. I want to learn from this experience but not suffer excessively because of it.

Life inevitably veers in unwanted directions. How much misery we feel depends to a large extent on how we respond to fate. This is true when life disappoints us, and also when we disappoint ourselves.

People sometimes slight us, leading to mild irritation. But as we mentally replay the offense later, we may build up resentment or even rage. Of course, we could instead view the occasion from a broader perspective and forgive the insult. Similarly, a personal gaffe can be made worse by negative obsession, or better by viewing it as a learning experience.

Before we begin to mature as adults, we may not be aware that such choices exist. Resentful obsession seems like the natural and inevitable response to an insult. Humiliated rumination seems like the deserved consequence of social mistakes.

Fortunately, as we gain skills we learn to transform resentment into forgiveness. We abandon narrow focus on a single slip-up for a broader and more compassionate perspective on our personality.

When we are faced with really serious illness or other trying circumstances, our resources can get overwhelmed. Our healthier skills are most likely to fail us when we are hurting, hungry, frightened, or lonely. Not only are we more likely to overreact to minor injustice, and to act childishly, we are more likely to punish ourselves afterward.

My system has seldom felt so physically stressed as it does now. As already mentioned (in this essay and the last), the duress has increased my tendency to behave with embarrassing immaturity and selfishness. Before I started paying attention to this cause and effect relationship, I had begun to berate myself for getting so far off track.

Yesterday during a conversation about these issues with a dear Buddhist friend, we talked about how the Buddha distinguished between what he termed the first and second darts.

Fate throws the first dart into our sphere. For instance, an unexpected major illness arises. It could be anything. For the sake of argument, let’s imagine sudden pain arises in the abdomen and doctors discover a nest of abnormal blood vessels near the pancreas, along with a bleeding aneurysm. Prolonged hospitalization becomes unavoidable, along with its discomforts and inconveniences.

We toss the second dart ourselves. Perhaps it penetrates consciousness in the form of worry: does a cancer lurk under that tangle of vasculature? Is death on the march? The second dart drives resentment and frustration: plagued by worry and feeling persecuted, we complain and act out. The second dart accentuates our misery. If we simply experienced unavoidable hardship without layering on toxic interpretations and retaliations, we suffer less.

During yesterday’s conversation with my friend, we came up with the idea of a third dart. We use this missile to attack our unskillful response to fate. Just as the second dart arises in reaction to the first, in that we worsen a bad situation by distorted thinking, the third dart flies as we reject our own negativity. We could choose to be compassionate toward the second dart: “Oh jeez, I yelled at that phlebotomist after he jabbed me a third time trying to suck blood out of my arm. How predictably human I am! When he comes back I’ll apologize.” Quite often, however, we instead launch the third dart and berate ourselves for shortcomings: “How ugly of me to sound so hostile! Didn’t I learn anything from all those years of meditation and acceptance practice?”

Notice we won’t be susceptible to such self-reproach if we don’t value skillful behavior. The red-faced tailgater leaning on his horn as traffic slows for a yellow light is unlikely to suffer from the third dart, though he is hitting himself hard with the second one. He probably won’t be blaming himself for his intolerance. In this sense, being self-critical shows more maturity than being self-righteous. Even so, the third dart does little to actually improve our responses. It simply makes us pay a higher price after we misstep.

The third dart is a danger to those of us who hope to tread a spiritual path, because we replace helpful noble intentions with damaging self-criticism. We feel painfully aware of our inadequacy compared to the highest exemplars, like the Buddha or Christ. To intend skillful behavior is edifying, but to punish ourselves for human failings is destructive. We gain nothing from the third dart.

I’ve been pulling a lot of third darts out of my butt lately. A prolonged hospitalization for a confusing, painful illness is a great way to lose one’s grip and begin acting unskillfully. Instead of giving in to my inclination to beat myself up afterwards, I’m working to recover my balance as quickly as possible: correct my behavior, apologize to whoever I hurt, and forgive myself. I yank out the third dart and keep aiming for my better path.

