staying ahead of the pain {3/1/13}

I had hip surgery a couple of days ago, and before I left the hospital my doctors and nurses repeated one thing a dozen times: stay head of the pain.

What they meant was that I should take my medications before I felt like I needed them, but I couldn't help thinking what a rare situation I was in. It isn't often that you get a heads up when something is going to hurt, much less a cure that fits in the palm of your hand. It got me thinking about all the pain that we can't stay ahead of, the pain that smacks into us out of nowhere like a meteor, shattering our lives and blasting us with aftershock.  ​

When we lose someone, or fall into a deep depression, taking care of ourselves can feel impossible. But knowing that suffering is a part of life, and that some days (or weeks or months) will be harder than others, we can do some prep work. So while we may not always be ahead of the pain, we can have a plan for taking care of ourselves when it comes. Here are four suggestions for making it through difficult times:

1. Be gentle with yourself: surround yourself with things that make you feel calm, nurtured, comforted, and safe. Start paying attention now and keep a list, so that you have it ready when things get tough. My list includes: meditation; getting outside; petting my dog; reading Anne Lamott, Pema Chodron, Thich Nhat Hanh; listening to music; dancing; wrapping myself up in heavy blankets; and lighting candles.

2. Reach out. Have a list of people you feel comfortable calling when life gets hard. It doesn't have to be a long list, just a few friends and/or family members who will listen when you cry without trying to fix it. People who will tell you that you are not alone. 

3. Be present. Making space for your pain will help you identify your emotions. This is hard to do, because when we are hurting we seek distraction. But ignoring or pushing down our pain means it leaks into other areas of our lives.  If we can be patient with our pain and give it space to breathe, we are likely to move through it more peacefully, with less collateral damage. 

4. Look for changes, no matter how small. Write them down if it helps. Grief, depression, anxiety--these things are not the same everyday, and taking stock of the changes will remind you that nothing is permanent. 

stemming despair {12/23/12}

This article, by Andrew Solomon, appeared in today's Sunday Review section of the New York Times. By the second paragraph, I was on board:

Adam Lanza committed an act of hatred, but it seems that the person he hated the most was himself. If we want to stem violence, we need to begin by stemming despair.

In the days after Newtown I too had thought about Adam Lanza as both the perpetrator and a victim of the tragedy. I thought about his family, the people who cared for him that were still living, and wondered how they would possibly deal with the way he'd ended his life. I thought about his brother. I wondered how I would feel if my brother had chosen to take the lives of others before taking his own. And, though I knew it would be an unpopular, maybe even unfathomable reaction, I felt compassion for Adam Lanza. I kept it a secret, because everyone around me was showing anger. Even the Buddhist service I attended to honor the victims did not list Lanza (or, for some reason, his mother) among the dead. The pictures of Lanza in the media made his actions even more bizarre. This young man looked more terrified than terrifying. What had happened to him, I wondered, to cause such violence? 

Solomon goes on to define the spectrum of perpetrators, the range of difficulty in predicting behavior, and, of course, the hindsight that prompts an outcry. The mad scramble to assign blame. Who failed? Was it the parents? The educators? The mental health professionals? Finding a fixable root for the cause allays the terrifying reality:

[P]eople are unknowable...We have to acknowledge that the human brain is capable of producing horror, and that knowing everything about the perpetrator, his family, his social experience and the world he inhabits does not answer the question “why” in any way that will resolve the problem. At best, these events help generate good policy.

So what is the answer, then? How do we stem despair? Solomon doesn't venture a suggestion. He falls back on the old, tired "better mental health screening for children." I'm not saying that we shouldn't be paying more, closer attention to our children. We should. But screening children won't solve anything. Treating children might. As might treating ourselves. 

As someone who entered the mental health system as a teen, I can tell you this: it was frightening, cold, impersonal, and filled me with shame. I only knew that there was something "wrong" with me. I believed I was broken. Psychiatrists did not educate me in medications or options. Therapists were a world apart from the psychiatrists, and they didn't offer any practical advice on how to deal with problems or feelings. I was treated as though I was a problem that needed to be solved. I felt like it was my job to get "well," and the longer it took, and the more I relapsed, the worse I felt about myself.

These days strides are being made with Dialectical Behavioral Therapy and Acceptance and Commitment Therapy, but I'm not sure how widely used they are, especially in regards to children. Here's the thing, though: they apply to everyone. Life is hard. We all need positive, productive tools to cope. What if they taught mindfulness in schools? What if they taught acceptance and impermanence? What if children, teens, and adults with depression or anxiety or bipolar or any other form of mental illness weren't singled out, pulled aside, and made to feel like they were missing something that other people had? We are all trying to learn to be kind, to be loving, to be gentle with ourselves and each other. Maybe some of us just need extra tutoring.

And maybe that's not a sufficient answer either. The truth is, I don't know how to stem despair in anyone but myself, and it took me 33 years to figure that out. But I do know that mental health is not an exact science. I know that children are in a constant state of change and development, and I worry that chasing after them with clipboards and diagnoses will do them more harm than good. Perhaps the best thing we can do for our children is to become a society of mentally healthy adults. Perhaps if they see us reacting to the world with more understanding, more curiosity, more compassion and less rage, their own fears and insecurities will feel less overwhelming.

We can change policy. We can change procedure. But first and foremost, we have to change ourselves.