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Monthly Archives: October 2016

Being Present, Part 2

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Yesterday I met with a client whose grandmother is coming to the end of her battle with cancer and Alzheimer’s. Of all of the scenarios I can imagine, practicing mindfulness when your loved one has a degenerative disease seems the most challenging. Every day you try to be in the moment, grateful for good days, for what they are still able to do, knowing that eventually they will have fewer good days, fewer things they are able to do. But I guess there is always something to be thankful for–that their suffering is over, the pleasure of having known them, memories that you treasure.

This past month and a half has been tough. Practicing mindfulness and gratitude have become survival mechanisms rather than a choice. Sometimes I think about what my life was like in August, when my primary stressor was going back to work after being off for the summer, and it seems like a luxury. Now, in addition to the usual stressors of work and family crises, I have become a parent.

Ironically, the hardest part is the stuff that “normal” people do every day–meal planning, cooking, grocery shopping. Domestic tasks in general. I hate all of them. Even if I were married, I wouldn’t be as domestic as I am now. But I have no choice while my brother recovers from heart surgery.

In moments of weakness, I think about what my life used to be like. I never thought I’d say this, but I miss my solitude. I miss boredom. I miss the freedom of not having to go to the grocery store and eating a bowl of cereal for dinner instead. Of spending hours reading and writing in my journal, even if it was because I had no one else to talk to.

Likewise, I feel even more saddened by my single state. Before, although I didn’t love it, being single felt more like a choice–even though that was an illusion, since I hadn’t met anyone. Now dating isn’t an option. I barely have time to get ready for bed.

I know that I am not clairvoyant. I don’t know what the future holds. Things won’t be like this forever. Still, my current situation is a loss of freedom similar to what I experienced when I got divorced. Although I would have never quit my job while I was married, we could survive if I lost my job. Knowing that I had to work after I was divorced made keeping my job a necessity that caused me anxiety.

But as soon as I become aware of these thoughts about my past and future, I have to focus on the present. Not because I am trying to push myself to a higher state of happiness or enlightenment, but because it’s all I can do to get through each day. I would not have chosen my current situation, but hardship is an inevitable part of life, and my life is no exception to the rule. I cannot think about what my future holds because there are so many things to come that are overwhelming. I can only focus on this thing, in this moment.

This week that thing is returning to work full time, in the midst of the period in the semester with the highest volume of clients. Which is often the beginning of my descent into depression. Except this time, I can’t get depressed, because I have to take care of my brother. But since I can’t control whether or not I get depressed, I’m scared.

But I can’t worry about that today. Today I am not depressed. Today I will focus on getting through the day, and that will have to be enough.

One could argue that my life is worse than it was before, but I cannot afford the luxury of entertaining that thought, either. Nor do I feel that way. I just focus on the things that I can be thankful for now. Although they are different things, they are as plentiful as they were before. My brother is alive. He is getting better every day. He is able to help with more domestic tasks as he gets stronger. He is happy and appreciative. He is a football expert.

In fact, he recently informed me that Aaron Rodgers is not a fake State Farm agent. He is actually a really good quarterback. It makes pro football more interesting because now when Green Bay is playing I can cheer for the State Farm guy.

See? I can still find happiness in the little things.

Perception is Reality

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In “A Beautiful Mind” John Nash, a Nobel Laureate in Economics, talks about how he learns to cope with his hallucinations by ignoring him. That is a pretty amazing thing to do for someone who has schizophrenia. There are several disorders in which the person’s thoughts are so convincing, despite being false, that it is difficult to cope with them by deciding that you’re not going to listen to them.

For example, someone with anorexia may truly see herself as being fat, even though intellectually she knows that she is not. But her inner critic is so persecutory in its insistence that she not eat, not take up space in the universe, that she ultimately gives in. People with eating disorders often conceptualize their inner critic as having a relationship with ED, and ED is the most abusive partner I have ever met in therapy.

Or someone who is psychotic might be convinced that he is going to win a million dollars because Publisher’s Clearing House has told him that he may have already done so. And despite the fact that the check has not arrived in the mail after several years, he makes outlandish purchases based on the prize money that he is convinced is on the way.

I do not have delusional thoughts, but sometimes my obsessive brain tries to convince me of things that are not as insidious but still cause me to suffer. No one gives a crap about me. I am incompetent. Sometimes I can convince myself otherwise with objective evidence, but sometimes my inner critic is relentless in trying to convince me of the veracity of these assertions. It will repeat them hundreds of times a day. The effort to refute them is exhausting.

My psychiatrist tells me that I should put myself out of my misery at the beginning of this barrage by taking an Ativan as soon as the thoughts begin. But often I don’t because, despite all I’ve said about the importance of taking meds, sometimes I still don’t want to. And because, unlike depression, anxiety feels so normal that sometimes I forget that it is not. The meds definitely help. Most of the time I know that when the thoughts come, they are not true. But sometimes it takes a lot of work to keep them at bay.

Practicing mindfulness helps, too. One of the benefits of practicing is that it helps you understand the nature of the mind. Even for “normal” people, this is how the brain works. Random thoughts will pop up. They may not be based in reality, may not reflect what you actually believe. And in the next moment, the thoughts may be completely different.

But it’s really hard. Maybe if I dedicated my life to meditation like Buddhist monks do, my inner critic would be less effective in undermining my self-worth. Or maybe Buddhist monks don’t suffer from mental illness.

But my psychiatrist supports my mindfulness practice, in addition to my meds. He confirmed that it works, even for people with mental illness. But it takes a long time, and it happens very slowly. I know it works because I remember what I used to be like. And now when I go several days without meditating, in my moments of weakness the thoughts creep in and become more convincing.

So I continue to practice, and in the moment, I feel loved, competent, and worthwhile. So I’m writing this post to remind myself that this is true because, in the next moment, I may feel differently.