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The Third Dart was published on February 2nd, 2012 . 10 comments






The Highly Sensitive Soul

There is much psychological literature on sensitivity, which is no doubt familiar to many readers (see this Wikipedia article for a good summary); what follows is my poetic and non-scientific take on the subject.

Some people seem to feel life more deeply than others. Culturally determined preferences may judge high sensitivity as better or worse than its alternative, but in my opinion the trait requires no such valuation. On the other hand, those of us with systems wide open to pain and pleasure must comprehend our true nature so we can learn to function comfortably in a world that seems designed to challenge the heart.

Did you spot the lie in the last paragraph? The truly sensitive soul will never find lasting comfort save by rejecting the very quality that defines it. To feel life in the abyss of the self is inherently agitating; moments of peace will ever alternate with moments of distress. This is why exquisite sensitivity is commonly viewed as a deficiency.

Imagine for the moment a sentient God who watches our lives from on high. My position on whether such a deity exists is nuanced, complex, and changeable, but right now I don’t want to get into that tangle. Instead, just try to picture how humans would appear through the sagacious eyes of an all-knowing God. From that vantage, does the sensitive person look like he or she is lacking? Doesn’t it rather look more like the sensitive soul is the one who is paying the most attention?

Let’s face facts. Death hurts. Even birth hurts. Romance is seldom forever sweet, as most married couples can attest. Children bring joy to families, but not infrequently they also bring grief. Illness strikes us all, sooner or later. And these are just the ordinary, inevitable trials of life.

Add in earthquakes, hurricanes, famine, wildfires, and tsunamis, and you begin to feel the true impact of our dilemma. Then include the human-generated miseries of war, torture, exploitation, environmental destruction, child-abuse, racism/sexism, and so on. By this point we have before us a panorama sufficient to demoralize anyone who opens to its import. No wonder a responsive heart is often considered an infirmity.

Fortunately, there is more to life than heartache. We can appreciate the intricacy of a spider’s web, the majesty of the moon on a cloudless night, the joyous warmth of a rising sun. We can feel the heart’s faithful beating, the innocence of a child’s smiling face, the palpable waves of love in a family. We enjoy the delicate aroma of a field of wildflowers as we take a morning stroll in springtime, and we feel invigorated by the blustery swirl of leaves as we walk through a park on a windy autumn afternoon. We can meditate among granitic monoliths in the high mountains or feel lulled by waves lapping along the shore of a broad, clear lake.

The trick to embracing this infinite universe of splendor and terror is to remain, yes, sensitive to its charms.

There are two basic strategies for surviving life’s ordeals. One is to harden the outer walls and live protected from fate’s sting. The other is to open the windows wide and let the full blast enter, keeping faith that bereavement and dismay will be more than balanced by blessings and delight.

Sealing the mental house tightly shut keeps out the cold, biting winds, but also the butterflies and sunshine. Opening wide invites life’s full complement of chaos, but also its magnanimous smile.

The sensitive soul faces this choice early in life. In my own case, my upbringing felt overwhelming, so in response my young adult years became a study in progressive cynicism. By my age of twenty-five anger was the only emotion that remained easily accessible. Training as a physician completed the tempering begun years earlier; through medical education I became skilled at participating in the most affecting dramas without feeling affected.

That transformation led me to many of my most disastrous decisions and lasting regrets. I became cut off from my ethical foundations and acted on the basis of superficial logic fueled by deep-seated angst.

How much better it would have been to leave my gentle heart on my sleeve, where it naturally wanted to perch. How much happier I’d have been following my quirky inner leadings rather than society’s call to ambition.

No matter. In the end I found my way back to my true nature. And indeed, as I mentioned in the last post it may be that this current epoch will be my ending turn on life’s wheel. Yes, I feel terribly pained by how much I may be losing before long. I feel even more sorrow about how much was lost through mistaken efforts to protect my heart from breaking. But better to return to feeling at last than never return at all.

Poets, artists, reformers, healers, and saints all rely on sensitivity. The majority probably were born into this world with giant, vulnerable hearts. Many may have lost their way for awhile. But in the end, the sensitive person can neither be happy nor effective except by allowing his or her insistent affection and exquisite tenderness free reign.

