Tuesday, August 9, 2011


Losses take on many forms in our lives. I am dealing with end of life decisions for our 15 year old cat, and feeling so sad about this impending loss. I know we can't expect anyone or anything to be around forever. But I don't believe accepting means denying the pain of parting.

Grief is a normal emotion. We all react in different ways, but the important thing is to allow the grief process to work. Elisabeth Kubler-Ross first formulated the Five Stages of Grief in 1969. Like most universal truths, this model has stood the test of time. The stages of grief are: denial, anger, bargaining, depression and acceptance. They are not linear stages, meaning we finish one and move directly to the next, but we may jump ahead, skip back, or miss some entirely. But most of the stages sound familiar and true to anyone who has grieved.

The loss of a pet can't be put on the same level as the loss of a human family member or friend, however, I know my pain is real. I can't deny my sadness, and I won't hide it from my family. My children will also experience sadness and grief, and we will have to help them through this, too. I will tell them to find the feelings of sadness in their body, to breathe into it and allow it to be real. Sadness is not something to avoid or deny. Cry when you want to, remember the good things and talk about them openly, and be gentle with yourself. Grief takes time, and we won't be over it by tomorrow. Together we will remember our cat with fondness, maybe we'll mark her final resting place with a flowering shrub, or a catnip bush. We know she'll have a place in our hearts forever, even though she's no longer with us.

Monday, August 8, 2011

What's Your Focus?

Last Friday I had a nice day. I was off work, and got to do some things for myself. Since I'm trying to be more disciplined about journaling, I finished the night by sitting down to write. The first thing on my mind was an unresolved issue that I've been worrying about. I started to write about this at length, getting into details about what might happen, how things could go wrong, and how upset I would be. That led me to think about my frustration with someone I felt wasn't doing as much as they could to resolve the situation, and I spun on for pages in anger. I finally stopped to take a breath and realized I felt very anxious and upset! How did that happen after such a relaxing day?
Luckily, I recognized my role in creating this mood, and quickly turned the page. Literally. I started my journal entry over and focused on the positive events of the day, how pleased I was to have time to myself, how grateful I was to have friends coming to visit, and my mood became cheerful and relaxed again. The events of my day hadn't changed, and neither had the worrisome situation, but my focus had shifted completely. Staying stuck on the negative, or mired in future worries, I was allowing my mind to create unnecessary drama which made me feel terrible.
So, the real question is, if I can choose my focus, why would I allow my mind to lead me down that path? And the question is just as valid when thinking about journaling or simply the thoughts in my own head. My mood is affected by my thoughts, and my thoughts are under my own control. Therefore... I think you can see where I'm headed here! So do I choose worries and anxiety, or negativity and anger, or can I look for the silver lining? I'm not saying my worries are invalid, or that my anger is unjustified. But I can choose to evaluate them and decide how to respond, rather than allowing them to spin uncontrollably through my head, affecting my emotions and behaviour.
It takes work to look for the positive, especially with all the bad news around us. I choose to practice gratitude, and that often allows me to reset my perspective. Some days I'm grateful for a roof over my head and enough food to eat. Other days, my list can go on and on. Either way, I start to focus back in a positive direction, and I notice the shift in how I feel. Try it yourself. If you notice your thoughts spinning in an anxious or negative direction, turn the page. Think of 5 things you are grateful for today, and allow your mind to really feel that gratitude. If you're journaling, end each entry with something positive, or write down your gratitude list. How can you shift your focus today?

Thursday, July 7, 2011

The Little Things

I often hear from patients that they don't have time for anything else in their busy schedules. They are usually reacting against my recommendation to do something positive and healthy for themselves, which isn't as high a priority as it should be for most of us! But what if there were really great things we could do that only took a few minutes of time? Things that could help us relax, or improve our mood, or become more present? Maybe we can create enough little moments of self-care throughout the day, that add up to a big shift in how we feel.

Here are a few of my favorite Little Things:

1. Take a deep breath. Unconscious, shallow breathing is the norm for most of us. Let's face it, we suffer from a lot of stress in modern society, and stress leads to faster breathing, a rapid heart rate, and classic fight or flight symptoms to a greater or lesser degree. The fastest way to reverse this effect is to use the body's natural relaxation response, which can be triggered by a nice deep belly breath. Close your eyes, inhale fully through your nose, and slowly exhale a big sigh through your mouth. On your next breath in, take a deep slow inhale through the nose, expanding into the area below your navel first. Exhale slowly and completely through the nose. Repeat 2-3 times, several times throughout your day, or anytime you start to feel stressed. Your body will remember this relaxed feeling, and you will be able to return to that calm anytime. Your breath is always with you!

2. Turn around negative thinking. Take a few moments to examine your thoughts. Are they pessimistic, blaming, or critical? If so, there's no doubt your mood has changed to match the words in your head! Now, really look at the thoughts. They have likely expanded into something far worse than actual reality, so try to gently nudge your inner dialogue back towards the truth. If you are focused on all the possible bad outcomes of your day, list some things that have gone right. If all you can see is bad luck and bad choices, find something for which you're grateful in your life right now. This is the simplest example of cognitive therapy, but for most of us, it is enough to remind ourselves to come back to the positive, and it only takes a few moments!

3. Come back to the present. I spend a lot of time in my head, thinking, worrying, planning, so much so that I miss things right in front of me sometimes! I am trying to add small moments of mindfulness throughout the day to remind myself to stay present. The easiest way to do this is to let go of the thoughts, and come into the physical body. Specifically, take some deep breaths and feel the sensations of your feet on the ground. Really sense the chair supporting your back, your clothing touching your skin, and the breath moving in your body. In this practice, there is no room for the past or future, only right now. I may forget again later, but it only takes a few seconds of focus to come back to the present, again and again.

