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Santa Fe 2009 298Many of the people I work with in both taijiquan and counseling have chronic pain. According to the National Health Interview Survey done by the CDC , about 25 million Americans suffer daily pain and about 54 million Americans have chronic pain. In working with pain, I use a combination of movement and mindfulness. Taijiquan and qigong can work wonders for pain relief. Each is a gentle way to get moving again and a way to attain balance in all parts of life.

There are several books I suggest to folks. First are the works of Toni Bernhard. You can read more about her at http://tonibernhard.com/. She addresses pain management from a Buddhist perspective. She has written several books on the topic and about her own coping with chronic pain. Another book is “The Pain Antidote: The Proven Program to Help You Stop Suffering from Chronic Pain, Avoid Addiction to Painkillers and Reclaim Your Life”, by Mel Pohl, MD and Katherine Ketcham. You can find out more about it at http://www.thepainantidotebook.com/index.html. Pohl helps people get off opiates and develop alternate and more effective ways of coping with pain.

Taiji and qigong work with pain by changing your relationship with gravity, changing the way you breathe, and calming your mind and body. A principle of taiji is that you only expend the energy and engage the muscles for whatever it is you are doing at that moment. Everything else is relaxed but ready. Your joints are never locked. Your spine is upright and your head rests in balance on your shoulders. If you had a plumb bob attached to the center of the top of your head and it ran down the center of your body, that plumb bob would always touch the floor somewhere between your feet as you move. Standing at rest, it would be equidistant between your ankles. Your shoulders are relaxed – neither tucked forward nor pulled back. When you change your relationship with gravity and are balanced, there is less pain because you are not tilted forward or back putting a lot of work on your neck, shoulders, and back. You also carry your body differently according to mood. Being in balance and harmony with gravity can also balance your mood.

Breathing to your diaphragm also reduces stress which can reduce pain. There is an emotional component to pain. Calming the emotions can help reduce the pain. Abdominal breathing slows the heartbeat, reduces blood pressure and blood sugar, lowers stress hormones in the blood, changes the blood flow in the body, improves digestion, and even changes your vision. You are going from fight-flee-freeze-faint mode to rest and digest mode. This is a guide to finding balance in a standing meditation.

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You can read more about the principles of taijiquan and qigong here.

You can also change your relationship with pain by changing the emotional relationship with it. Rather than fighting it, have a conversation with it. What is it trying to tell you? How does it feel? Is it hot, cold, throbbing, a dull ache? Notice it, be with it. Change your self talk with pain to change that relationship, too. Pain is not a bad thing, it is there to tell us something is wrong. Sometimes the harder we try to make it go away, the harder it works to be heard. Changing self talk can help with that as well. You change your relationship with pain.

 

Another option is humor. In 1979, Norman Cousins wrote a book called, “Anatomy of an Illness As Perceived by the Patient – Reflections on Healing and Regeneration.” I came across it back when it was published in 1979. My dad was in an intensive care unit for most of two years during that time. Cousins found that a component of his healing was humor and included things like watching Candid Camera and Marx Brothers movies. Laughter changes the hormones in your body and can bring on pain relief. Even just a smile can begin to bring calm and start to lessen pain. When people have found that support groups sometimes unhelpfully come down to contests of who hurts the most, humor can erupt to help with coping, especially in the form of Monty Python. Just the thought of the Yorkshire men can bring on a smile.

 

 

 

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2015 May 16 to 23 Bar Harbor 052

Root to the earth and rise to the sky like a tall straight tree.

It is difficult to feel centered sometimes. We are scattered by all sorts of distractions – perseverating thoughts, loud noises, flickering lights, and most often these days from electronic devices like phones and tablets. There seem to be multiple things at any given moment getting us scattered mentally and emotionally, and also physically. Pay attention to your body when you are feeling scattered. Are you grounded and relaxed and in harmony with gravity? Or are you tense, stiff, tilted forward or to one side with gravity pulling you down.

 

Our bodies and minds are one and when you are scattered in one, the other is out of balance as well. In taijiquan and qigong, your center is your lower dantien. That is the energy center about three finger widths below your belly button and three finger widths inside your body. Essentially, it is your center of gravity, and we move around and breathe from that center. I sometimes say in taijiquan class that life is a struggle in finding balance with gravity. It is always there. Astronaut Scott Kelly was two inches taller after spending about a year in space. Gravity compressed his body back that two inches after his return to earth. When you are out of balance with gravity, your body pays a price. Your neck, your lower back, and your spine all struggle to keep you upright. The outcome is increased pain and an increased risk of falling.