The best way to achieve this freedom is to keep the eyes open as wide as possible. Don’t close off to the pain you see, but don’t ignore the beauty of life’s spectacle either. Watch how the winds blow from all directions. Sometimes bitter Northers strafe us with ice, and sometimes balmy desert breezes blow in the darkest night. Sometimes death, sometimes birth. Sometimes cruelty, sometimes compassion. Sometimes illness, sometimes health.

Life is a circle. Live in the middle of the largest circumference you can imagine. From such an axis, no matter how much distress you feel, you will discover a greater measure of Bliss.

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The Highly Sensitive Soul was published on January 23rd, 2012 . 10 comments






Seeing the Face of Life in the Face of Death

The fear of death remains foreign to me, but for the first time I truly feel the tragic gift of mortality.

Many of my early memories revolve around my mother’s depression and her subsequent dying from it. During my fourth through sixth years, my mom had no will to live and expressed little joy. Her suicidal despondence taught me to think of death as a friend to invite, not an enemy to avoid. After her departure from this life, I spent the rest of my childhood fitting human impermanence into my worldview. It wasn’t easy, and along the way I also learned to fantasize and wish for different truths. But in the end the stark reality of love’s transience became solidly fixed in my adult philosophy.

You can spend a lifetime thinking of life as temporary and of limited ultimate value, but when you glimpse the unplanned end of your own time on this planet, mortality becomes far less abstract.

My last four days were spent in a hospital. Severe abdominal pain kept me awake most of Monday night, and by Tuesday morning I had no choice but to stretch out in the back seat of our truck while my wife drove me to the Emergency Department. It hurt too much to sit up, and the entire short drive was spent shivering from the frosty cold and cramping pain. After several hours of workup, the doctors informed me that a liter of fluid had been found next to my pancreas. They believed this was very likely blood from a sudden internal hemorrhage, but they were uncertain about its cause.

After a few days in the hospital the diagnosis remained unclear. The first considerations of pancreatitis and perforated ulcer were ruled out by further tests, and my wife and I were left with a short list of exotic benign problems but also the real possibility of pancreatic cancer.

As a physician, I know that this particular malignancy is highly lethal. It kills quickly and the longterm survival rate is extremely low. We hope, of course, that something else will explain my condition, but now that I’m back home awaiting additional studies, I’m finding mortality staring me down like never before.

You can contemplate suicide a thousand times and so convince yourself that death would not trouble you. But let the Reaper come knocking at your door in the form of a dangerous disease, and suddenly you realize that life is more precious than you ever admitted.

Any longterm reader of this blog has seen me become more welcoming of life’s uproar. I now find beauty in even the hardest circumstances, and I love all beings with more depth than I could have imagined in younger years. But although I’ve endeavored to walk through my days with increasing mindfulness, and to appreciate the shifting weather and achy momentum of my human body, this morning I am feeling life’s tender majesty with greater acuity than ever.

On our fence outside hangs a ceramic sun made in Mexico. It is a cheap item that we bought long ago. But seeing its bright, shiny face this morning nearly brought me to tears. How many more opportunities will I have to gaze upon this innocent bauble? How many times have I glanced its direction without noticing the serene, eternal message? Or appreciating my spouse’s sweetness in hanging an uplifting decoration where it can be seen every day whether I choose to look or not?

The clay sun is just a tiny example of how powerfully everything is hitting me right now. I hesitate to describe the wrenching, simple joy I feel in my humble stucco house, or how potent my wife’s worried smile feels to me as she gazes at me typing here next to the fireplace. So many heartrending gifts that I take in every day but seldom really feel. So much life surrounds me, and so much of it has passed me by as I obsessed about past mistakes or future problems.

Well, it all may turn out fine. Maybe it was just a burst aneurysm. Maybe I can go back to ordinary life without fear that the next six months will trace a slow, agonizing spiral toward extinction. But either way, I now see the futility of complaining about the problems we face. They will end soon enough, whether we want to let them go or not. In the meantime, our task is to embrace this terrible, spectacular, agonizing, and gorgeous moment of living. Most of all, we must love everybody and everything that shares our time on this plane, while we still can.