4. Stand up and stretch. We are a sedentary society, and a lot of our technology creates bad posture that can lead to physical discomfort (think the hunched shoulders and head hanging forward pose in front of the computer!). Studies have shown that sitting too much is a risk to our health, so it makes sense to stand up at least once an hour. Add to that a delicious stretch, like the Mountain Breath, and feel your energy start to return, your body waking up again. To do the pose: Stand tall in Mountain Pose, with your feet hips distance apart and parallel, your shoulders directly over your hips, your hips directly over your heels. Let your head float atop your neck, with your chin slightly tucked. Allow your hands to hang heavy, straight down from your shoulders. On your next inhale, sweep your arms out and up overhead, reaching the highest point at the top of your inhale. Look up for a slight back bend if that feels comfortable, then slowly lower your arms out and down to your sides on your next exhale. Repeat 4-5 times, using the breath to guide the movement, filling every motion with your inhale or exhale. Finish standing in Mountain Pose, sensing the energy shift in your body.

All of these simple techniques have the same goal: to return to our natural state of contentment. The 4 Little Things are always available, with no special equipment required. All we need is the breath, the mind, the present moment and the body to remind ourselves that our true nature is always there for us. A few minutes a day really can make a difference!

Monday, June 27, 2011

Timely Observations

I am typically punctual to a fault. I am more likely to arrive early than late, and have been known to hyperventilate the entire drive to an appointment if I'm running behind. I always wear a watch and I have several clocks in my office so the time is never out of sight. It shouldn't be too surprising that I often feel short of time. My fixation on the clock hands keeps me on schedule, which is often a good thing. My patients and hair dresser and yoga teachers appreciate punctuality. However, there can certainly be too much of a good thing.

I went on vacation with my family a couple of weeks ago. It was a wonderful, relaxing beach trip without much of a schedule. Since we were around all that sand and water, it didn't seem like a good idea to wear my watch... so I left it in the room. The first few hours I noticed myself glancing at my wrist, wondering what time it was. As the day progressed, that happened less and less. By the end of the week, our schedule was mostly dictated by our own inner clocks. We woke up when we were done sleeping, we ate when we were hungry, and rested when we were tired. There were times we noticed it was quite late to be sitting down to lunch, so the thoughts about an accepted daily schedule were still there. But why would we eat when we weren't actually hungry? Does the time on the clock really get to dictate things our bodies truly know best? It had been a long time since I was really able to recognize those internal cues, since I was so focused on whether it was dinner time.

I have since noticed other situations when the clock is hindering me, rather than helping. One of the biggest ones is when I'm driving somewhere. If I leave slightly late, I spend the entire drive looking at the clock over and over again, worrying whether the stop light is going to add an extra 2 or 3 minutes, and what that means for my arrival. I came to the realization (you'll laugh, this is so obvious) that the time doesn't matter if I can't do anything to get there faster. Traffic, stop lights, construction, the weather, these are uncontrollable variables that will affect my transit time whether I'm running late or not. Looking at the clock is distracting and doesn't make me move any faster, so why not let it go and just drive safely? The time doesn't matter.

The middle of the night is the other time I have learned to let go of the clock. I wake up during the night almost every night. I used to always immediately look at the clock. If it was early, phew, I have 4 more hours to sleep! If it was already 500am, it was a disaster. My mind would go into catastrophe mode, worrying that if it took me 10 minutes to fall asleep I'd only have 50 minutes left to rest, or what if I didn't fall back to sleep, that means I'm an hour short, on and on until I was wide awake and anxious to boot. Then I read an article that talked about digital clocks, and how the bright light of the numbers actually tricks the brain into thinking it's daytime. I turned the clock away from me at night and started to sleep better right away. Then I came to another realization: it doesn't matter what time I wake up at night. Whether it's 2am or 5am, I should calm my brain and try to go back to sleep right away. Maybe I only get another 30 minutes before the alarm goes off, but that 30 minutes can make a difference. I can guarantee I won't get that extra rest if I start to stare at the clock!

Clearly we need the structure of time in many situations. We couldn't have a developed society without some type of schedule. However, there are also many times the clock doesn't need to matter so much. I find I'm much more at ease if I don't look at the clock. The initial tension of being without my watch eventually gets replaced by freedom and a better sense of my own internal cues. The only time that truly matters is the present, anyway, and no clock on earth will direct to my own mindful presence. I am looking for peace in letting go of the hour and focusing on the moment.

Wednesday, May 25, 2011

What's Next?

This time of year gets busy for a lot of us. School is ending, and spring sports are in full swing. It seems there's something on the calendar every day, on top of all the usual stuff! It can get very overwhelming. I know I've stared at the family calendar and wondered how on earth we were all going to get where we needed to be, let alone be in clean clothes and have food in our bellies. I've learned some ways to keep my sanity when the commitments pile up, the trick is to use them myself, rather than just offering them as advice to others...

1. Prioritize. I know there are things that have to get done today, and things that can wait. I found a brilliant to-do app for my iPhone that helped me think of things differently. You get to prioritize your list according to what has to be done today, and the rest can be put off until tomorrow. It actually moves the items to the next day's list, so they're not sitting there staring at you, making you feel guilty. It even allows you to create a "long-term" list of things to do someday in the future. So, technology neatly gives me permission to label some things as more important than others. If only our brains allowed us the freedom.

2. Cut corners. Not everything has to be done perfectly all the time. This one is particularly hard for us type-A personalities, because I am actually advocating doing things half-way. Or even less! Buy the pre-cut carrots. Sweep under the table but leave the rest of the floors for a less busy day. Be at peace with the messy mud room, because it really doesn't matter in the long run. Eventually things will settle down and you can return to your usual standards, but when something has to give, the extra housework can wait.

