WillSpirit

Where Will meets Spirit
∞ A Blog Devoted to Balance, Peace, and Clarity ∞

A formerly depressed physician tells stories of trauma, grief and recovery, and offers suggestions for emerging from darkness, living with mood swings, and awakening to life.








  • 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.




Peace, Boring Peace

My last post talked about my encounter with emptiness, and how it has disoriented me. I phrased the dilemma in Buddhist terms, but I also pointed out that although much of that tradition appeals to me, I don’t define myself as a Buddhist. I resist such self-labeling for a couple of reasons. The Buddha himself, I suspect, would have discouraged people from defining themselves that way, or any other way. In addition, I want to remain wide open to other sources. In particular, I maintain loyalty to my Quaker roots. (The Religious Society of Friends figured largely in my ancestry, and that faith has helped me ever since I first questioned my atheist upbringing in the 1980′s.) In taking up the trade of acupuncture I’m encountering philosophies that, although not incompatible with Buddhism (since they are Eastern in derivation,) are undeniably different. In this as in all things, I like to foster a receptive mind, while picking and choosing what works for me.

During an appointment yesterday, my acupuncturist offered me an alternate way to frame my current angst. He pointed out that one can grieve for negative influences almost as much as positive ones. I know this firsthand from the death of my stepmother. I went through a clear-cut grief process after her departure, even though I don’t miss her in the slightest. She treated me kindly on only the rarest of occasions, and could usually be counted on to deliver a cutting comment that undermined whatever was most important to me. Add in her breathtaking cruelty toward me when I was little, and you’ll understand why I primarily felt relief when she died. And yet, I also felt bereaved.

The loss this time is not of a person, but of a battle, or a war. For as long as I can remember, I’ve been fighting psychic demons. Self-hatred, discouragement, bitterness, fury, confusion, grief, doubt, and many other painful mental states have often threatened to consume me, and I’ve attacked them all, tooth and nail. An enormous amount of energy was expended in this ceaseless assault against my mind’s weather. How could it not be all-consuming to wrestle the incontrovertible fact of one’s emotional condition at every moment? I finally understand the futility of my lifelong struggle. If one feels something, one feels it. Why not just settle into the experience? Then one will have more energy to pursue thoughts and actions that might foster better frames of mind. But it’s a waste of effort to fight the emotion that’s already in place, or to bemoan the past, or to fear the unknowable future. Change happens with action, not fretting. But I have made a religion out of fretting.

No longer. I simply don’t feel the internal pressure and outrage anymore. I can sit comfortably with sorrow, or disappointment, or any of the other other so-called negative emotions, and wait for it to pass. Each discomfort passes away. And then it comes back. I see that now, and I’m OK with it.

Which leaves me standing on a silent battlefield, in full war regalia, with no enemies in sight. It’s as if an exciting, epic Hollywood war movie suddenly came to an anticlimactic ending. The enemy vanished without warning, as did the allies. The war and the armies disappeared. You can see how that might be a little disorienting.

Now what? I don’t know. The only thing I can think of is to reach out to others, to help them gain the same insights into the futility of fighting reality. In my current dullish frame of mind, I almost wonder if offering this will truly be a kindness. Maybe it would be better to let others remain in maximum battle mode. Then I remember that I know peace now, as I never have before. If the price of serenity is a bit of boredom and grief, it is worth it. At least I find the bargain fair, and I believe others should be offered the same emotional armistice. Some will no doubt choose to pursue a better victory rather this slightly unfulfilling stalemate. They are welcome to fight onward. Others, I am sure, will welcome the freedom to live with a peaceful mind. And yes, peace can be a bit boring.

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A Moment of Calm as if Before a Storm

She is smiling from chin to brow.
He is jumping on the bedspread in baggy toddler overalls.

He is laughing as if he will never stop.
She is holding his hands as if she will never let go.

His eyes are not sunken with grief.
Her smile has not vanished forever.

She has not hidden in this bedroom for the past six months.
He is not choking on her stale cigarette smoke.

No one has clamped electrodes onto her skull.
No one has tried to shock her out of her sorrow.

She has not lost interest in her son.
He has not lost faith in his mother.

She is still smiling and he has no reason to be afraid.

(Based on a photograph.)