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Seeing the Face of Life in the Face of Death was published on January 21st, 2012 . 9 comments






The Body Didactic

Too many of us grew up in families wracked with pain. Emotional wounds accumulate in settings of neglect, abuse, bereavement, molestation, violence, and misery. As adults, these ancient injuries undermine our happiness. We often choose poorly in relationships, careers, and pastimes. Even if we don’t make gross mistakes, we lack the confidence to endorse our own choices. We feel uneasy in good times and overwhelmed in bad. This is the legacy of childhood trauma.

At times we shut down emotionally, closing ourselves off from the affection we crave. Other times we act out and hurt the ones we love or destroy our own reputations.

Still, healing can happen after even the worst of upbringings. It takes time, and backslides are unavoidable, but eventually we stabilize in greater maturity and emotional openness than we ever imagined.

In the last post we highlighted the body’s gentle wisdom and how often we ignore it. As I move further along the path to peace of mind, the importance of befriending physical nature becomes ever more obvious. The injuries of the past are stored in our biology, where they affect every aspect of our lives.

For instance, upon remembering painful events from our past, our minds recoil in shame, anger, or sorrow. In equal measure, our bodies respond with corresponding feelings of hollowness, tension, or exhaustion. Just as emotional surges reflect the state of mind that accompanied past trauma, somatic symptoms recreate the physical feelings recorded at the time of the original hardship. Often, such emotional and somatic reactions arise without any conscious memory of the childhood injury that caused them. For example, when a spouse criticizes us, we may feel ashamed and small, or furious and explosive, without overtly connecting these responses to the parental harshness that first established the pattern.

Before we learn healthier strategies, our habitual response to distressing sensations is avoidance. We turn our mental spotlight away from our body’s messages. We may lose ourselves in thought and analysis, ignoring the cramp in our gut, the ache in our shoulders, or the shallowness of our breath. We may evade direct, felt experience by focusing on the actions and misdeeds of others. We may use the distraction of intoxicants, food, sex, or television as shields against painful emotional and sensual turmoil. We become skilled escape artists.

The solution can be found in the body. In fact, we cannot fully transcend our pain until we face its somatic legacy. At first, this feels excruciating. When we begin to tune into our bodily responses, we become aware of a sensory universe populated by knots, soreness, burning, blockage, agitation, and numbness. These discomforts are the physical counterpart to the emotional uproar that also arises. We discover how underneath our superficial and obsessional thought, our core system buzzes with anxiety, grief, anger, and fear. It all seems so noisy and confusing that we may find ourselves pouring a bowl of cereal with little memory of rising from meditation and heading to the kitchen.

The good news is that as we reacquaint ourselves with our bodies, the sensations become less intense. We relax into nonjudgmental awareness, which lessens the stimulation of tension and pain. It can seem like our systems shout less loudly when they have our attention.

Furthermore, we can learn to enter even the most unpleasant symptoms with an attitude of openness, acceptance, and love. In my own case, I experience deep, burning pain in my neck and upper back that worsens during times of stress. It is easy to hate this discomfort and resist it, but doing so only increases the misery. A better strategy is to move toward the soreness with focused attention and gentle affection. I apologize to my neck for all the times my activities harmed it. I feel compassion for its burden of muscle spasm, arthritis, poor posture, and neglect. I honor the hard work it performs in service of supporting my head every day.

By treating my body with the same care I would treat any beloved animal, I send a message of acceptance and affection to my entire being. The self-compassion resonates on the somatic, psychological, and spiritual levels. It feels profoundly healing. Often, the pain seems to abate with this practice, but the goal isn’t to alter my experience in any way. I seek only to honor my body and whatever it communicates.

All painful experiences can be approached in similar fashion. Crushing sorrow, vertiginous loneliness, shattering fear, and even livid rage can all be embraced with this attitude of loving, wise embrace. One finds that life is full of pain, but that this does not mean it is going badly. For as we open to our discomfort and terror, as we accept uncertainty and loss, we automatically increase our ability to feel joy, love, and spacious bliss.

The body will teach us the inexhaustible majesty of life when we surrender to both its wounds and its strengths.

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The Body Didactic was published on January 10th, 2012 .