3. Plan ahead. I keep a calendar so I know what's coming up. I can ask for help the days I need to be in 2 places at once, and buy the cookies I volunteered to bring to baseball ahead of time. I would love to say I have fully prepared meals waiting in the freezer to be pulled out when I'm too busy to cook, but that's on my "someday" to do list. That is clearly a fantastic idea, though!

4. Plan to say no. There are a lot of demands on the whole family. The kids could be in a different activity every day, and I could drive or volunteer at every one of them after work. However, eventually I have to start saying no. After all, one more sport isn't just one more hour a week, is it? Let's practice a few helpful phrases: "I am not be able to volunteer this week, but I will put it on my calendar for next month." "No, I am not able to head the planning committee of whatever next year." No excuses, no I'm sorries, just no in a polite but firm way. It can be very liberating!

5. Take care of yourself. When I'm busy, the first things I'm likely to ditch are my own needs. I eat on the run, stay up too late and my yoga and meditation practice becomes an after thought. Eventually it catches up to me, and I notice my irritable mood and impatience in every area of my life. We are taught to give and think of others' needs first. But if I am not grounded and healthy, I am not able to give my best to anyone else.

6. Just do the next right thing. I got this lovely gem from a person in recovery. It works for people overcoming addiction, and it will work well for the rest of us, too. When I see the tasks before me, it's easy to become overwhelmed. If I remind myself of this phrase, I realize that I can't do everything at once, I have to choose one thing. Also, I don't have to choose the right thing, only the next one. I get to choose again later. I can work my way through my tasks knowing I'm making the best decisions.

Every day is a new chance to do the next right thing, so I'm moving forward instead of beating myself up for allowing myself to lose sight of some of these ideas. I will start by keeping mindful today. The right things are so much easier to recognize if I've kept myself grounded and present!

Tuesday, April 19, 2011

It's All in Your Head

Have you ever misread a situation and created a whole big drama in your head that later turned out to be false? Our human minds are constantly at work, trying to explain the world around us. Thoughts come at us from all directions, defining situations or people as good or bad, judging everything so we can form a conclusion that makes sense of it all. We use our knowledge, however it was obtained, to help us decide how to feel about things. So we feel good or bad about any given situation based on our thoughts.

That makes great sense in theory, but it's not so simple when we're busy living our lives. For example, I just picked up the dry cleaning, and there was an envelope attached to it. My thoughts immediately went like this: envelope=bad news, they're closing, I will have to call the neighbor and see who their dry cleaner is, I don't have time for this, . All this before even opening it. So, of course it was no big deal, the dry cleaner was just giving information about their services, but my thoughts had already created a catastrophe that sapped my energy and good mood. An envelope is not inherently bad, but my thoughts judged it to be so, and my emotional state dove right in, despite multiple other logical scenarios.

Other times our thoughts create a long-standing judgement that affects us on a regular basis. I saw a patient yesterday who is often on call for work. When he is on call, he works 24 hours a day responding to technical emergencies. He regards his pager as a curse. I can't say I blame him, because I have my own emotional reaction to a pager beeping. We explored his thoughts and feelings about his job to see if we could change his emotional state. He likes his job, which provides the livelihood for his family. His pager could be a reminder that he is employed by a company he likes, doing work he enjoys, or it could be a reason to become anxious and upset because it might go off at any time. The pager hasn't changed, but the thoughts and emotional reactions to it have.

So how can we patrol our thoughts to keep them from ruling our mood?

1. Remain mindful.

Like a lot of people, I live on autopilot. I am multi-tasking and unaware of things going on around me. In this state, my thoughts are as automatic as my fingers on the iPhone. I don't notice the scenery, and I don't notice thoughts until an emotion takes over. Why am I suddenly so irritable? If I'm unconsciously going through my day, I will have no idea. On the flip side, if I take time to check in with each moment, noticing the input from my senses, observing my thoughts and reactions, I can see the conclusion waiting to be jumped before I do it. This makes #2 much easier.

2. Recognize your triggers.
I have unresolved insecurities, and worry whether I'm liked by others. I know this is true, and by remaining conscious of this trigger, I can avoid an emotional pity-party when someone doesn't return my phone call right away. This leads directly to step #3.

3. Evaluate each situation logically.
Remember that every situation, person or thing is not either all good or all bad. Just like my patient's dreaded pager, the emotional label comes from our thoughts. Cognitive therapy advocates an almost "scientific" analysis of our thinking with every emotional state. When a friend doesn't return my call, I start to evaluate possible scenarios. I stay mindful, recall my triggers, and suddenly I can think of other reasons for the delay. I understand that my assumption, that my friend doesn't like me anymore, isn't the only explanation (or even the most logical one!).

Thoughts are powerful, but we can remain in control of our own emotions by staying mindful. Over time, we can be more conscious of the emotional baggage that distracts us from the moment, and we are more steady. Then we get to choose how to react instead of bouncing from crisis to crisis all day long. I am striving for equanimity and balance. I think these steps can lead the way.

Thursday, April 14, 2011

What Do You Know?