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Sweet Sorrows

Romeo_and_Juliet_last_scene

Very often a person who suffers a major setback later describes the once-bitter cup as a fount of unexpected rewards. The loss of a job leads to an enthralling new career. The dreadful illness guides a patient to unprecedented fulfillment helping others with the same disease. Bereavement opens the heart to awareness of the fragility and preciousness of each day alive.

Suffering leads to growth; we see this all the time. One year of hardship will do more to mature a person than a decade of ease. Those who have suffered little often have trouble understanding those in pain. Tragedy releases wellsprings of wisdom, empathy, and art.

Yet we bridle against loss and injury. We grasp desperately for security, and yearn for freedom from depression and grief. We take drugs or overwork. We distract ourselves with orgasms and shallow entertainments. We accumulate possessions and bank accounts as hedges against want. We even fear the only thing certain in life: death. The core of western living is a ceaseless and futile battle against the inevitability of loss.

Sorrow is not a demon. Those who can embrace uncertainty and impermanence, and stand ground as what they fear approaches, are the strongest and most peaceful among us. Sorrow is a teacher.

Grief is not the only emotion of value, or the only source of understanding. But when we quit running from pain and loss we find they connect us with the human condition, help us deeply appreciate every moment of happiness, and enrich our souls. Sorrow is not the enemy of a fulfilling life. Instead, it is the shadow that highlights the bright outlines of joy.

It took me five decades to accept what I’ve known all along: many of my most painful experiences were also the most valuable. I now recognize my cruel and grief-stricken upbringing as the crucible that tempered the most sensitive aspects of my personality. Adult losses and humiliations that once threatened to crush my spirit now look like crucial pruning.

I don’t mean to romanticize the process. Much of my life felt like hell as it happened. But all that remains, and all that ever remains, is the current moment. From the vantage of the insistent present I look back on all my disappointments, and foresee much pain that I will likely someday suffer, and understand loss and sorrow as mentors that awaken me to the human drama. What’s more, they have opened my eyes to the eternal equality of sweetness and tragedy in life.

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The Value of Sorrow

SpanishAmericanWarDead

My previous essay promoted acceptance as a sure path to inner peace, and as a route to transcend the concept of mental illness. By fully embracing our lives, and ourselves, we are freed from the misery that comes from wishing things to be different.

For instance, depression is uncomfortable, but one can live perfectly well while feeling quite low. Only when we fight against the sadness, and judge ourselves because of it, do we find ourselves hating life. If we can accept the darkest depths of our mood swings, and move through them with grace, we can find satisfaction, fascination, and even inspiration in our experience.

Unfortunately, our culture does not endorse this view. Everywhere we look we see the message that a successful life is a happy one. Electronic screens of all sizes show us smiling, beautiful people loving life. How could one ever believe that a person who often gets flooded by tears and sadness is succeeding in modern society? Can we imagine those lovely models crippled by anxious worries? In real life, of course, the models probably suffer just like the rest of us, but on the screen all is happiness and light.

From the earliest ages we are led to discount the texture and wisdom that come with disappointment, injury, and bereavement. Sadness, we are told, is for losers. Yet some of the greatest artists and innovators have been burdened with depression and other so-called psychiatric symptoms. If these feelings are so awful and destructive, how come they occur so regularly in the greatest minds?

Acceptance does not mean acquiescence to injustice or destruction. It simply means living with full understanding, and without hating any part of our experience. If we can act to prevent future harm, we should do so. But whatever injury has already occurred is now part of the universe. Resisting it only creates tension and dissatisfaction; it does not change established reality. Whatever is here in this moment can be embraced, even if our intention is to prevent anyone else from suffering a similar fate. By accepting our current lives and minds, we can grow and learn and teach. Despite the pain, loss, and sorrow, we can enjoy this brief time we have to live as humans.

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What’s to Celebrate?

100thCelebration

(This post was revised as of 7 January 2010, 13:45 PST.)

This is post number 100. A commemorative essay about all the wonderful things blogging has taught me seems in order. But I’m not in the mood.

Mystical themes come to mind. More of my transcendent moments demand to be shared. I’m brimming with ideas about peak experiences. But yesterday sucked. I don’t ‘feel spiritual’. (Note: see the comments on this post regarding the distinction between emotional feelings of spirituality, and the moment-to-moment fact of our spiritual natures.)

