With luck, I’ll be leaving the hospital tomorrow. A long convalescence stretches before me, starting with a minimum of two weeks without any sustenance by mouth: I’ll be receiving nutrition only via intravenous infusion. An X-ray after the first fortnight will show whether my intestinal blockage has diminished so I can start to add in actual food. I’m hoping for the best in that regard, since the alternative will be surgery to bypass the obstruction.

My body has been weakened by this episode. After a week of starvation I have lost both abdominal fat (yeah!) and muscle mass (ouch!). How completely I can regain my conditioning while being fed with milky fluid streaming directly into my heart remains unclear. Most likely, robust health will only begin to return once I’m on solid meals.

A friend visited yesterday morning and I told her that my default position on hardship is that it teaches me about life. Looking at setbacks this way is my main mechanism for sidestepping discouragement. You’d think, perhaps, that simply living through this life-threatening episode would be sufficient, but I’m perverse enough to still worry about the fate of my acupuncture practice. And I’m carnal enough to feel frustrated that I couldn’t join my wife last night as she ate at a restaurant with friends. Only by seeking meaning can I quell the riot of discontent.

How can we be sure meaning even exists? Some of us are convinced the universe is random and pointless; others believe in a creative God; many find comfort in spiritual practice but resist religious dogma. Whether reality as a whole seems of deep significance varies accordingly. But there is a difference between unveiling the purpose of the entire cosmos versus finding meaning in the stories of our individual lives. We can all discover meaning in this smaller sense of the word.

In Man’s Search for Meaning, Viktor Frankl paraphrases Nietzsche: “He who has a why to live for can bear almost any how.” My own personal why has become a quest for ever broader understanding of human life, suffering, and fortitude. This means I look for patterns in the cosmos that illuminate our daily lives. It means I examine when and how difficulty gets transmuted into wisdom. And I investigate why most of us continue to value life despite its trials.

Here is one pattern I’ve tried to keep in mind throughout this ordeal: all living things are connected so intimately that it is artificial to conceive of individual persons as separate from the whole. The appearance of division is superficial, whereas the reality of unity is profound. All that I experience is part of what everyone goes through, and vice versa. As a result, I feel less alone and beleaguered. This conviction that life is shared greatly reduces my sense of suffering. Moments of hardship are like the troughs among ocean swells: they are transient depressions that blend seamlessly with the peaks. At this moment I may be far from the higher, more pleasurable heights of living, but somewhere out there a couple is making love for the first time, or cradling their new baby, or sitting on a veranda appreciating nature and retirement.

Here’s what this disease taught me about how hardship can transform into realization: When pain gets extremely intense, past and future recede from consciousness and only the present moment remains. During my most agonizing hours of abdominal pain and vomiting, I no longer worried about my acupuncture practice, or even whether I might have cancer. I remained utterly fixated on my body and its insistent sensations. Since absolute present-moment awareness is the goal of many meditative practices, I see the tendency of intense pain to focus the mind as a surprising consolation prize that ameliorates its awful sting.

And here’s something I’ve known intellectually but understand on a deeper level after spending so much time on an inpatient ward, where the mostly elderly population deals with so much disease and discomfort: No one gets through life without hardship, illness, and death. It may seem that the first two get distributed unevenly, but sooner or later every person sees his or her share of life’s dark side. And yet, everyone also enjoys moments of contentment and affection. Life is not as unfair as it seems, since all are privileged to live it, all must cope with infirmity and mortality, and all discover moments in the sun.

These observations place my current difficulties in a larger context. I see how my tribulations are balanced by others’ joys. I appreciate that pain connects me with the instantaneous jolt of life. I recognize that illness and death are universal, but so are pleasure and love.

This major illness has proven a wise teacher. How much it has enlarged me! Even though my recent problems have been uncomfortable and disruptive, I see so much meaning in them that I feel grateful. Because I find lessons, I embrace my troubles despite the agony, uncertainty, and grief.

Do my words sound like hollow rationalizations? I suppose people will interpret this essay according to personal beliefs, but I’m sincere when I say that these perspectives helped me find precious moments during the past few weeks, despite the arduous challenges.

Many times in years past I believed my trajectory so punishing that I planned to truncate it. Now that I’ve learned to create meaning out of those same hardships, I can’t imagine wanting to shorten this spectacular span of living.

With luck, I’ll go home tomorrow. With Grace, I’ll keep seeing humanity as shared, imminent, and balanced even as my life gradually returns to normal.

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.

Acceptance underlies most of my recovery from what was once diagnosed as bipolar disorder.