How is knowledge formed? We learn about things from books written by experts, or a teacher explains a concept to us in school. We continue our process of learning each day by reading or listening to the news, perhaps we consult with specialists in their fields if we need to learn something specific. We rely a lot on others to provide us with the tools to gain knowledge, and hopefully we recognize that the facts may change over time. New scientific discoveries totally negate previous theories, and we have to update our knowledge base. What about less concrete types of knowledge? I'm thinking of our preferences and dislikes, opinions and social knowledge. I know I don't like beets. Or at least I used to know that. I spent the majority of my life so far believing I am a non-beet-eater. Then I tried one after a friend extolled the virtues of the bright purple root. I have to update my database: beets=good! Now that is obviously a personal preference, and based on my senses. Tastes can change easily over the years, but I easily could've spent my entire life claiming non-beet-eater status if I hadn't tested my previous theory. Then there are other types of "knowledge" that are opinions masquerading as fact. Think of stereotypes or superstitions. Multiple generations in this very country "knew" that people with dark skin were inferior and not due the same rights as people born with light skin. That is the most dramatic example I can think of to illustrate this type of knowledge. A smaller example would be our constant re-learning of what is healthy to eat. Remember when carbs became too awful to even consider consuming? I am fully aware that this is not true, yet I still feel a tinge of guilt whenever I grab a piece of bread from the basket! Lastly is what we know about ourselves. A lot of this self-knowledge is based on sensory input (I have brown hair and blue eyes), but it is colored by what we think other people believe about us and our memories. I know that I am not a beautiful woman, because in grade school I had a bad perm and acne and couldn't hang out with the popular girls. Ok, that was 25 + years ago, but that "knowledge" hangs out in the back of my head affecting my self-worth on a regular basis. I know countless women who know they are fat because someone once said so, even though they now look like a model for Yoga Journal. How do we sort things out and decide what is truly Knowledge? I can easily accept that scientific discoveries happen and former theories are proven untrue. I also know tastes change and that a food or scent or activity that was once unsavory is now pleasurable. Harder to question are the societal and personal opinions that we all accept as fact. I have to listen to my heart and my intuition whenever I am presented with new information. I can evaluate the source, the way it's presented and how it "feels" to me inside. My own thoughts are more difficult to police in this way. Negative thoughts based on distant memories or traumas sneak in without being noticed, and suddenly I'm certain I shouldn't wear that outfit because I'm too old for a mini-skirt. The best method is to constantly notice the running commentary of the mind. I can tune into the negative beliefs and really explore whether they are grounded in reality. I can use my intuition to explore if this knowledge is real, or a sham, and really work to uncover my Self. The more mindful I become, the better I get at discerning the truth, about myself and about the world around me.

Wednesday, April 6, 2011

Do What's Good for You

I saw a patient yesterday who explained her very reasonable diet and exercise goals to me. She also told me she has had these goals for many months now, and has yet to start on them. She knows what to do, where to go to do it, and how. But she just can't seem to follow through. Why don't we do what we know is good for us? I think there are a lot of reasons why we procrastinate, avoid and ignore what's in our best interests. Fear of failure would be up there at the top, I think. If I never try, I can't fail, or so the thought process goes. This can hold us back in so many ways, from our health goals to work aspirations to personal growth. People stay in jobs they hate because they might not get the promotion if they try for it. Others stay in lousy relationships because they might not find anyone else. So, the devil you know is safer in their thinking. Fear is a big obstacle for most of us, and there isn't a simple answer to get over it. The guidance of a counselor or coach can help us move forward, even when it's scary. Maybe next on the list is the myth of no time. We can talk ourselves into believing there is not one more minute in the day for another activity. Some days, that may be true, but most of the time things can be shifted, Facebook can be logged off, and the TV reruns can wait. Right? I went to a meditation workshop last weekend, and the teacher asked us straight out "You can commit to meditating for just 10 minutes each day, right?" It sounded so completely reasonable and manageable, we all were nodding and agreeing with him. I planned to sit every morning, yet the next day passed without me getting on my cushion. Finally, as I went up to bed, I remembered his query, and sat down for those 10 minutes. It wasn't at the time I had planned, it pushed back my bedtime, but it felt great. I've been able to find those 10 minutes a day since then. Another roadblock is the fear of commitment. Like my meditation practice, a lot of what's good for us requires daily upkeep. We have to eat right every day, exercise regularly, keep up with our continuing education credits, the list goes on and on. If I start something new, it's one more daily obligation, something I'm forced to do. If I start off thinking that way, of course it will feel like a chore. If I instead focus on the benefits, I can spin this into a positive. Thank goodness I get to exercise every day because it keeps me feeling great! That sounds a lot better. The best answer to why we avoid what's good for us is that we're human. We have a thinking mind that can come with an excuse for anything at all. But, the mind can be trained. My patient and I broke down her goals into bite-sized portions and chose one to start with. Something small and manageable as a first step to prove she doesn't need to be afraid of the change, she indeed does have the time, and the commitment will become a daily habit in no time. I will check in with her in a couple of months, but in the meantime I will work through my own excuses to avoid meditation. I'm so glad I get to start each day in silence, it really helps me stay peaceful throught the day. I think that may work!

Tuesday, March 29, 2011

Be You

Last week I listened to the new Lady Gaga song, Born This Way. I mean really listened, to the lyrics and the message. I was so moved by her words about being yourself no matter what. She says early in the song that her mother told her "There's nothing wrong with loving who you are, she said, 'Cause He made you perfect, babe." Oh, if every child in every home heard those words! Lady Gaga refers to a person's skin color and race as well as sexual orientation in her powerful song, telling us all that beliefs about our differences have no foundation. So many of us grow up hating some aspect of ourselves, spending countless years wishing we were different somehow: thinner, blonder, whiter, straighter, it's different for everyone. Does anyone really believe they are perfect the way they are? We are bombarded by messages implying we need to be better somehow, more like the people in the movies or magazines. Articles tell us how we can achieve a better body, ads proclaim we can have whiter teeth and perfect hair, there are even therapists who claim they can change a person's sexual orientation. If all this were true, wouldn't we all be happy? And wouldn't we all look and act exactly the same? Diversity is a word that is used commonly these days. It's interesting because companies want to promote a diverse work force, yet certain groups are routinely discriminated against. Women still earn less than men, people of color are less likely to be top executives and gays aren't allowed to provide benefits for their partners. If we all looked and acted alike, would we all be equal? And would we all be happy, instead of choosing some aspect of ourselves to hate? I don't think there are answers to these questions, but in an age when depression, eating disorders, bullying and suicide are commonplace, I can't help but ponder them. I read a wonderful book recently called "Women Food and God" by Geneen Roth. The book is all about feeling emotions and living in the present instead of trying to change or numb ourselves with food. She makes a case over and over for acceptance of what is, be it the body, the situation, or the pain, and that will set us free. Towards the end of the book, she sums things up in a particularly profound way. "When a diabetic tells me that she can't eat what she wants because what she wants will kill her (and therefore she feels deprived), my response is that what will kill her is wanting another life than the one she had, another condition than the one that is hers." Ok, I'm going to leap here and say that Lady Gaga and author Geneen Roth are saying the same thing in very different ways. Be who you are, don't try to change it. Don't hate it or pick at it or obsess because something about you is different from your ideal. In fact, don't believe there is an ideal because people are born with differences that make us unique and special. The differences should be celebrated, not marginalized or used to create a culture of hatred and fear. So, as I've heard Lady Gaga say: Let your freak flag fly. Rejoice in every aspect of your beauty, because we're all perfect.