Sorrowful Grace

Mental states become oddities once taken less seriously.

At the moment my heart feels heavy. Perhaps my dip in spirits amounts to post-holiday blues. Our Thanksgiving celebration turned out quite pleasantly, despite the anticipatory angst of recent posts. Today’s drop in mood temperature might be an automatic reaction to the heat of happiness, just as diminished energy follows a sugar rush. Sounds plausible, though with little effort I could ferret out more ominous explanations. But as I’ve stated before, elaborating reasons for depressed feelings often just amplifies the sorrow.

Instead, let’s return to the first sentence above. What happens if heartache is not judged as good or bad, or attributed to circumstance. What’s left? When verbal analysis is forgone, nothing remains but a vaguely unsettled mental state.

Imagine you had never lived through a summer storm, with its smoke-colored thunderheads and drenching curtains of rain. Imagine you had never smelled the ozone or felt the prickly static that precedes the arrival of such meteorologic turmoil. If you stood in open grassland and caught a scorched scent on the air, if you felt a rising charge, you would not know what it meant. The sensations might make you feel apprehensive, but they would not associate with any memory. You would not anticipate an approaching downpour. Rather than heading indoors or pulling out a raincoat, you might absorb these natural energies in a spacious and unprejudiced state. You would not predict anything, you would not act, you would simply experience.

This is how I feel today. Rather than letting my mind project catastrophe, or reconstruct grief, or explore my issues, I’m keeping quiet and feeling the sensations rise and fall like ripples on an infinite sea of awareness. Rather than giving them names and family trees, I let them roll past with neither history nor destiny.

With this attitude, mental states come and go, push and pull, build and shrink, but something (or someone) beneath the surface remains unshaken. The mind rests submerged in stillness: unstructured, boundless, timeless, and exquisite. This is not depression as I once knew it. This is Grace.

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Sorrowful Grace was published on November 25th, 2011 . 2 comments






Thanks & Giving

Thanksgiving Holiday has arrived, and upon reviewing my post from last night I feel moved to balance that critique with a more positive spin on the occasion. Yes, there is something unsavory about celebrating gluttony, but that is not the central point of the feast. The day is meant to highlight our good fortune, and why should I complain about that?

The Pilgrims were not frolicking in gluttonous abundance at the time of the first festival. They had merely survived a challenging predicament, and that was cause enough for gratitude. Also, their Native American neighbors had helped them persist in an arduous time and place, so they felt moved (we are told) to express appreciation to their new friends. (Sadly, the Europeans soon forgot their early dependence on Native wisdom and culture.)

In this era of declining expectations and imminent meltdown, it is easy to criticize the modern lifestyle that created our dilemma. But we in the West still enjoy much good fortune. Look at the shanty towns that spread across miles in many poor nations, often extending to the horizon like shattered versions of Los Angeles. Even the poorest in the USA eat better than the residents of such places, and only the homeless here dwell in similar rudimentary shelters. How could we consider ourselves anything but fortunate?

It is tempting to also highlight our so-called material advantages, like the internet and automobile. But considering how much time I devote to keeping these gadgets running, it’s hard to see them as blessings. I’d rather take care of goats and chickens than smart phones and routers. But should I refuse to feel grateful because my own excesses have disturbed my peace? Not at all. I am blessed in many ways, and today is a good time to say so.

In truth, we’d be better people if we expressed gratitude 364 days a year, and then spent one day taking everything for granted, rather than the other way around. Still, one day of thanks is better than none, and this is the official time for it. So let me say thank you for all of it.

All of it? Including the depression? The neck pain? The career loss? The financial uncertainty? The failures and humiliations? Age, sickness, and looming death?

Yes. All of it.

Take the neck disease, career collapse, and severe psychiatric problems that landed in my lap twelve years ago. You might think I’d rue those dark times and wish they’d never happened. Indeed, I sometimes imagine how my life might have proceeded had I been able to sustain my surgical work. Perhaps I’d have purchased a twelve meter racing sloop and renovated a Victorian cottage near Pacific Heights. Maybe I’d have dumped my lovely current spouse to marry a nubile model/artist/yoga instructor, with whom I’d have fathered 2.4 baby Einsteins. Possibly I’d be living in luxury, thrilled to be me.