As earlier posts have made clear, I no longer buy into the concept of ‘mental illness’ because the phrase refers to putative brain disorders that are viewed as irreversible. My recovery demonstrates that my formerly intense moodiness did not result from a structural or genetic neurologic condition, but rather from errors in relating to the chaotic vicissitudes of life. My instability resolved once I learned to accept my experience, no matter how painful.

Healing through acceptance used to be a common theme in my blogging. I learned from those earlier posts that many people feel uncomfortable with the idea on first hearing. In fact, I resisted it myself. Aren’t some things in life simply unacceptable?

In working to make the concept sound, well, acceptable, I’ve tried a number of strategies. One that seemed effective was to distinguish between acceptance and acquiescence. In this context, the former means embracing what can’t be changed. The latter refers to giving up. Most of the time we feel calmer when we quit fighting the unavoidable, but first we should be sure we aren’t yielding to something we can effectively work against. In political life especially, a state of affairs can appear as fixed and unchangeable, but if committed objectors band together, the edifices of power frequently topple despite their apparent solidity. It is a mistake to acquiesce to injustice on the grounds that it can’t be rectified. It can.

One key distinction is between past and future. Obviously, anything that has already come to pass might as well be accepted. It can no longer be changed. On the other hand, those events that have yet to manifest can potentially be influenced. The degree to which we can change what’s coming varies, as does the effort we feel ready to exert in trying.

If our home is engulfed in flames, we probably can’t prevent its destruction. To stay calm in the face of this disaster is to accept the inevitable. It would be foolish to run in with a garden hose if the building appeared doomed. On the other hand, a child trapped inside might compel us to attempt rescue even in the face of grave danger and high likelihood of failure. Either way, we’re talking here about responding to an unfolding future, which is fundamentally different from making peace with the settled past.

We always have choices to make, and we should only accept an approaching problem as inevitable when we have worked as hard as makes sense to divert it. We don’t waste effort on minor inconveniences, and we don’t give up on important causes. But whereas our relation to the future involves important judgment calls, our relation to the past truly does not. For instance, once a tragedy has occurred we can no longer prevent it. Our only choice lies in how we cope with misfortune. And the first step in adapting to past events is to accept that they have occurred. Why rail against manifest fact?

In mindfulness meditation, we learn to embrace what we call the ‘present moment’. Note how we can spot a subtle misnomer here. What we are actually experiencing is not the present, but the near and immediate past. Granted, rather than remembering last year or anticipating next week, we pay attention to sensations and mental life immediately as they occur to us. In doing so we may feel like we are attending to ‘right now,’ but in truth we can only feel something after it has happened. The true ‘present moment’ is an infinitesimally short interval that always lies just ahead of conscious awareness.

If a breeze caresses your cheek, you feel it not when it actually happens, but microseconds later, after the neural impulses reach your consciousness. And as the sensual experience of ‘wind on cheek’ registers, there are a few cycles of awareness that occur extremely rapidly, often before we are fully awake to what’s happened. Watching this early processing is the closest we can come to living in the moment. We can’t attend to the breaking edge of ‘now’ because it happens much too quickly. One picosecond later, and we’re already in the past.

This simplifies the task of acceptance. Any process we seem to be experiencing this moment (but which is actually already in the past), and any event more clearly historical, can be safely accepted without fear of slipping into the acquiescence trap. It has already happened and so it is unchangeable. The healthy choice is to honor it as a reality.

We may have an obligation to prevent future reoccurrence of mishaps or mistreatment, but events in the past are solidly fixed in history. I wrote the most recent poem on my blog with this in mind.

It helps me to visualize the eternal now as a membrane that rides the forward wave of cosmic unfolding. To the rear of this infinitely brief moment lies the past, while to the front lies the future. Everything behind the ceaseless sweep of history’s curtain is grist for acceptance. Everything ahead should be evaluated for action. Mindfulness means riding the trailing edge of time’s membrane as the potential coalesces into the actualized. We hold in mind the goal of accepting every experience which the fleeting fabric of now has moved beyond.

We can start with the simple serenity prayer:

Grant us the serenity to accept the things we cannot change,
The courage to change the things we can,
And the wisdom to know the difference.

One step toward gaining discerning wisdom is to be mindful of the boundary between past and future. We remain alert to the Membrane of Now.

Does brain science help us? In times past, I never doubted it. Then, last week, I attended an all-day seminar about the neuroscience and clinical management of destructive habits. Afterwards, I found myself wondering how much our massive research into the brain’s activities is really benefitting human life.