Thursday, March 17, 2011

Shhh... Listen!

I am making changes at work, getting ready to begin a new style of treatment. It's been a busy time, and I've been worrying a lot about how this will go. I am also trying to think of a name for my combination of yoga, mindfulness and psychiatry, but I've been frustrated because I can't come up with something that fits. I have been feeling stressed, for sure. This transition at work is coming at the same time as a transition in the weather, and all these changes at once stir the jumbled pot of thoughts in my head. I am thinking constantly!

Our minds are always at work, of course, but sometimes it's easier to see the space between the thoughts. Right now, I feel bombarded by questions. I get up in the morning and ask myself what I should wear, whether I need to wash my hair, what I should eat for breakfast (then think about lunch and dinner), and on and on and on. This goes on in the shower, while I'm driving, even when I'm doing yoga, if I'm completely honest. Oh, that's bad, if my usual quiet place is being disturbed by all this thinking!

So the questions are buzzing around my head, but I find I'm not able to confidently answer any of them. Even the simplest seem beyond me. I doubt myself after I finally grab something to wear, and I'm reading about 4 different books right now. I can say I'm not really getting much from any of them! The questions are constant, but the answers aren't forthcoming. I finally pulled out my journal last night, after inconsistent writing for the last few weeks, and started to explore what's going on here. I realized after some introspection, and literally writing down every question I'm chewing on right now (this took up about 1/2 a page, for crying out loud!), that I'm not finding answers because I'm not stopping to listen for them. One query leads to the next, I'm not breathing or looking for a pause between them to see what comes up. I can't hear my Self respond because of all the chatter.

So as I thought last night about my morning practice, whether I should go to my usual yoga class before work, or practice at home. Then I listened. I didn't get a hard and fast answer, but I recognized that I didn't need to decide right then. In fact, I couldn't possibly know how I would feel in the morning, so I needed to wait. I hate waiting :) but I did it. This morning I woke up and scanned my body and felt achy and stiff. Clearly, not a day for a vigorous practice. I went to the kitchen to look at breakfast options and thought about what I actually wanted to eat, not what was fastest or easiest or what only had a day left before it expires. I felt good after eating, because I paused and realized when I'd had enough, too.

Now, obviously these are the simple questions so far. I'm hoping the listening can go deeper. I am still looking for the right name for my therapy, and I feel like it's there inside me, I just can't hear it yet. I will be sitting more quietly, letting go of the next question while I answer the first one, and maybe the more profound insights can bubble to the top.

Wednesday, March 9, 2011


I was trying desperately to catch up my continuing ed credits this weekend, and came across an entire month of articles devoted to ethics. Contributions were written by bioethicists, people serving on hospital ethics committees, and even some ethics policy-writers. It was really interesting stuff, because I haven't had to think about some of these issues in a while. The most interesting one for me was written by George Blackwell, PsyD, and it was about how to de-escalate conflict in tense situations. The author was coming from a perspective of helping a hospital team agree on a solution to an ethical dilemma, but the concept he explained seems pretty universally helpful. I tried to Google this and see where it originally came from, but had no luck. I will simply say I did not come up with this beautiful idea, and give thanks and credit to the person who did!

The concept is the ARCH principle. It stands for "Acceptance, Respect, Curiosity and Honesty." It begins with "accepting every person where they are, as they are." We respect a person's right to their own opinion, and show curiosity about how they came to it. Then we open an honest discussion that still follows the other principles. I think it's pretty clear how this could be useful in daily interactions. There are as many different opinions as there are people in the world, eventually we will come up against someone with whom we disagree. My usual tactic is to allow them to speak, maybe make a comment or two, and let the discussion drop because I don't like conflict. Later I'm left feeling empty because I didn't speak my mind. I have seen other tactics that work even less well, where someone starts shouting and calling names to show their disagreement. Neither of these methods results in a fruitful meeting of the minds, and they both leave someone feeling bad.

If we follow these principles, however, we can have a discussion and not end up angry or upset, hopefully. I accept that another person has a different background than I do, and have come by their beliefs in a different way. Right now, we disagree. I respect that they have an opinion, perhaps even a strong one, and they are entitled to it. I show curiosity by asking questions about how they came to this conclusion, trying to learn more about them and their belief-system to be more informed. This in turn shows them I'm interested, and willing to listen. We can discuss things calmly because everyone feels safe in this kind of environment. When we come to points of disagreement, I can honestly say that I understand they have a different opinion, I respect that, but then explain my views, without using language that is harmful. In an ideal situation, they would afford the same ARCH principles toward me. We may never agree on everything, but we will both have learned more about each other, and about another point of view. That kind of knowledge allows me to interact with others in a more intelligent way in the future, too.

