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 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 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 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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Cells in the Body of Life

These points of light are mostly galaxies; the entire field is the size of a full moon.

What makes a successful life? As we enter an era of decreasing expectations and lowered living standards, we can welcome the growing recognition that focus on material accumulation fails to deliver lasting contentment. The Protestant ethic of ambition and accomplishment likewise is proving unreliable, as it becomes harder and harder to achieve amidst intensifying competition.

Of course, by midlife most of us recognize that satisfaction more reliably derives from aligning life toward love. We appreciate the comfort gained from attending to our circle of friends and family.

So can life be considered successful if we develop deep and abundant relationships? Certainly these go a long way toward creating happiness, but an intractable problem remains. All our loved ones are mortal. Tragedy could strike and unexpectedly deprive us of those we hold most dear. And even if no unexpected calamity occurs, the relentless passage of time will eventually sever all our attachments.

Furthermore, there are those who simply lack personal connections. Many of the elderly end up isolated. Some people have suffered so much wounding that they feel uncomfortable in relationships. And all of us eventually must cross death’s threshold alone.

So although caring for others is uplifting, we should seek another measure of living well. Otherwise, those who suffer losses and traumas might believe that life has failed them, or they have failed life. This would be both tragic and unnecessary.

As a first step, we can expand our arena of concern to include people outside our immediate social circle. If we are fortunate enough to be able to help others who are struggling, much fulfillment will follow from doing so. But even those unable to assist can find comfort in a meditative awareness of their connection to all who dwell on this earth. When fully realized, such studied wisdom can fortify the heart against loneliness and despair.

For instance, one can vicariously enjoy the pleasures of strangers. No matter how painful our own situation, someone, somewhere, is falling in love, or getting to know a newborn child, or laughing and dancing with friends. If we recognize humanity to be of one body, and not seven billion, we can participate from afar in this ceaseless fountain of joy.

Of course, there is a wrinkle here. If we become viscerally aware of our interconnection, if we believe in unity at the level of soul, then we must also temper the joy we feel when fate treats us well. If we experience good fortune, we will appreciate it and yet remain distressed that suffering never ends. Someone, somewhere, has just lost the love of his or her life. Many beloved children die every day. Natural disasters destroy whole villages.

Developing appreciation for the interweave between ourselves and the entire collective of humanity, and indeed all biological forms, is a healthy goal. In our dismal moments it can uplift us, and in our most abundant epochs it can humble us. Either way, however, we do not find the lighthearted satisfaction we once valued. Instead, we plunge into the turbulence of organic nature with all its rejoicing, tragedy, death, and irrepressible fertility. This is not happiness of the usual sort, but a kind of endless heroic storm.

So if the most expansive embrace of others will awaken us to nearly infinite psychic turmoil, must we abandon universal love? Obviously, that is not the point. Instead, we need to ask if we hold correct assessments of grief, disappointment, loneliness, despair, and all the other seemingly negative feeling states.

Our culture remains immature. Advertising firms promote values of youth, wealth, material possessions, and pleasure. No products (except antidepressants) are marketed with models displaying frowns or tears, because unhappiness and grief are considered undesirable, if not moral failures. The unmistakable message is that if you aren’t affluent, beautiful, and bubbling with delight, you’re not successful.

This misplaced ethic used to upset me, but now I am able to smile at our society the way one indulges a child. The average person simply doesn’t understand that life never ceases displaying beauty. The most despairing moment is sometimes nearly radiant with a mysterious and sorrowful esthetic. After all, it is the poignant loveliness of tragedy that motivates the most affecting and enduring literature and art.

Fortunately, there is a growing minority of folks who understand. In every city meditation teachers are slowly leading the population toward a more accepting and openhearted perspective on the ups and downs of life. Books roll off the presses with inspiring messages that help people see their hardships as manifestations of grace.

Of course, we are left with many problems no matter how much we surrender into the world’s vigor and tumult. In particular, we confront the exploitation, greed, and cruelty that so often damage lives. I suffered the effects of this selfish and sadistic aspect of human nature during my upbringing. And yet, despite some harrowing memories, I no longer feel that the abuses were unmitigated injuries. In many ways they became my most potent kernels for later blossoming. So although the vicious tyrants of the world are undeniably corrupting their own souls, in the end they may be providing a painful but crucial fire that tempers the core essence of those they harm. This doesn’t excuse evil or imply we shouldn’t resist it, but it does offer a more nuanced comprehension that might make us hesitate before we assume the universe has been badly made because it contains such darkness.

I realize that there are other popular modes of grappling with the human condition. I’ve worked my way through many of them in my search for peace. But so far every other approach has disappointed me. Material accumulation, professional achievement, and romantic attachments have all let me down; if they had not, I’d probably still be a surgeon dwelling in an oversized house. Living from a sense of personal importance while striving to satisfy desires has never worked for long; sooner or later I fail in my goals or tire of my conquests. Although religious belief provides solace for many, I’ve found faith in anything more particular than vague mystical currents difficult to maintain in the face of disappointment and loss. Only humble recognition of my small but engaged role in this kaleidoscopic universe has led to stable peace.