The neurophysiology of addiction has been studied in depth, and the lecturer talked a lot about it. Dopamine secreting neurons in the ventral tegmental area (VTA) send messages to the nucleus accumbens apprising it of opportunities in the environment. The accumbens integrates all of its inputs and either releases the basal ganglia (e.g., the striatum and substantia nigra) to indulge in a habitual action, or restrains them to abstain. Drugs of abuse, especially those that act directly on dopaminergic neurons (e.g., cocaine) are acutely habit forming because they trick the brain into thinking a tremendous payoff will result from their ingestion.

This brief sketch belies an enormous amount of investigative work. Countless scientists now study addiction, mental illness, and brain science in general. Pharmaceutical marketing and popular media have celebrated how this huge and costly investigative effort has yielded many advances for treating psychiatric disease, substance abuse, and neurologic problems. But has the clinical payoff really been that high?

At the seminar, when the presenter started speaking about the treatment of addiction, rather than the science of it, there was a shift in emphasis. Medium spiny neurons and dopamine physiology dropped out of the discussion. Instead, we heard how changing social groups is important, so addicts can find support for abstinence rather than peer pressure for addiction. We learned how alcoholics should clear their homes of booze. The speaker extolled healthy activities like exercise and yoga. She strongly endorsed mindfulness meditation to improve tolerance of uncomfortable emotional states.

Sure, there was a section on drugs that treat addiction, like naltrexone for alcoholism, buprenorphine for opiate dependence, and mecamylamine for nicotine cravings. But in each case we heard how the medications won’t work in isolation, and instead need to be part of larger programs of behavioral management. In other words, they aren’t miracle cures.

What are we to think when the brain science sounds so sophisticated, but the best treatments remain based on common sense (e.g., change social networks), or come from ancient wisdom traditions (e.g., meditate)? Can we conclude that brain science has resolved much mental distress? To me, it would seem premature to assert that neurophysiology has greatly helped us in day-to-day life.

I say this as someone who underwent cutting-edge psychiatric treatment for many years. A prominent Bay Area psychiatrist managed my mood issues with as many as six medications at a time. I seldom questioned her advice when she added another drug, or increased the dose of one that clearly wasn’t working. Only as side effects overwhelmed me and my productivity plummeted did I finally begin to question her strategy.

Unfortunately, it took a long time for me to realize that I’d be better off with meditation than medication. Now that I no longer use pharmaceutical support, I see that although drugs help in crisis situations, they often serve poorly as long term treatments. Don’t take my word for it. Robert Whitaker’s book, Anatomy of an Epidemic, shows clearly the many shortcomings of psychopharmaceuticals. Whether we speak of addiction management, or treatment of depression, or assisting schizophrenics, the sparkling promise of brain science remains largely unfulfilled in clinical terms.

Understand that I studied synaptic signal processing as a biophysics graduate student. In medical school I took most of my elective classes in neurology and neurosurgery. I’ve educated myself about the nervous system ever since. I’m well aware that neuroscientists have collected impressive quantities of information about the brain and its component parts. As an intellectual enterprise I continue to support this research. But we need to recognize that genuinely safe and effective treatments have not so far been forthcoming.

It frustrates me that despite this limitation, it has become difficult to say anything about human behavior without invoking the findings of neuroscience. Although meditation clearly helps people cope, and has done so for millennia, its benefits now need the imprimatur of functional MR scanning in order to be accepted. Although building positive activities into one’s lifestyle can assist with battling addiction, we apparently need to hear this common sense advice framed as neuroscience before we’ll take it seriously.

If it were just a question of objective science validating ancient wisdom, I’d have no complaint. But because of the neuroscience perspective, human behavior is now viewed as a product of computations carried out in brain tissue. Different aspects of our experience get ascribed to named nuclei in the brain. Thus, the amygdala is our ‘fear center,’ the hippocampus is a ‘memory module,’ and so on.

These descriptions are not only highly reductionistic, and therefore a bit suspect, they are also gross simplifications of exceedingly intricate and redundant neural processes. By describing people in these stark terms, we strip them of their native complexity. Perhaps this wouldn’t be a problem if something valuable were gained, but as I noted above, the best clinical treatments come from experience with people, not experiments with brains. The largest effect of neuroscience has been to persuade us to think of ourselves as computers made of flesh. Is this really an improvement over the view that humans are sacred beings of mysterious origin? Is it an accurate belief? Could it not be the case that there is more to humanity than synaptic activity?

Personally, I’d recommend a grandmother’s advice about how to achieve happiness over a neuroscientist’s. I’d embrace a yogi’s opinion about how to manage anxiety over a psychiatrist’s. And I’d endorse a saint’s ideas about the meaning of human life over a reductionist’s. Sure, let’s continue to study the brain. But until the research proves itself in the behavioral realm, let’s not grant it so much influence over how we view ourselves and our struggles.