I think this principle correlates really well with yogic philosophy. In the Yoga Sutras of Patanjali, the yamas are the first limb of Ashtanga Yoga. They describe the ways we should relate to others in the world. The first 2 of the 5 yamas are ahimsa (non-violence) and satya (truthfulness). The usual "rule of thumb" is that ahimsa, or non-violence, trumps all the others. So, if our honest truth is hurtful, we do not speak it. The ARCH principle gives a simple and modern perspective on these ancient concepts that really speaks to me. We have multiple interactions with people every day, from our family members to our co-workers to the people in line at the grocery store. Reminding ourselves to accept each one of them where they are is a great way to begin any conversation. That alone sets a positive tone for the rest of the interaction, even if there is no disagreement.

Tuesday, March 1, 2011

Take Care

I saw a woman yesterday who has a familiar story. She told me about her busy full-time job, her family obligations, her health concerns and all the pressures in her life. We discussed her symptoms, which included poor concentration, tension in the neck and shoulders, irritability and difficulty sleeping. I gently explained that all of her symptoms are classically related to stress.

The human body is programmed to respond to stressful situations in a way that allowed us to survive in ancient times: we recognize a threat and our body gears up for fight or flight. Of course, millions of years ago, we were fighting or fleeing from wild animals. That's rarely the kind of stress we face today. But, our bodies cannot differentiate the threat of attack by tiger or a deadline at work. The physiologic response is the same in either case. A lot of people feel they are under constant pressure, so their sympathetic nervous system (that of the fight or flight response) is always firing. The body is flooded with stress hormones like epinephrine and cortisol which help us to move fast and escape danger, at the expense of mental concentration, rest and digestion. We end up burnt out, finally exhausted physically, but with the mind still racing ahead, worrying about the next day.

So what is the remedy to daily pressure when we can't escape the stresses? We have to work and take care of family, after all. However, too often the priorities are out of sync with our own best health. My patient listed all of her obligations, and said she had no time to get help for herself. She was doing everything for everyone else, including things that could be delegated, and choosing to put herself in last place. I talked to her about reducing the stress response with proven remedies, such as talk therapy, yoga, meditation and massage. I could see her getting anxious trying to insert even one of these things into her schedule. After some problem solving, she was able to come up with a few things she could delegate, or allow to go undone for a day so she could find an hour here and there. She agreed to start meeting with a therapist right away. That's always a good outcome, because I know she'll feel better just having taken the step to put herself first for a change. All too often, though, I will see a patient like this for a follow-up and find out they haven't called the therapist or scheduled the massage or attended the weekly yoga class. And they aren't feeling better.

Why is it so easy to put ourselves behind every other obligation in life? I know from experience, if I'm not healthy and relaxed, everything else I undertake suffers. I bet you've noticed the same thing in your own life. I often say goodbye to people in conversation or email with the words Take Care. We throw this phrase around in casual conversation, and I often say it without thinking what I really mean. Today I recognize when I tell you to take care, I mean put yourself first, thinking of your own physical and emotional needs. So take care, please, and notice the difference you feel in your day.

Wednesday, February 23, 2011


I've been at a yoga training for 10 days now. It's at a lovely ashram in California that is kind of rustic. I knew there would be things I would have to forego while staying here: wine, chocolate, my own bathroom, as a few examples. I didn't realize there was also a water restriction in place. We were told the first day that we must turn off the shower while we're soaping, then turn on to rinse, etc. That didn't sound so great to me, because I love a long hot shower. You might even say I'm attached to my hot showers.

But a funny thing has happened the longer I've been here. I don't crave Starbucks chai, I don't wish for a glass of wine after dinner, and while I don't relish the shower rules, they have become a total non-issue. I suppose it's like any change in habit or routine. Initially we react strongly, then we notice it less and less, until the new habit becomes our norm.

But, we have to release our grasp on the old in order to embrace the new. If I spent every morning moaning and complaining about the shower, I would constantly be reminded of what I'm lacking. My attachment would continue and certainly a bad attitude would follow! I'm not saying I won't hop into a nice long shower when I return home, but I have felt good about being able to change without huge pain. This can be a lesson for future changes: if I allow what needs to be to unfold, observe and not stay stuck in the past, I will adapt. I will release the attachments to the old and step into the new.

- Posted using BlogPress from my iPhone

Wednesday, February 16, 2011

Sing out loud

I am new to the practice of chanting. I have felt the power of a group Om, and I have recently had the opportunity to experience more complex Sanskrit chants. The energy created by a group of voices chanting in unison is incredible. A recent lecture explained that ancient sages taught chants to pass along sacred texts, but also to align the chanter with the spirit of the text and it's meaning. Simply chanting the text by heart opened the singer to enlightenment. Whoa!

But raising our voices doesn't have to include ancient languages to affect our mood. Singing out loud is an uplifting experience. Think of sacred hymns, or national anthems. Something so deeply personal can be revealed in a vocal song. Plus, singing in groups adds a social aspect, engaging members in a complete community effort. Then everyone is working together toward a common goal.

But the best singing is often done where no one else can hear. There's nothing wrong with that, because the act of singing itself has benefits. When we sing, we must start with a deep inhale. As we vocalize, we lengthen and slow the exhale to produce the tones. These are the same breathing techniques taught to calm anxiety. We increase the capacity of the breath, and calm the nervous system with deep belly breathing and lengthening the exhale. The next time you feel anxious or short of breath, try singing a simple song, or chanting a long Om. The calming effect can be felt quickly, and will be music to your ears.