When you are out of balance, you also do not breathe as efficiently. Beginning about age 6 or 7, our breathing tends to start moving from our belly towards our upper chest. This style of breathing is less efficient. We get less oxygen, we have to work harder to breathe and tend to breathe more quickly. This “upper chest” breathing engages your sympathetic nervous system, or your fight/flee/freeze/faint system. Your heart rate, blood pressure, blood sugar and breathing rate all rise. You get tunnel vision. Your blood moves from your internal organs and brain out to your arms and legs to get you ready for action. Your ability to think and improvise goes away and you automatically “go with what you know.” Your adrenalin and cortisol levels rise and form a feedback loop between your adrenal glands and your brain that causes the levels to continue to rise. Take a moment and put one hand on your upper chest and the other hand on your abdomen just below your belly button. Now breathe like you normally breathe. Which hand moves? Are you breathing from your abdomen or your upper chest?

You can practice getting your center – finding your balance and breathing efficiently. You will move better. You will feel better. You will function more from the parasympathetic nervous system’s rest and digest way of being. You might even be more likely to use the other response to a threat – tend and befriend – when you are balanced.

This is an exercise we do at the beginning of classes to find balance with the earth and harmony with gravity.

Kona Hawaii 2013 116Recently a friend mentioned how different he felt while on prednisone, and as a Buddhist it helped bring home the tenuousness of the concept of self. Alan Watts wrote extensively about the concept of self in Daoist and Buddhist philosophy, with one example here.

I get to listen to about 10 or 15 minutes of Radio Lab on NPR during my Wednesday commute and recently there was a piece on the element lithium. Lithium is used as a psychotropic, but they also mentioned that towns which have an incredibly small amount of lithium naturally occurring in their water supplies also have lower suicide rates than towns with even smaller amounts. It reminded me that when lead was removed from gasoline and paint, crime rates went down. Transcranial magnetic stimulation not only helps with relieving depression, but in at least one study, people changed a decision after the stimulation. They didn’t realize the stimulation had occurred and had a rational explanation as to why they changed their minds, and the explanation went along with our concept of self and free will. So much of what we do and who we are occurs below our conscious level.

One theory in neuroscience I have come across is that the construct of “other” evolved first followed by the construct of “self.” These came about so that we could communicate and get along in this world. Music also evolved for our social and emotional well being, and it can have a very big impact on emotion. Think about the use of music in the soundtracks of movies, television and radio and how that affects your experience of the story. Athletes use music to change their performance. You can even use a soundtrack in your mind to change your mood and to change your self-talk. In Negotiating the Nonnegotiable, Daniel Shapiro tells how at his workshops he uses a soundtrack of drums to increase the sense of tribe for workshop participants who have to negotiate bringing their separate tribes into one tribe or else the world will end. The world almost always ends in the exercise. I wonder if that would change without the beat of the tribal drums during the cohesion of the tribes.

Shapiro devotes an entire chapter to the self – the “dual nature of identity.” He refers to our sense of self as the “fixed-identity problem.” Identity is not static, and includes our beliefs, rituals, allegiances, values, and emotionally meaningful experiences. We have various mindsets of the self. There is the fundamentalist who sees identity as fixed and governed by forces outside our control. There is the constructivist who sees identity as an “ever-evolving social construction.”   There is the anattist who sees us as having no permanent identity and transcending “the material world of attachment, experiencing identity as shifting waves within the ocean of life.” Lastly, there is the quantumist who sees identity as “a combination of nature and nurture” with identity both fixed and fluid and there are many possible selves. And we may change that perspective over time. They are not fixed either. With these different perspectives, how do we get along with each other? We change our relationships in that space between us. You can learn more by listening to Shapiro here.

A few years ago, I was cleaning out the attic in the home where I grew up. I found the speech I gave at my high school graduation. The last line was “we are all in this together.” All these years later, I still believe that. Shapiro’s work gives us good guidance on how to get along with each other in this world, and some different perspective on just what the “self” is.

When you hurt another, you may ask forgiveness from them. The Pope has asked forgiveness of those molested by priests and for the treatment of indigenous people in the New World. People convicted in court may ask forgiveness just before sentencing. Preachers and politicians ask forgiveness when caught in sin and then enter rehab to prove just how sincere they are. All of us do wrong at some time. Forgiveness is an issue that comes up often in life and in counseling. What does that word mean?