Human maturation happens. Whether we pursue growth or not, we gain wisdom. But by actively trying to grow up, we can speed the process. This benefits our loved ones, who get to experience us as more giving, tranquil people. And it benefits the world, by increasing humanity’s stock of enlightened beings. I would add it benefits ourselves, but by the time we reach the state of Open Heart, that no longer seems so important. On the other hand, it is usually the self’s suffering that spurs the quest for transcendence.

So let’s say we’re looking to grow. How do we facilitate development? There is no shortage of sage advice along these lines. I’m continually amazed by the number of books that offer terrific insight and suggestions that can guide us to awakening. Most cities have meditation centers, and many spiritually potent teachers travel the world leading retreats. So resources abound.

But this is a blog post, which to my mind means it should offer a pithy simplification of how to effect the grand blossoming of awareness. Last night I participated in a meditation group and as the post-sitting discussion roamed, a nice way of framing growth occurred to me. It centers around the two main poles of Eastern meditation: concentration and mindfulness.

In Hindu and Buddhist meditative practice, one hears of samadhi, which can be loosely translated as concentration. It means using mental effort to develop the power to control the activities of mind. One trains to focus on breath, or various bodily sensations, or anything one choices. The point is that one can learn to direct the mind rather than letting it run riot. Rather than hopping from thought to thought, we focus, and choose mental content. This ability to steer the mind extends to an ability to choose our behavior rather than acting impulsively. We are enabled to bring our actions more in line with our deepest moral principles.

Satipatthana is a Buddhist (Pali) term for the other aspect of meditation: mindfulness. Similar concepts run through Hinduism, but I am less familiar with how they are framed in that system. Mindfulness in pure form means simply observing the flow of thoughts, feelings, and bodily sensations that form the substance of experience. By practicing mindfulness, we identify ever more closely with the ‘observer‘ part of ourselves. We step back from entanglement in the experience of human life, and by so doing we connect with a deeper awareness, one less buffeted by the drama of day-to-day turmoil. The more we connect with this equanimous consciousness, the more we become freed from the ego’s concerns for its own safety. We feel more infused by the currents of intimacy that intertwine all life and all creation.

The two meditative poles can be seen as the Yin and Yang of mental development (to add Chinese philosophy into the mix). Mindfulness is the Yin, receptive aspect of mind. It is awareness without action. It leads to serene clarity, and the ability to embrace everything that happens, both interior and exterior to the self. Concentration is the Yang, active principle that helps us build proper thought and behavior. It transforms us from impulsive reactors to thoughtful agents of life.

Both are necessary to human maturation. We can’t choose our actions properly if we don’t learn to unflinchingly observe ourselves. We can’t learn the skill of profound observation unless we develop an ability to steer the mind away from useless and distracting chatter. We use mindfulness to observe our behavior, and concentration to improve it.

I’ve invoked Eastern philosophies so far, but it seems to me that many spiritual traditions can be broken down into a similar dyad. In Christianity we are taught to use our human free will to avoid harmful (“sinful”) thoughts and behavior. This is roughly similar to samadhi/concentration. At the same time, we are encouraged to pray in order to open our minds to the presence of God/Christ. This is parallel to satipatthana/mindfulness, as we are awakening to a deeper conscious principle, and learning to see the world as God sees it.

There are doubtless neurophysiological correlates for concentration and mindfulness, but despite my attempts to read and understand neuroscience, I can’t authoritatively identify distinct brain regions as mediators of these two instruments of mental/spiritual progress. My guess is that even if one could safely name the prefrontal cortex, for example, as the site of concentration, one would not be advancing the discussion in any meaningful way. Besides, it seems likely that large swaths of cortical and subcortical brain tissue must get involved. Likewise, Andrew Newberg has shown that the left parietal lobe reduces its activity as meditators enter what sound like deeply mindful states. Perhaps this information could be used if we bought neurofeedback devices to assist our meditative practice, but otherwise it offers little practical guidance to those hoping to grow.

Obviously, there are many other types of meditation, but in simplistic terms they can usually be identified as either Yin (mindfulness) or Yang (concentration) practice. In Buddhism, one often pursues ‘lovingkindness’ or metta meditation, which projects compassion to sentient beings everywhere. To my mind, this is a subtype of concentration practice, and a highly beneficial one. Christian contemplative prayer, whereby one focuses on the deep meaning of Christ’s love, can also be seen as concentration, though if practiced with a focus on opening to that love, it might be more akin to mindfulness. There are meditations wherein one ponders the nature of the universe using cognitive skills. Here again concentration seems like the dominant principle, but if insights arise via spontaneous inspiration, there may also be mindful features at play.