But I doubt it. More likely I’d have grown covetous of the ketch in the next berth. Rather than appreciating my third wife at the breakfast table, I’d have angled my chair to ogle the twenty-somethings as they jogged along Jackson Street. Rather than enjoying San Francisco, I’d be wondering if life would be more fun in Manhattan. I’d have sidestepped relating to my preteen son by shipping him off to soccer camp in Switzerland. Sad to say, that is the person I might have become.

So what did my midlife crisis gain me, given that it deprived me of all that? It led me to launch this obscure blog where, miracle of miracles, I occasionally hear from readers who say they gained something useful by reading. They feel less alone and more hopeful. What a blessing it has been! And how could I have benefitted my visitors had I never suffered the depression, suicidal thoughts, psychotic mania, and panic attacks of years past? Those afflictions have granted me the ability to guide people who feel lost and defeated as I once did. I can offer suggestions to those who suffer emotional agony that is simply unimaginable to anyone who has not felt it.

So what makes me most willing to express appreciation? The fact that my life has taught me valuable coping skills that I can offer to others.

That is how I frame this Holiday. Not as an occasion for Thanksgiving, but as a chance to give thanks for the opportunity of giving.

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Thanks & Giving was published on November 24th, 2011 . 3 comments






The Most Wonderful Time of the Year?

Does anyone else find this time of year challenging?

Naturally, that was a silly question, but it still comes to mind. The self resists recognizing that individual distress generalizes to large segments of the human population. Rather than acknowledging the universality of my angst, I assume it to be personal and unique. Why is that?

Partly, it’s because so many people have family and I don’t. Aside from an aunt who lives in a distant state, there is no one I consider family left. Sure, there are a few cousins I rarely see, but besides my aunt there is nobody I’m related to who expresses genuine concern for my welfare. So as I watch many of my friends (and seemingly the entire Western world) arrange to spend holidays with family, the painful fact of isolation hits home. The problem is worsened by my wife’s identical situation: her family has passed on, too.

Why this should so deeply trouble me isn’t clear. After all, there was never a time in my entire life when I enjoyed a supportive family. Right from the beginning my home felt chaotic, dangerous, and/or grief-stricken. Why should I feel as if something has been lost? I never had a true family in the first place.

Yesterday I took a class at a holistic healing center in Berkeley. The teacher taught me some interesting techniques, and she seemed like a skilled healer. But then she asked me about my Thanksgiving plans. When I told her my wife and I would be spending it at our Quaker Meeting and not with family, she pushed on to inquire about my relations. After I explained that none remain, she expressed shock and dismay that a person could exist in this world without family. Not exactly the kind of uplifting message I expected in a center devoted to positivity and health. Am I really the only person without living relations?

Luckily, I’m getting better at taking hurtful experiences and transforming them into lessons. Although I admit it was a weak comeback, I told the teacher that by not having blood relatives, I’m made more aware of the fact that the entire world forms my family. Why should we separate the population into two parts anyway? Why divide humanity into those who matter, and those who matter less?

In addition to reframing my situation, I can now escape to that wordless space of consciousness that has become so familiar through meditation. When ordinary life feels too painful, I quit thinking about it. I find stillness within, where conflict ceases and only unity remains. This time of year, with its forced emphasis on the importance of family, is a good time for me to distance myself from society’s myopic value structures. Meditation gives me the necessary breathing room.

If we lived in a truly healthy culture, everyone would feel like he or she belonged, regardless of the details of family tree. In the documentary film, The Human Experience, an African villager states that if a child is orphaned, new parents are found by the community. No one is ever without family because the group takes care of all members in this way. Would that we lived by such communal ethics.

But we don’t. So this time of year pushes me to continue to accept and to grow. By healthy contemplation and focused meditation, I can embrace my situation. After all, if I don’t love my life for what it does offer, if I only focus on my lacks, I will remain neurotic and unhappy. But if I rise above the details that trouble, and honor the universal truths that support, I find peace of mind and soul.