Why does this awareness succeed where other systems failed? Because it depends only on the obvious facts of biology and society. The air we breathe, water we drink, and food we eat are all endlessly recycled through our bodies, passing from one organic form to the next and from person to person. Our genetic code unifies us in an incontestable way: we are indeed one family of life. On a social level, we depend entirely on others for goods, power, housing, roads, and every other convenience and necessity. I often feel moved by deeper and more spiritual links between my inner consciousness and the outer living world, but the factual and profound interconnection that I find so sustaining does not depend on mysticism.

Although many lead valuable lives without understanding the full scope and scale of our glorious predicament, anyone who learns to see the big picture in this way can feel successful. With such awareness it doesn’t matter if you live in a mansion or a hovel. It doesn’t matter if you are loved by many or nearly alone. You know you are but a small piece of something enormous and myriad-faceted, and that any experience at all is both magical and essential to the whole.

This is my felt reality. It is not theoretical. Admittedly, there are times when I forget and slip back into the murky nightmare of isolation. But more and more often I remain in touch with this immanent fact of life.

Whenever I start thinking of my personal situation as overly significant and my trials as unbearable, I remind myself of this fact: With some seven billion humans on earth, reciting each individual’s name at the rate of one per second would take more than two hundred years!

How important can any of our trials really be in such an ocean of humanity? The most reliable way to find solace in the face of this awesome truth is to welcome our vital and dynamic immersion in the vast and abundant whole.

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I’m Happy For You

RedTailedHawk

Sympathetic joy is the term used in Buddhism to refer to the happiness we feel when others experience success. The precise opposite expression would be Schadenfreude, a German word that indicates pleasure at another’s failure. Most of us have probably felt both, and most of us recognize that the former is an elevated and noble sensation, while the latter is base. Sadly, unexamined human nature is more inclined toward schadenfreude than sympathetic joy.

The good news is that one can easily train the mind to abandon its selfish tendency to favor its own happiness over that of others. I’ve written lately about the value of sorrow, and I’ve tried to make clear that bereavement and disappointment are unavoidably painful, but can even so be experienced as beautiful. One reason grief carries such a rich seasoning of grace is that it is universal. We all know the pain of losing something or someone we love. This sense of shared experience can be the seed of sympathetic joy.

On a recent meditation retreat, I several times visited a shrine where visitors have placed mementos of the people and pets they’ve lost. The altar is adorned with images, poetry, dog collars, amulets, and other tokens of love and memory. Almost every time I stood before this sacred accumulation of sorrow, my eyes brimmed with tears. It’s not that I ever knew the young woman with lovely large eyes smiling from a faux-antique print, who died earlier this year at age 24. I never met Alex, whose snare drum rested with a poem written on it by someone he left behind. The perky Chihuahua in a photo next to its cedar box of ashes looked a bit like my own dog, Emily, but other than that had no connection to my life’s narrative. So why was I so sad?

I was mournful because the pain expressed by these sacred offerings is universal. It is the bereavement I know well from losing my thirty-seven-year-old mother in first grade. It is the complicated mourning I experienced when my alcoholic father died in 2003. It is the grief I remember from the time my Pomeranian was killed by a large dog on a beach in San Francisco at 6:00 in the morning. It is familiar and shared by us all. It is tragic, but it is also the kernel of life’s beauty.

By recognizing the universality of emotional experience, we can begin to cultivate sympathetic joy. We soon find that it’s not a grudging acceptance of another’s high spirits, but a kind of benign theft. We discover that the ecstasy felt by our fellows can be brought into our own heart. There is no loss to the other party, and a great gain in our own treasure.

On a hike a few days ago, I passed a young couple glowing with the pleasure of early love. The girl smiled broadly at the sight of a soaring red-tailed hawk, and her boyfriend’s face shone with the pride of an infatuated lover. I hate to admit that not long ago my reaction might have been envy. A man in his fifties knows that such passion will never again come his way. Even were he to initiate a new love affair in later life, and even if he took a mate three decades his junior, it would never recreate that joy of youth. But because of my recent meditation and work on expanding my heart, I felt nothing but absolute delight. I recognized that happiness is still exquisite, even if it’s not ‘mine’ in the narrow sense of the word. This couple’s good fortune was not only something I could appreciate from afar, it was actually pleasure that I intimately shared as a member of this grand human consciousness.

When we recognize the universality of life, loss, and love, we become larger beings. Our hearts swell to encompass so much more than our own little stories. We become vessels for the entire human drama, and we understand the eternal nature of life.

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