The point is that by discerning the roles of these two poles of meditative effort, we can begin to develop greater maturity, more tranquility, and more beneficial agency in the world. We observe. We change. We grow.

The recent marriage between neuroscience and meditative traditions may hold the key to the future of human civilization. Few other modern trends hold any potential to derail humanity from its track of destruction. Many of Daniel Siegel’s writings demonstrate how a combination of internal (meditative) and external (scientific) explorations of the mind can relieve age-old sufferings of humankind. Rick Hanson’s book, Buddha’s Brain, distills this fertile and vast field into a roadmap for personal breakthrough to peace.

Living north of San Francisco, I am fortunate to be able to attend a weekly meditation event led by Dr. Hanson. Recently he guided a discussion about the fruits of practicing a venerable Buddhist meditation called Satipatthana. In the course of such work, one sequentially pays attention to body, to feelings, to mind, and to the obstacles and vehicles one encounters on the path toward awakening. Rick inquired about our personal takes on the benefits of this system of meditation. My thoughts cohered too slowly for me to participate in the discussion, but after returning home I wrote down what I believe Satipatthana is teaching me. I soon recognized a close connection between this meditation practice and what I’ve been saying on this site about the value of sorrow.

Back when I still suffered from chronic depression, my mind seemed like a monolithic psychic prison. With effort I could adopt a few moments of positive thinking, but all-too-quickly my internal world spiraled back into its baseline state of despair and negativity. It was as if my emotional habitat had been formed of poured concrete; it looked like a solid and monotonous block of cold gray stone. Changing my inner experience seemed about as likely as a prisoner breaking through the walls of a penitentiary with his fists.

Partly as a result of Satipatthana, I now understand that my mind is actually a fragmentary collection of mental activities that can be reshaped with the right kind of effort. The gray monolith turns out to be no more rigid and massive than the Styrofoam used to make stage props. By using this meditation practice to explore my body, feelings, and thoughts, I have learned that my mind is composed of many different parts. There is a module that directly monitors sensations; another evaluates what has been perceived; a slightly separate unit grasps or rejects the judged experiences. Further along the line, there is a component that suffers when desired experiences dissipate or undesired ones persist. Finally, there is an expansive region that remains detached and simply observes. While enjoying the steady peace of meditation, I can shift my focus and attend in turn to these distinct elements.

This helps me recognize the difference between the bodily and mental sensations that accompany sorrow, and the suffering that results. In the ordinary course of mental life the experience of grief and loss seems inseparable from the anguish that arises. In actual fact, there is a sequence: first comes identification of loss, then comes the sensation of grief (often felt as a hollow ache in the viscera), and finally comes the mental anguish.

Loss is inevitable. Grief is a natural and largely unavoidable reaction to major loss. But we can influence the depth of anguish and despair to which we descend. Before I started this work, the experience of grief almost always led to depression and a loss of all enjoyment of being alive. Meditation helps me embrace ongoing sadness while appreciating that life is a beautiful gift.

There is a difference between the sorrowful ache of mourning and the choking darkness of despair. The second does not necessarily follow the first. One can experience and even savor pangs of grief and remain grateful for every moment of human life.

Today I am filling in at the local Suicide Hot Line. Since this time of day tends to be slow, I’ll probably have time to complete a post. As I planned this essay, knowing where I’d be writing it, the topic of suicide naturally suggested itself to me. But after giving it more thought, I decided to write about something a little less depressing.

In the book Buddha’s Brain, Rick Hanson explains that dwelling on negative memories and feelings strengthens them. If we habitually focus on unhappy topics, and especially if we simultaneously harbor unpleasant emotions, then we increase the neural circuits that promote misery. The converse is also true: dwelling on happy topics and pleasant feelings leads to brain changes that foster contentment.

My goal these days is to improve my mental balance, and spend less time obsessed with depressing topics. Since my childhood was loaded with trauma and my adulthood has brought huge disappointments, negativity is already well entrenched in my brain. It will take the rest of my life to build in enough positive memory and feeling to counterbalance that burden of loss. Reliving my suicidal feelings and remembering the suicides of loved ones seem like counterproductive exercises. They can wait for some future day; no doubt depression will eventually descend despite my best efforts, and such subjects will be on my mind already.

Two readers have requested posts about neuroplasticity; since I’ve already introduced the idea by mentioning Hanson’s book, I might as well develop it further. Neuroplasticity has become a hot topic in neuroscience, but it is actually something we make use of every day. If we wanted to be less technical, we could replace the fancy jargon with the word learning without losing much meaning. Both terms refer to long-term changes in the brain.