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The Most Wonderful Time of the Year? was published on November 22nd, 2011 . 6 comments






Masters of the Universe, Masters of Mind

Almost a dozen years ago, as neck problems caused the implosion of my surgical career, my moods spun out of control. From my earliest years I had been highly emotional, easily wounded and often upset. My temper would flare without warning, but I could also settle quickly into good cheer. My instability worsened under the stress of child abuse, and I suspect my stepmother enjoyed pushing me into emotional collapse–a sensitive child must be the perfect victim for a sadist. By reasons of genetics and trauma, I entered adulthood accustomed to rapid and dramatic shifts in feeling. But in 2000 my moodiness rose to new heights. My lows became lower and my highs higher.

I presented twice for hospitalization. The first time I sought confinement as I became frightened by my growing determination to jump off the Golden Gate Bridge. In fact, frightened isn’t the right word, because I knew very little fear. The cold and collected way in which I was arranging my end dismayed me and led me to seek help. After two weeks the doctors discharged me from the first hospital, and I left feeling much happier. A bit too happy, in fact. The powerful new antidepressant worked quickly to elevate my mood, first into mild giddiness and then, five days after discharge, into full blown manic psychosis.

Psychosis was the technical term for the experience, and I suppose it describes well enough what the psychiatrists saw in me. But from my side, it felt like a series of the most profound and mind-expanding experiences imaginable. I heard angels, saw God, and met Jesus. A lifetime of habitual atheism evaporated. My entire perspective on the mystery and meaning of life was transformed.

But this post isn’t about that. It’s not about visionary experiences, the relationship between insanity and grace, or even the power of psychiatric medications. It’s about how quickly life’s value can seem to change. During that period of time, while all I’d worked for disintegrated, my attitude shifted so frequently that it must have been bewildering for my wife to watch. One day I’d be relieved to be free of the intense physical and emotional stress of being a surgeon. The next I’d despair at my bad luck in losing such a challenging and rewarding career.

I vacillated between feeling like the most worthless person on earth to believing myself blessed with knowledge known only to saints. I’d berate myself for myriad sins, then pride myself on my ability to see the heart of creation.

As all this went on, however, I wasn’t aware of my mind shifting very much at all. It was the world that seemed to change. It didn’t seem like my brain moved from its depressed state to its ecstatic one. Rather, the entire cosmos gyrated. One day it appeared to be hell and the next, heaven. One day the weather looked dismal, my future unfaceable, my past a disaster. The next everything glowed with preternatural radiance, my future looked limitless, and my past seemed like the perfect prelude to spiritual breakthrough.

Am I making this at all clear? Although I knew on some rational level that the problem resided in my nervous system, experientially the difficulty seemed to dwell in the outside world. It was as if the lenses through which I viewed the world changed from gray to rose when my mood flipped from low to high. I saw everything differently, but I felt like the same Will the whole time.

A similar process must explain why some people refuse to understand that they are in the throes of abnormal mentation. The person ranting at unseen tormenters believes himself in a hostile world; he doesn’t locate the problem in his own mind. When parents of young people suffering from schizophrenic conditions hear their children refuse to ‘admit’ their problems, they get frustrated and angry. But it isn’t stubbornness that makes this connection difficult. We simply cannot separate the world as it really is from the world as we experience it.

There is a deep point here about the human condition. Whatever it is that exists outside our brains, beyond our eyes, and past our skin, it is not the same thing we experience inside. We live in a reconstruction of the real world built from sensory input, memory, and conditioning. This is probably what the Hindus understood when they named the formed world Maya, or illusion. The cosmos may be real in material terms, but our experience of it is determined by far too many subjective and internal factors to be solid or reliable.

Consider this scene: two strangers sit on a wide, sandy beach on a warm day. They both feel the sunlight streaming onto their faces, and they both hear the surf’s watery heartbeat in equal measure. Imagine they both come from similar families and backgrounds. They don’t know each other, but they share like temperament and values. They are, in fact, nearly identical people. But just before sitting down, the person on the right learned that her beloved father died unexpectedly a few hours earlier. Do you think these two women are experiencing similar inner states? Everything surrounding them is the same, everything in their history is nearly so. But a potent bit of news has completely darkened the bereaved woman’s day. This time on the beach will ever live in her memory as a vertiginous epoch when her world felt upended, and a central pillar in her life gave way. The woman on the left may not think back on this beach scene at all.