It does not mean saying that the wrong is now okay. “Sure you hurt me, but I forgive you, now it is okay.” That definition makes forgiveness extremely difficult if not impossible. It is giving a gift of dispensation to the one who harmed you. There is another view. Forgiveness can mean, “I don’t like what you did, and it is not okay but I will let it go. It doesn’t mean I want to have anything to do with you again, but I am not going to let anger and resentment devour me.” A quote attributed to the Buddha is that holding onto anger is like grasping a hot coal. The one who gets burned is you.

Many years ago I was having a conversation with a person who was working on recovery in AA and was doing step work. The eighth step is making a list of people you have harmed and you become willing to make amends to them. The ninth step is to make direct amends to those you have harmed except when to do so would injure them or others. It became quickly obvious that the person’s goal was to seek forgiveness even though in that case it would cause pain to the person wounded and to others. There was no talk about making amends. One universal principle throughout cultures and spiritual traditions (including secular ones) is to give without thought of return. When the Bodhidharma met with the Emperor Wu, one of the questions Wu asked was how much merit he had earned for all the monasteries he had built and all the other good deeds he had done in the name of the Buddha. “None,” said Bodhidharma. According to the story, the conversation was a short one. There are times when asking forgiveness is a manipulative act. We are asking forgiveness of the one we have already harmed with the sole purpose of making ourselves feel better. What is the merit of that? None. You are just doing more harm.

This is a place where the steps give good guidance. Look into your heart. It may be better to seek how you can make amends to those you hurt rather than ask forgiveness. Forgiveness belongs to the one harmed, and it is for them and within them that forgiveness occurs. If you are going to ask anything, ask how you can make amends and even then, only ask when doing so causes no further harm. Making amends with no expectations (including the expectation of forgiveness) may be a better way and work better at allowing yourself forgiveness with time.

For further thoughts on working on reconciliation and the process of forgiveness I strongly recommend “Negotiating the Nonnegotiable: How to Resolve Your Most Emotionally Charged Conflicts,” by Daniel Shapiro. Shapiro is the founder and director of the Harvard International Negotiation Program. As a psychologist and negotiation specialist, he has worked with families as well as corporate and governmental groups including conflicting parties in the Middle East. He provides a very thoughtful and guided method for the process of forgiveness and reconciliation.

On Friday, we had snow, then sleet, then some rain and then into Saturday it became sleet and then back to snow that lasted almost into Sunday morning. The weather forecasters had been tracking this storm for a while. It looked touch and go as to what we would get and how much and when it would start here in eastern Virginia. A manager at one of the places I work sent out one of the best cancelation emails I have ever received: “Due to the impending doom, classes are canceled tomorrow.” She is from upstate New York and has a sense of humor about snow south of the Mason-Dixon. And my work schedule put me at the particular work place just as it started to snow. She ended up canceling classes for the afternoon as well. The snow stuck to the roads pretty quickly.

Today, Sunday, is chilly and beautiful. The wind has calmed and the sky is achingly blue. When I looked up early this morning, I thought “I haven’t seen a sky that color since I was last in New Mexico.” I went out after breakfast to start shoveling the driveway. We have a fairly long and curved driveway. It is uphill all the way to the street and trees line both sides. I have to shovel the whole thing side to side so that we can get traction up the hill to get out, and so that we don’t accidentally slide into a tree or slip into the side of the house trying to traverse its aggregate length on the way back down. I decided last year that I would know when it was time to move when I get too old to shovel it.

I have a system for shoveling. I start at the top and work in angles and use gravity to help. It is the simple kind of geometry I liked back in late elementary and early high school. I still wear the galoshes I got around 6th grade complete with loafers from that time inside. My coat is a nylon jacket I got in 9th grade all those decades ago. They feel like old friends that are there for me every winter. And I wore thermal and wicking shirts I used in winter while I trained for marathons some years ago. Marathons take over your life. I just run for fun these days. It is a nice meditation time. I think I wrote most of my dissertation while running.

I walked up to the road. The only tracks in the snow were birds and squirrels and rabbits. I wondered how the little fox who used to hang out some last summer is doing. Hope he or she is okay. The first thing I noticed as I started shoveling was that the alternation of the types of precipitation resulted in snow on top of a layer of ice. Ice does not shovel very well. Hidden in the snow were lots of branches and small limbs that had come down in the wind yesterday – little barriers that could stop a blade quickly. The combination of snow and ice took me back to the snows of ’66 back home. We missed a lot of school for snow days that year, and a snow fort I built in our front yard stayed there for weeks with its ice armor over the snow walls.