One of the first and most striking demonstrations of neuroplasticity came from the research of V.S. Ramachandran. He showed that after an amputation, the brain regions that used to handle the sensory input from the lost limb do not simply go silent. Instead, adjacent functions spread into the unused area. So if an arm is amputated, the sensory system of the face expands into the area that once served the severed limb. As a result, people have odd phantom limb experiences, such as touch to the cheek causing ‘feeling’ in a hand that no longer exists. More elegant examples include the expansion of brain representation of fingers in musicians, or the larger memory modules of London taxi drivers, who have to memorize maps of the entire city.

The outer and most evolutionary recent part of the brain is the neocortex. In effect, it is a flat sheet of nerve tissue that has been folded and balled up to fit inside the skull. Although different parts of the cortex have somewhat different structural details, in every region the sheet is layered. In the visual cortex there are six layers, with some receiving input, some primarily performing internal processing, and some creating output to other regions. The number of layers and the specific appearance varies from place to place on the neocortical sheet, but one is struck by the overall uniformity. Regions that handle functions as diverse as vision, language, touch, movement, and judgment all look more or less the same, and areas with similar functions can appear identical. Thus, the sensory area serving the arm is indistinguishable in appearance from that serving the face.

This makes it easy for cortical regions to take up new functions. In people who are blinded, and especially those blinded from birth, hearing functions encroach on the visual cortex. This expands the processing space for auditory signals, and probably partly explains why people who are blind often hear better than those with sight. Enlarging the cortical space for fingers in musicians presumably increases manual dexterity.

These are large-scale changes that demonstrate the brain’s impressive ability to reorganize itself in response to need. Restructuring on that scale takes time, but smaller shifts in brain structure and function happen every instant. Every thought is accompanied by a ripple of neuronal activity that forms an organized ensemble and then dissipates. Every time a memory is created, new connections are established between nerve cells. The brain is changing all the time as we learn new skills, see new things, and think new thoughts. As we live we learn, and as we learn we change our brains. This is the essence of neuroplasticity.

We should feel both sobered and empowered by the fact that everything we think and do sculpts our neurons. Sobered, because every single thought leaves traces that accumulate; a lifetime of negative thinking strengthens the neural foundations of stress, fear, and sadness. If we clumsily allow our minds to obsess on whatever attracts attention, no matter how discouraging or counterproductive, we will develop brains prone to unhappiness. Empowerment comes from recognizing the opposite principle: fostering positive thoughts, memories, and feelings will gradually increase our ability to remain contented.

About four years ago, the mental health providers who were helping me encouraged me to ramp up my meditation practice. I’d been pursuing silent worship and retreats as a quaker for twenty years by that point, and had taken my first mindfulness meditation class six years earlier. But I had slacked off in my efforts. Since that prompting to be more serious about meditating, I’ve found settling into the mind that lies beneath surface turmoil to be very helpful to my emotional balance. No doubt many readers will find what I write to be naive, which is unavoidable given that my intensive practice began so recently. Still, meditation helps my state of mind so much that I can’t resist commenting on a recent realization.

When I first began to practice mindfulness meditation on a regular basis, my instructors cautioned me to toss out the idea of emptying the mind of thought. They taught me to observe thoughts, sensations, and emotions without trying to influence them. Given the context of a psychiatry clinic, these instructions were all presented from a medical perspective; they followed the Jon Kabat-Zinn formulation. There are many other approaches to meditation, and some schools place more emphasis on achieving a mind free of domination by verbal thought streams. But that early teaching held, and for a long time I assumed that attaining silence in the mind would be difficult if not impossible.

Being a newcomer to this practice style, it’s no surprise that I’m finding my early understanding to be incomplete. More and more, I’m finding it easy to shut down verbal thought, and not only while formally meditating. It’s becoming a bit of a refuge, in fact. When I find myself starting to obsess, and especially when the thoughts take a negative turn (as they almost inevitably do), I find it easiest to just stop thinking. Cognitive Behavior Therapy taught me to challenge my assumptions, and recognize the distortions in my interpretations. To do so is still useful at times, but often the quicker route to relief is to simply shut down the thought apparatus. It takes a bit of effort, and it certainly requires that I remain conscious and alert, but it’s not as hard as I believed. If I were to dissect the experience, I would probably find a few echoing words deep in my awareness, but the loud and intrusive thinking is becoming relatively easy to turn off.

I sleep better as a result. It used to be that worries or even pleasant fantasies kept me awake; there was always something that seemed interesting to attend to. If I shut down the thinking apparatus, in contrast, then if my body is tired sleep soon comes. If sleep eludes me it usually means I’m not that tired, and I either get up for a while or I lay on my back and simply experience the peace in my mind. It’s another opportunity to meditate.