The problem was my appointment with an ophthalmologist. As it happens, she started working at my old department at Kaiser soon after my departure. We’ve spoken several times, but yesterday she seemed to have forgotten. I was ‘just another patient’, which happens more and more as time passes. Before, most of the doctors and staff at my local Kaiser recognized my name. And when you’re a Kaiser physician you get a gold-colored membership card to identify you. So the service used to be, well, gold-plated.

What a difference a decade makes. Now I get treated like everyone else. It should have been like that all along, of course. If Kaiser doctors could see the system through the eyes of ordinary patients, they might work harder to improve the experience. Until recently, it was difficult for me to understand why so many people complain about Kaiser. Now, without the coveted gold card, I feel like ‘just another body’.

The technicians were brusque and dismissive. The visual field operator refused to show me the results of my study. He was neither polite nor apologetic. When the next technician came to put dilating drops in my eyes, I asked her if we could dispense with the dilation, because it would cause me to lose a day of writing. She told me dilation was ‘required’ by the doctor, and necessary for good photographs. A moment later she lined up the camera and took pictures, long before the drops took effect.

Later, during a quick exam, the ophthalmologist used two lenses that I know require dilation. But I also know that she could have assessed my issue without those instruments. Nauseous and unable to read or write, I came away with deep resentment about how the technician did not slow down, get the MD, and allow for a reasoned discussion about the need for drops. The fact it was my own fault for not being assertive left me feeling even more frustrated.

The doctor spent less than five minutes with me, and seemed confused about why she sees me every year. I understood she felt harried, and she did not do anything technically wrong. Still, I disliked the assembly line style of care.

In truth, grief and regret were the real reasons the saga bothered me. Ten years have passed since the last time I worked as a physician in that department. All the old people are gone. No one remembers me. Instead of being an important guy, a subspecialist getting referrals from all over Northern California, I’m just another patient who gets pushed through in minutes. Although I sometimes think my ego has toughened, and can thrive without those old props, it is clear that part of me still hurts. With a hard-won career in ruins, it’s troubling that others perceive me as nothing but a washed-up surgeon with a crippled neck and major psychiatric problems, living on disability.

No matter how much progress my psyche makes, it remains vulnerable. Careless words, bored facial expressions, abrupt treatment in the clinic, all these things get to me.

Anyone watching my trajectory for the past four years would say that my condition has greatly improved. Consider what happened over a short period starting ten years ago: I lost my career; nearly committed suicide; spent time in two different mental hospitals; suffered a psychotic break; learned that my severe chronic pain could not be cured; had reason to believe my spinal cord had been damaged; almost lost my marriage; had a lawsuit settle against me; moved out of the city I’d called home for sixteen years; and began accumulating distressing medication side effects. Over the subsequent six years, my body grew into an obese caricature of its former shape, I failed at three new career directions, and dreadful hormonal imbalances struck at the core of my identity as a man. My father, two good friends, and my stepmother all died (losing my abusive stepmother led to a lot of emotional conflict, complicated by anger that her will deprived my sister and me of most of my dad’s estate). My spirits sank and sank. In recent years, thankfully, I’ve started to turn things around. I’ve lost fifty pounds, gotten at least some of my sexual identity back, and have learned to forgive myself for the early retirement. I’m writing regularly, and beginning to see how my wife and I might scrape by financially. My flight path is climbing, and most of the time I soar above the clouds.

But yesterday hit me hard. By the time I returned home my mood had plummeted. Everything looked blurry and my stomach churned. Unable to sit at the computer, unable to read a book, unable to go outside (too bright, even with sunglasses), I became bored and angry. Most of the afternoon passed with me curled up on the guest bed with one of the dogs. We laid together in the dark, and felt sorry for ourselves. (Actually, Ralphy probably felt fine, getting all that attention.)

So it wasn’t a banner day. I would feel fraudulent writing about grand spiritual ideas after an afternoon like that. And celebration is more fun when you feel celebratory. Today, I feel hammered and bruised. But the morning is just getting started. I’ll walk the dogs, go to the gym, spend the afternoon writing, and try to get back on track. As they say in AA, “Progress, not Perfection.”

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