I like shoveling snow. It is a kind of meditation. There is the cold, the stark clarity of the landscape, the clean scent of frozen air. There is the serenity of the quiet. Just birds and squirrels were out except for three times when people and their dogs walked by. Today was interesting. How to push snow while standing on ice. I do a lot of balance work with taijiquan and qigong. I used those principles to stay upright. Relax, sink your energy (qi) down to your center and below. Root your feet to the earth. Let energy come up through your feet and legs, direct it with your waist – silk reel – express the energy with your arms and hands. Keep the posture up, breathe to the diaphragm, move from the lower dantien. Embrace tiger, return to mountain. Flow with Dao in harmony with nature. Hard to stay mindful all the time, though, and that is okay. Memories of past snows, thoughts of internal ongoing conversations and writing projects, the occasional blasts of songs by Adele in time to movement of the shovel. Sometimes the brain was as busy as the arms and legs. If I did start to slide, I would just flow with it and stay upright and in control. Just pretended I was in a pickup hockey game with Denis Leary.

The fitbit says I walked a little over three miles. I could probably go out and do the whole thing again now. The sun has softened up the ice. But it is getting late in the day. The temperature is falling. The sun and its yang power will be back tomorrow to take the yin cold of the ice and turn it to water. Let softness, yielding, and flexibility overcome the hard and rigid – practice wu wei in the aftermath of the storm.

There is a Zen story of a master who stands with his eyes closed and yet catches a falling object while those wide eyed around him have not yet perceived the object’s fall. He is in the moment and completely attentive.

Ruth M. Buczynski, PhD, president of the National Institute for the Clinical
Application of Behavioral Medicine
, recently talked about how to rewire your brain to improve willpower. A March 23, 2015 article in Medscape discussed a study in Sydney, Australia that looked at nine modifiable triggers for low back pain. The leading trigger is distraction while performing a task or activity.

What do willpower and distraction have in common? Both are associated with losing focus. How can we practice focus and get better at it? Buczynski suggests a simple breathing exercise for five minutes a day. Simple does not mean easy, however. Many people give up mindfulness or meditation because of a racing mind. Buczynski recommends just focusing on your breath, and when thoughts come into your mind (as they inevitably will) just acknowledge them and return to breathing. You can focus on the sound of the air as it flows in and out or the temperature of the air or whatever works for you. The important thing is, return to focusing on the breath. It gives you practice for staying on task, and returning to the task when you wander.

Any time I work with someone who has issues with anxiety and stress, we start with the breath. Slowing your breathing and breathing abdominally does many good things for you – lowers blood pressure and heart rate, lowers stress hormones and in doing so lowers blood sugar and redirects blood flow to the organs. You are balancing your sympathetic and parasympathetic nervous systems.

So if you want to feel better and more balanced mentally, emotionally, and physically, start just focusing on breathing to your abdomen slowly and mindfully. You will improve your willpower and your focus. Paying attention to where you are now can also save your back.

Sunday – I went running this morning in the clear cold air. I came upon a flock of migrating black birds – hundreds, maybe more than a thousand of them. They seemed to be on every branch of every tree. Some were on the road, and a guy had to blow his horn to clear a way to his driveway. The sound of all those birds took me back over thirty years to the first time I came upon such a group. I was walking in the woods to Lake Matoaka to take pictures. I was checking my camera as I walked and suddenly realized I was surrounded by an incredibly loud noise. “What IS that?” I thought. I looked up and was surrounded by birds everywhere. So of course I immediately thought of Hitchcock’s “The Birds.” It was like being swallowed up by a great big living, vibrating-with-sound-and-movement organism. I walked along more slowly and mindfully and just watched in amazement. I remember that day there were at least two or three species each in their vast group. This morning I just smiled at all the racket and hoped nobody rained on me as they flew over and I ran in their shadows. I wondered what it was like in the days when passenger pigeons were still alive and their flocks would block out the sun for days because their numbers were so large as they crossed the sky. And now there are none, thanks to people. A few moments later a shot rang out somewhere down across one of the ravines. The woods immediately became silent. Within a few moments, the bells of a church over in Toano started to ring through the woods in the direction from where the birds originally came. I kept going with the only sounds that of a few local birds that live here year around, and the sound of the bells. A few seconds the only sounds were just a couple of crows and sparrows and my footsteps. I got back to the house and listened intently and maybe about a half mile or so across the ravine, I could hear the cacophony of birds again, recovered, back in the groove, calling out to each other and the world, carrying on their journey. My run became a meditation of yin and yang.