Once on my Twitter stream I wrote, “If you can’t think anything nice, don’t think anything at all.” Although I think this phrase was my own creation, it’s possible I heard it somewhere; it is a variation, in any event, on the old line: “Don’t believe everything you think.” Regardless of its origin, the statement was meant more as a joke than true advice, but now I’m taking it to heart. I’ve added the technique to my chest of tools for building peace and sanity.

Looking back, I realize it has taken a bit of discipline and practice to get to this point, and that my ability to achieve tranquility has gradually increased over time. Recognizing how my understanding has progressed makes me realize that meditation must have many surprises in store for me. The recent trend in mental health toward emphasis on mindfulness (seemingly the preferred label for meditation in clinical circles) appears to be well founded. Especially for someone like me, who once pursued favorable mind states so vigorously that I developed troubling relationships with intoxicants, the discovery of self-generated tranquility is profound. Anyone dedicated to improving mental health probably already knows the value of meditation, but if you have delayed putting that knowledge into practice, I highly recommend meditating regularly.

After perusing a variety of texts about spiritual growth, I better understand the universality of my recent stirring mind states. This perspective helps, because it is easy to get carried away after numinous experiences. Hopefully, visitors will forgive my naïve enthusiasm and beginner’s ignorance.

It is no secret that profound experiences have blessed many people around the world and throughout human history. Those committed to spiritual paths devote their lives to seeking and exploring such epiphanies, and no doubt enjoy far greater understanding, equanimity, and wisdom than I ever will. My purpose here is only to describe my particular journey, and perhaps offer hope to others burdened with chronic depression. The most important fact of my ‘breakthrough’ is that it has swept away most of my misery. Even when I stumble and feel defeated for a few days, the memory of a better place remains, and the ease with which I exit the darkness astounds me. Six months ago my plan was to learn how to live a full life in spite of depression. That I would ever be completely free of it, even temporarily, seemed impossible. Before, in my best frames of mind, there remained patches of depression that threatened me with shade, like scattered clouds on an otherwise sunny day. Now I spend the majority of my time feeling light and balanced, with no ominous darkness on the horizon. And when depression does descend it doesn’t linger, it leaves behind no shadow, and while it lasts I appreciate its solemn beauty (most of the time, at least).

The Varieties of Religious Experience, by William James, is familiar to many western seekers of spiritual growth. The book describes the vast range of spiritual frames of mind, and the large variety of ways we reach them. Sometimes a person achieves transcendence after years of meditation, study, and intention. Spiritual awareness accumulates gradually as the result of such effort, with progress punctuated by moments of sudden growth. But a life of seeking is not required. Not infrequently, a person ‘awakens’ in the aftermath of catastrophic stress or after collapse into utter despair. Crisis and failure offer us the opportunity to give up the fight and drop all barriers. The reward can be a flood of clarity, acceptance, and universal love.

If I were to classify my current situation, it would fall between those extremes. Although I have certainly not devoted my life to a quest for meaning, I nonetheless have been studying and searching. And despite a decade of bad luck, nothing in the past year has been particularly awful, nor did my ego disintegrate in an acute moment of hopelessness.

The nature of my recent spiritual experiences also lies between extremes. Ten years ago a series of ‘visions’ transported me into a mood of wide-eyed ecstasy, a kaleidoscope of marvelous sensory experiences, and a conviction that I had seen and spoken with God. A more magnificent and soul-quaking episode would be hard to imagine. However, much of the mental content was unbalanced, irrational, or poorly grounded. Although the clarity and salience of recent weeks equaled those of the earlier episode, they were not accompanied by ecstasy or hallucinations. As I’ve discussed, strictly supernatural beliefs played no role. Instead, what I know to be true about how the world is structured and how my life has unfolded took on a new light. Every particle of my mind understood that the universe is both dispassionately random, and lovingly numinous. This sounds paradoxical when stated in words, but from a state of exquisite nonverbal awareness, it made perfect sense. This solidly sane sacred experience felt just as profound as the arguably insane ‘religious visions’ of a decade earlier. But it was a little less intense, and was free of ‘delusional’ and ‘hallucinatory’ content.

Looking at the other end of the spectrum, I’ve explored mindfulness meditation for some years, and the recent ‘awakenings’ felt akin to the state of wordless peace that comes with such practice. The way I felt intensely ‘alive’, for instance, mirrored the way mindfulness brings one in touch with one’s body and sensory surroundings without the intervening filter of the verbal mind. In fact, three days ago it was a combination of meditation and acupuncture that returned me (for a whole afternoon) to the frame of resonant clarity that began with my spiritual retreat in January, and which is becoming more and more familiar. But the psychic impact of my recent moments of understanding exceeded that of even the deepest meditative states I’d previously achieved.