- Posted using BlogPress from my iPhone

Wednesday, February 9, 2011

Emotional Body

Feelings come and go throughout the day. I may get angry at someone who cuts me off in traffic only to feel happy when I get to work and find cookies in the kitchen. Some feelings stay with us longer, though, especially if they're tied to negative events in our lives. The anger over a betrayal by a friend or loved one can stay lurking around for years. But where do our emotions lie? Are they simply our thoughts, in our heads? Or do they take root in the body? I know from yoga classes that certain poses can evoke an emotional response. Back bends create a happy, energetic feeling, while hip openers can trigger tears or anger. Where do these emotions come from when my mind is not thinking about anything in particular? Maybe my body knows something my mind hasn't figured out yet.

Maybe you've experienced sadness as a hollow pit in the stomach, or fear as a tension in the chest. We know emotions create a physical response. When we're afraid, stress hormones are released, our blood pressure and heart rate change and muscles tighten up. There are noticeable effects in the moment. But then a few minutes pass, and our breathing slows again, we release the tension and start to return to a more normal physical state. We have a mental memory of the fear, but can the body "remember" too? If you try to remember a time you felt fear, can you feel that same tension in the chest? Does your body still have a memory of that event? I never tried this until recently, and was amazed to discover the physical sensations that came with memories. The anger in my solar plexus, the sadness in my throat, how had I never noticed this before?

I have spent a lot of time hiding emotions. To open up to "negative" emotions like anger and sadness creates a vulnerability I couldn't handle so I would stuff the feelings and ignore them. Well, that energy had to go somewhere. I have read about sitting with emotions, breathing into the feelings and actually living in sadness, or anger, or whatever is coming up. Then the energy can naturally dissipate as it should, without coming back to haunt the body or mind years down the road. This can also be done with past events. I can look back on times of sadness and fear, I remember them in my head, but if I really pay attention, I can feel them in my body, too. Then I breathe into the sensation, I allow it all to happen without stuffing or running away. It is difficult, it leaves me raw and open. But the sense of lightness and peace afterwards is truly amazing.

This is challenging emotional work, and best done with the supervision of a trained therapist if you have a history of trauma or abuse. The power of the memory is obvious, but allowing and recognizing the physical sensations adds an intensity that can be disarming. In the long run, that is my goal, though. To disarm. I hope to lay down my defenses that no longer serve me and allow myself to open up to grace. Practicing feeling and acknowledging my emotions is a start. Sensing their place in my body acknowledges that I am a whole being, not just my thoughts or emotions. My body is not just a vehicle for my mind, after all, it is the container for the soul.

Tuesday, February 1, 2011

Too Much Stuff

Every January, a friend of mine posts an invitation to the "Month of 100 Things" on Facebook. It is a call to donate, recycle or otherwise dispose of 100 things we no longer need. I never find this too challenging, because I am the opposite of a pack rat. I can easily donate clothes we no longer wear, toys that are no longer played with, and books that I won't reread. The challenge for me is to not fill the emptied space with a bunch more stuff. I am not an excessive shopper, but I like to buy clothes, shoes, books, and toys for my kids. I know we have plenty, and possibly even way too much stuff, yet we always seem to accumulate more. I also recognize that it feels good to purchase something I like. I like getting rid of 100 things every January, but I see that it's pretty scary that I have 100 things I can easily part with!

I was recently reading a translation of the Yoga Sutras in Desikachar's book, The Heart of Yoga, and I was struck by sutra 2.7: "Excessive attachment is based on the assumption that it will contribute to everlasting happiness." I interpret this to mean that we are searching for happiness from our stuff, believing it will take away the pain of everyday life. We find it difficult to part with things (or to stop getting more things) because, for a short time, something new makes us excited again. The new toy is always played with the most, but it will eventually end up forgotten at the bottom of the toy box. Once the newness has worn off, we are no longer interested. We feel the same old feelings of loneliness or isolation, sadness or irritability. What do we do? We go shopping for something to make us feel better again. But everything loses its luster over time, even people. We age, our bodies and faces look different, and not in a good way. It happens to all of us, yet as a society we spend so much time and money trying to fight against it. We try to keep our external appearance shiny and new, just as we search for the newest car or phone to fill us up again. We keep looking and looking outside, we buy and buy and yet we aren't satisfied.

I think this sutra is pointing out that we aren't happy because we are looking in the wrong place for fulfillment. Yoga teaches us that inside, we are all whole. Instead of facing outward, searching for pleasure and avoiding pain, we need to turn inward. Our true essence at its core is perfect, in every one of us. When we attach to stuff, we lose sight of our own capacity for joy. I don't need a new iPad to feel content, peace is always with me if I choose to access it. I can sit quietly, listening to the wisdom of my own heart. I can allow this moment to be, without wishing it were something else. I can open to the universe and feel a part of it all. I can do all this anywhere, I don't need a new cushion or special chime to find bliss. I recognize that I have all I need, and I can continue to work on releasing the itch to acquire more.

Monday, January 24, 2011

Accepting it all

I have written before about my ongoing struggle with acceptance. This weekend caused me to think about it again, as I dealt with cold weather, loss of sleep and work crises. I became more irritable as the weekend went on, culminating in a serious bad mood when the Bears lost yesterday. Why did I feel so out of whack? I started to take a good look at my thoughts and realized I'd fallen into my old pattern. During challenges, I tend to really really wish things were different than they are. I walk outside in the winter and think if only it were warmer. Or I wish the Bears defense would play better. Or I hold a long pose in yoga class and grit my teeth, wishing we could only straighten our legs! My mind grasps at what it would prefer, rather than accepting what actually is. That takes up a lot of energy, and, I'm sure you can already tell, brings down my mood.

If I'm convinced this moment isn't right, that it could be better, and wish it were over, I am focused on what I'm lacking. I feel cheated and angry that I don't have what I want right now, whether it's peace and quiet or warm sunshine. I deserve it, right? My thoughts create this atmosphere of negativity, and I end up feeling lousy. It's amazing how many times I find myself wallowing in these thoughts, though. I have been trying to recognize when this is happening, and it's pretty much all day long. Noticing the pattern, however, allows me to do something to alter it.