This is the nature of human experience: wholly colored by interpretation and expectation; unfixed, unfixable, and and ever surprising. Catastrophe and delight waiting at every turn. Nothing reliable, everything mortal, and all beliefs vulnerable to contradiction. No wonder we go mad.

And no wonder the best path to sanity is to quit fighting. Only by letting the world have its way with us, by swimming with rather than against life’s currents, can we finally make progress toward stability. As an adolescent I spent much time bodysurfing off Southern California beaches. A lesson you learn early is to not fight a riptide, but let it take you where it will. Swim sideways to limit how far the current pulls you, but never confront the flow head-on. To do so is to invite exhaustion and possibly a watery death.

Life is exactly like those riptides, always tearing us away from what we thought was reliable ground. The gift of temporary insanity is that it teaches you that your mind determines the world, not the other way around. Sure, evolution, genetics, and upbringing may sculpt our inner processes, but after we are formed the internal shapes the external. This is why people get seduced by suicide. There is little thought given to the loved ones left behind. The mind is enthralled by the horrifying delusion that it can end a punishing world by ending itself; it thinks itself the Master of the Universe.

But no, the mind cannot destroy the cosmos, only the happiness of those nearby. But it can also, with proper motivation and instruction, reshape its own viewpoints so that life is finally understood to be magical, precious, and utterly mysterious, no matter what it brings. Our experience is an illusion, but it is one we create by our own thoughts and attitudes. Let us create a beautiful world. Let us be Masters of Mind.

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Masters of the Universe, Masters of Mind was published on November 9th, 2011 .






Faith in Faith

A blog is forever a work in progress, never a polished and completed tome. Unlike a book that gets reorganized and revised many times before publication, a blog flows with only a little more planning and control than stream of consciousness writing. Sometimes I write a series of posts in which each new piece serves as a corrective to the last. This is such a time.

First I wrote a post describing an approach to life that leads to peace with no dependence on metaphysical beliefs. Then in a second essay I remarked on numinous and nonverbal realizations that sometimes erupt in the human mind, and described their transformative value. At the same time, I cautioned against forcing interpretations on the resulting transcendent states of mind. In that second piece, I rather inexpertly equated faith with belief. I told of the dangers of combatting doubt with ‘blind faith’. In so doing, I sidestepped a subtlety I want to address now.

There are actually two different uses of the word faith in this context. In the first and shallower meaning the word is employed as a stand-in for belief. This is the species of faith that gets people and societies in trouble. It results in admonitions such as: “Don’t question your faith.” Its outcome is dogmatic sectarianism. Allegorical texts written in distant epochs and regions become deified as literal truth and the word of God. Because these ancient stories and precepts were written and revised by multiple authors, they are rife with internal contradictions. But the “faithful” are commanded to accept inconsistencies as indicative of God’s inscrutable ways. They are encouraged to defend a logically indefensible belief system. This sort of faith resides in the egoic, verbal mind. In the worst case, it leads to violence.

The second, deeper, faith is gentler and heart-derived. When we see people who weather terrible suffering with grace, we are watching such faith in action. There may or may not be a particular religious belief system at work, but peace in the face of terror arises from heartfelt confidence in cosmic ‘rightness’ that arises from the deeper wells of human spirit. It is faith that the universe is so lovely and mysterious that the only sensible stance is to surrender before its howling gales with awe. It bespeaks a tender relationship with life that makes no demands, but accepts the gift of every living moment.

This second, organic faith underlies the awareness of cosmic interweaving that I proposed as a basis for inner peace two essays ago. It is the ultimate fruit that grows from the intrepid kernels of mystical awakening I mentioned last time. When fully developed, one stands humbled before the magnificent complexity and timeless beauty of cosmic unfolding. One lives as the willing and admiring flesh of the earth and no longer struggles against fate.

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Faith in Faith was published on August 2nd, 2011 . 2 comments






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