Experienced practitioners probably read my descriptions with a bit of amusement. I must sound like an adolescent who has just discovered sensual romantic love, and thinks he or she has stumbled on something personal and exceptional, when in fact it is universal and expected. But even if everyone else already knows about such love, it’s new to the teenaged romantic, and soul-penetrating clarity is new to me. So I hope those further along this path will indulge my childlike wonder.

A reader left this comment in response to a recent post about sitting still with depression:

I too struggle with despair and have done so all my remembered life. Sometimes it is just in the background, other times mind numbing. My T will ask what has triggered it and I never have an answer for her. I have never tried sitting with it. Something to think about and maybe even try if I can find the courage to do so. Thank you.

My policy is to answer every comment, even if with just a few words. From my own experience, I know leaving a comment on a blog and having it sit there ignored can be annoying. I much prefer to get some kind of response. Since my readership is by no means huge, and the number of comments never overwhelming, I always reply. After writing two responses to the above comment, and losing them both to computer glitches, I moved over to the word processor and wrote a more formal answer. It got quite long, and used up my blogging time for the day. Since what I wrote seems like it might interest more than just one person, I’m going to cheat and use it as my post for today. So here’s my response to this dear reader; I hope others can glean some useful words from the text:

Lostinamaze—

Like you, I have been dogged by despair all my life. The death (probably suicide) of my mother when I was six, which followed years of repeated psychiatric hospitalizations, set the stage. But whatever the cause, depression has robbed me of many years of enjoyment, by making so much of my time on this planet feel like living in Hell.

The good news is, and I want to say this emphatically to you and anyone else who suffers, one can make progress against the darkness. In recent years, I have worked hard to get better, and have been blessed to find some guidance that has made growth possible. (I’ve spent much of my adulthood in therapy, but often I either was not trying hard, or was stuck with a therapist who lacked the kind of skill I needed.) My years of introspective therapy may have helped, but CBT and (more recently) ACT have been decisive. (Books to search out include ‘Mind Over Mood’ for CBT, and ‘Get Out of Your Mind and Into Your Life’ for ACT.)

My ACT therapist’s trick of making me sit still with depression is a spin-off from a pain management technique used in mindfulness meditation. I actually learned it years ago, but quit implementing it. The idea is to mentally move toward, rather than away from the sensations. To explore them like neighborhoods in a large, confusing city.

For physical pain one might ask: Does the hurt burn, stab, throb, or ache? Where in the body does it sit? Does it move around? Does it wax and wane, or is it steady? And so on…

With depression the steps are very similar: Is there pain in the chest, or stomach, or whole body? Is it an ache, a sinking feeling, or a sensation of deadness? Do I feel restless, or irritable, or lethargic? And so on…

By investigating, one gets distracted from snap value judgments, and begins to look more dispassionately at one’s sorrow. The panic, hatred and revulsion get replaced with grudging curiosity. It’s a bit like carrying on a conversation with a crotchety and snide relative at Thanksgiving, rather than storming into the next room and complaining about him.

It’s hard. And it does not lessen the pain (ACT insists that is not the goal) as much as reduce the aversion. But it helps.

I would also suggest Tom Wootton’s book ‘The Depression Advantage.’ In interest of full disclosure (since I’m plugging his book,) Tom is a friend of mine. He has been advancing the notion that ‘depression is beautiful.’ Believe me, I found it a very hard sell at first. But Tom does have a point, even if I won’t go as far as he does with it: there is a sense in which depression deepens experience. It helps one get in touch with life, humanity, and maybe even God (for those who believe.) If nothing else, I have come to realize, sorrow informs my writing. It helps to remember how many artists throughout history have mined their grief for inspiration.

I know this all sounds facile. And maybe you already know far more than I do about these things—I always worry that I will sound pedantic and give offense. I just want to spread the message that depression can be befriended, or at least tolerated.

By the way, I’d suggest gathering and practicing tools to combat negative thinking (i.e., CBT) either first or at the same time as starting this ‘sitting’ work. That way one approaches the project with a sense of at least some control over one’s mood states. This step may not be essential, but it made me feel a little safer to have some emotion-modulating skill before letting the sorrowful feelings flow through me without resistance.

I am not a psychiatrist or psychologist or any kind of mental health care worker. I am not recommending that anyone read just my blog and start practicing this technique. In fact, there is a danger of making things worse if one falls into feeding depression with negativity, rather than staying neutral in one’s exploration. Please do not overwhelm yourself. My point is only that in this third millennium of the current era, effective techniques exist for working with troublesome moods. Books abound, and well-trained therapists can be enlisted.

Good luck, and thank you for being such a consistent reader of my blog.

–Will