I have a choice, after all, about the direction my thoughts take me. I can push away the present, longing for something better, or I can accept this moment as it is. When I breathe into a challenge, I find resiliency, the ability to come through adversity unchanged. Once I let go of the tugging and grasping, I can let go of my anger and frustration. Every moment is perfect as it is. I want to spend less energy wishing for something different and more finding the beauty in the here and now. Patterns are often deeply ingrained, and this is one of my deepest. I know if I take it a moment at a time, I can make real change.

Monday, January 17, 2011

Beginners' Mind

I have had a few seriously challenging yoga classes recently. I have to say, I found myself getting frustrated and even a bit mad at the teacher for doing difficult sequences and poses I could not achieve. I left the first such class feeling all out of sorts. At the second one, the teacher mentioned a Zen concept called Beginners' Mind. Wikipedia defines this as "having an attitude of openness, eagerness and a lack of preconceptions when studying a subject, even at an advanced level." I started to think about the practice in a different way.

When I first started yoga, every pose was a revelation. I didn't know what would happen, I had no idea there were Sun Salutations that were done in the same order every time, and I didn't expect to be able to do every pose. Far from it! I developed a sense of humor about myself that I didn't have anywhere else in my life. I could attempt the impossible, like an arm balance, or my first nemesis pose, Ardha Chandrasana, and laugh if I fell. Somewhere in the last 3 years I've lost some of this ability. I needed a healthy dose of Beginners' Mind for sure!

Think back to when you started something new: learning an instrument, trying a new computer program, or a new dance move. I'm sure you learned to take things one step at a time, without jumping ahead or trying to learn everything at once. Clearly you didn't expect greatness the first time around, or even the second or third. Unfortunately, for so many of us, that eagerness and openness quickly gets replaced by a fight to the finish, and an expectation of perfection. We become dissatisfied or even angry if we can't get it just right. That's exactly where I found myself on my mat.

Now I could be frustrated at my teachers for kicking it up a notch, or I could see this as the opportunity it clearly represents: to return to my starting point. Be a novice again. I shouldn't be able to do every pose, because that's where I've been (mostly) for a while now, and my practice was feeling a bit stale. I no longer had the feeling that I could walk out of class and deal with anything life threw my way. I didn't have to work or foster a sense of humor in the face of a challenge, so I stopped trying as hard. I was coasting. I am hitting the reset button, to find that eagerness and lack of preconception again. Where might you be treading water in life? Can you step forward by looking at it with the mind of a beginner?

Sunday, January 9, 2011

Do Your Own Pose

I had pose envy in yoga class last week. A beautiful yogini on the mat next to me held handstand for a couple of minutes, and I was in awe. My heels were touching the wall, as I tried to come away and balance for a few seconds at a time, while she was just holding there, still and strong. Wow. Anyone who has attended a yoga class has experienced this feeling, I'm sure. There are people who seem to be able to do every pose, or look like the cover of Yoga Journal. Now, I know that yoga isn't about the perfect pose, but I sometimes get into my head and start to wonder if I'll ever look that steady, that strong.

The ego doesn't have a place in yoga. Yet, as humans, our egos are often the strongest part of us. We are used to competition, constant striving to be better, or even perfect. In yoga, we start where we are. We recognize every pose can be modified to fit every individual, and that no one is going to resemble anyone else, on or off the mat. Sometimes I need to remind myself to turn my attention back to my own practice. The best classes are when I am so into the flow, I don't notice anyone or anything else. Later I can't recall what order we did the poses, or what songs were played. That is when I lose my ego and it's all about the breath and the flow. Peace in my mind and in my heart.

So I reminded myself last week to do my own pose. My friend on the mat next to me has a different practice and a different starting place than I do. I don't need to emulate her or wish to be like her. I can applaud her beauty and grace and recognize that every being in the room has something different to offer. I try to keep my ego out of the yoga studio. I'm certain it will be there waiting for me when I leave, but the more often I can set it aside for any length of time, the closer I get to true freedom.

Monday, January 3, 2011


I have been working through the darkness of winter by trying to focus on gratitude. I admit I don't like the cold, the gray days are hard for me, and my bright light doesn't seem to be enough to start me off on the right foot every day. But every night before I go to sleep, I think of things I'm grateful for. Just for a short time. This deliberate exercise isn't Pollyanna-ish positive thinking, it's not cheesy or false. It is simply recognizing that I have a lot, even on days when I feel a lack.

Let's face it, if you're reading this blog, you likely have a roof over your head. That is definitely something to be grateful for, because there are clearly people for whom that isn't the case. The same is true for having enough food to eat, warm clothing and boots to keep your feet dry. Simple stuff, but these items alone can cue me into the abundance I have in my life. My heart starts to feel uplifted because I am grateful.

The people in our lives can obviously be a mixed bag. We can feel so thankful for friends and family, but loneliness affects a lot of people. We may feel sadness or loss thinking about relationships, but sometimes even the smallest encounter can be a reason to be thankful. I like to focus on a seemingly meaningless interaction, like the smile I received from someone in the hallway at work, or the coffee barista who is always so cheerful. I'm grateful for positive communication in any form, and enough small moments like these can turn a day around.

Some days it's harder to find things to list, but I can always come up with something. Even the most mundane, like hearing a song I like on the radio. Every time I turn my attitude toward gratitude (ooh, a rhyme!), I feel lighter. More compassionate towards myself and others. I may try moving this practice to the morning, and see if I can open my day with these feelings, as I've felt a need for a real boost the last few weeks! A few things on my list today: I'm grateful for time this morning to do yoga and write this blog entry before work. I'm grateful for my cats who joined me for both activities, and I'm grateful that school has started again! What are you grateful for today?