Tuesday – Another running morning this time in the cold damp gray overcast of a day between winter storms. I passed by a man unloading his pickup of his hunting gear. About a mile later I passed a woman in her front yard smiling with joy and wonder at a small deer in her front yard. She was holding her hand out to the deer trying to get him to come to her. I thought of a time years ago at Bryce Canyon as I walked along with a young summer ranger intern. He was studying ecology in graduate school. Every time we came upon one of the little ground squirrels that frequent the trails, he would stomp his foot and scare them away. “You don’t want to habituate them to people,” he said. The deer today was already pretty habituated, and getting more so. Every action we take is linked to everything, and our intentions don’t always play out in a way we hope for or even think about. A gesture of felt kindness and wonder may have consequences we are not mindful of – like making a deer more vulnerable as prey.  You really can look into any action, or even a bowl of rice, and see that we are connected to everything in the infinity of time and space. Every why has a why. I kept running. A mile or so later I was in the part of the neighborhood bordering on deep woods. A single shot rang out. I just kept running.

The end of the year is near on the Gregorian calendar.  There are other calendars – Chinese, Jewish, Muslim, and others including some structured so that dates fall on the same day of the week every year. But, like the metric system, our culture for the most part ignores the way others measure time.  Theoretical physics says that time should be able to go backwards as well as forwards and is not linear. But we experience time linearly and we look for causes from the past and long for or dread the future, and often miss the moment we are in. We resolve, especially at this time of year, to change.

Often people want to know the “why” of problems they have, or of behaviors. They feel they must know the why before they can change, or to make the change permanent. I sometimes tell the story of a research psychologist I once worked for. He swore he would never do clinical work because of an experience he had in rotation during his doctoral program. The rotation included a clinical track. He had a client who was afraid of plants. He tried the standard exposure therapy but got nowhere.  Eventually she came up with a story of being frightened as a child in the presence of a plant. He had no idea if the story was true, but it worked. Too inexact for him. He went into research.

But how exact is research?  Does the why or the cause matter? There is an article in Wired well worth reading at http://www.wired.com/magazine/2011/12/ff_causation/all/1.  It is called “Trial and Error: Why Science Is Failing Us” by Jonah Lehrer.  He looks at the story of the cholesterol drug torcetrapib and how what should have easily worked failed miserably. Causes are shortcuts, are stories, that we tell ourselves to make sense of the world. We are wired to try to make sense of the world, and we do this with stories.  What we forget is that they are stories and we sometimes make them unquestionable truths.  They matter, but in the end, they are our constructs. Statistical analysis in research can help, but too often the questions are asked in ways that affect outcomes, or the wrong tests are chosen or funding affects outcomes. At best, we can predict with probability.

Jonah writes:

“David Hume referred to causality as “the cement of the universe.” He was being ironic, since he knew that this so-called cement was a hallucination, a tale we tell ourselves to make sense of events and observations. No matter how precisely we knew a given system, Hume realized, its underlying causes would always remain mysterious, shadowed by error bars and uncertainty.”

One problem with a cause is that there is always a cause for the cause – an infinite regression of “why.” Often we have difficulty with randomness and ambiguity and shades of gray. But things happen. One of the interesting things about quantum mechanics is that subatomic particles can disappear and reappear somewhere else for no apparent reason.  We may long for the certainty of predictable waves in the flow of life, but to live, we need to be able to surf. To swim against what we think should be the tide is to wear ourselves out and risk drowning. And realize that nothing is permanent.

Jonah concludes:

“… (W)e must never forget that our causal beliefs are defined by their limitations. For too long, we’ve pretended that the old problem of causality can be cured by our shiny new knowledge. If only we devote more resources to research or dissect the system at a more fundamental level or search for ever more subtle correlations, we can discover how it all works. But a cause is not a fact, and it never will be; the things we can see will always be bracketed by what we cannot. And this is why, even when we know everything about everything, we’ll still be telling stories about why it happened. It’s mystery all the way down.”

What we can do is flow with the mystery in the moment we have and the story we tell. And a new year can start any time we choose in our lives. Calendars are constructs for marking time. Lives are for living.

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