Sunday, February 24, 2013

No one's favorite place

Hospitals are weird places. I find them compelling and deadening, comforting and scary. The big hospitals are labyrinthine, sprawling, ugly places lit by buzzing fluorescent lights and smelling of too much hand sanitizer. When I find myself inside a hospital, I always have an odd sense that I'm going to get in trouble, that I shouldn't be there, though it's perfectly normal to visit clients when they're hospitalized. I get disoriented and almost always have a hard time finding the right room, even in the hospitals I visit most often.

People in hospitals are dying, being born or very close to death, hooked up to an array of machines that click and beep constantly, and to bags of mysterious fluids. It's so creepy, like a horror movie just before something violent happens.

There are whole wings of hospitals devoted to the art of cutting into the living flesh of a person and fiddling around inside. While this is going on, the anesthesiologist is administering a cocktail of drugs that keeps the patient nearly dead, completely paralyzed. Surgery is bizarre. It is so unnerving! And yet I would love to sit in on a surgery some day. Brain surgery would be great. My dream is to fill the surgical theater with Reiki, let it pour into the room. That way, both patient and medical team would be bathing in Reiki. The plan is rather grandiose and probably will never happen, but I would love to experience that, even as weird as it is. Surgery is one of the compelling yet creepy things going on in hospitals. It's heroic and cold hearted in a way, too. Surgeons are very strange people.

It's no wonder hospital staff behave as they do. Most are as kind as they can be, under the circumstances. Some of them are mean as hell, understandably if you ask me. How would you feel if you worked in that kind of environment? Hospital staff works too hard or too intensely. Or maybe they are the way they are because of the never-ending atmosphere of emergency/crisis that is part of every hospital.

I experience most hospital workers, from lowly receptionist to the most high fallutin' surgeon, as burnt out. They're so fried, in fact, that they often seem blasé. I understand how easy it would be to shut down. Sadly, this does not benefit the patients in any way. It's a big problem.

That macho thing of working ridiculous shifts in medicine - 48 hour shifts with no sleep for instance - what the hell is that about? Seems like hazing to me, but what do I know?

Originally hospitals were more like hospice - a place to go where you could comfortably die. Then they became places of heroic rescue from the jaws of death. Later still it was thought that mothers in active labor should leave the comfort of the home to give birth in hospitals.

We trust hospitals. It's where people go in a crisis, definitely. If I broke my arm, I would not call my acupuncturist. But oh, they are strange domains.

Thursday, February 21, 2013

Walk your Talk

Harder even than mindful listening is mindful speech.

How often do you pause before speaking to think about what you're going to say? Maybe at a job interview, people think before speaking. Also possibly in psychotherapy sometimes (though the juiciest bits in therapy are times when the client blurts out something freshly risen from the unconscious). People about to propose marriage probably choose their words carefully, maybe even rehearse before popping the question. I could go on but you get the picture.

But in general, we in my society are not careful speakers. The practice of thinking before speaking is something I find excruciating. One of the methods I've tried involves asking myself, before uttering a single word, "What do I hope to accomplish by saying this?" Nine times out of ten, I have no goal in mind except to share all the interesting things I'm thinking about. When I pause, whomever I'm speaking with invariably starts or continues talking, oblivious. Sometimes I think people will say anything just to capture the floor as it were.

I've also undertaken 24 hour word fasts from time to time. It is so hard to keep my mouth shut. I have many fabulously interesting things to say at all times! Don't you?

We who are in the business of massage therapy are renowned for mindless speech. I've received massages from people who never stopped talking for a second throughout the session. I find it unpleasant and believe the talking does not add to the benefits of massage since yacking therapists become distracted by their reverie and hence aren't able to pay attention to what they're doing. I have one client who prefers to chat while on the table. Most people enjoy an hour of peace in which they can space out, daydream or focus on the sensation of massage.

Likewise I do not appreciate the unnecessary diagnoses many therapists feel they must share with their clients. I'm talking about statements like "Your back is so tight!" As if we, the receivers, don't already know. The use of words like knots to describe muscle tension is never appropriate. It's inaccurate and plants a seed in the mind of the receiver that I believe can make him or her feel worse. Muscles do not ever tie themselves in knots!

If it were up to me, I would require all health care workers to practice mindful speech. It's a big problem. The things doctors say to their patients are appalling. I hear stories literally every day and wonder what they were trying to accomplish by saying such horrible things. When we're ill or in pain, we are suggestible. We health care practitioners should be especially mindful.

One of the foulest forms of mindless speech is what we call gossip. I'm not referring to the practice of sharing news about other people. Gossip involves saying something about a person who is not present, something you wouldn't say to his or her face. That kind of talk is poisonous to both the speaker and the listener. It can also be toxic for the person who is being gossiped about. I know this from personal experience. Gossip is toxic.

We're lucky to have the right combination of vocal chords, tongue, teeth, lips and breath which which to make speech. I know we do the best we can when it comes to mindful speech. It is really hard.

May you speak clearly and mindfully today. May you speak well today of yourself and others. May it be so. Shalom.

Saturday, February 16, 2013

Mindful Listening

Psychotherapy is often called the talking cure. I don't think it's the talking that's curative since most of us actually can't stop talking no matter what. All our talk talk talk isn't, in and of itself, measurably healing. Sometimes it is just the opposite.

It's the listening that makes psychotherapy effective. Therapists listen carefully. They listen for cues to help them keep their clients headed in the direction of awakening and healing. Psychotherapy is mindful listening with an agenda.

Of course therapists aren't the only careful listeners in the healing professions. My acupuncturist, for example, listens not only to what I'm saying, but also pays attention to my tone of voice, how loudly I'm talking, how fast, that sort of thing. Mindful listening is a part of diagnosis in Chinese medicine. I listen for the same things before a session of massage. Clients who naturally shout need a lot more relaxing than the whisperers who need, in my opinion, a more lively kind of massage. I also listen for hoarseness and the nasally tone that accompanies congestion. It really helps.

Mindful listening is hard because it's the function of human consciousness to assess incoming data, analyze and decide what's happening as fast as possible so our response will be appropriate. We're built to respond to the world as opposed to taking it in slowly and thoughtfully.

Some of that is the survival instinct. If we're lucky, before we have time to think, we jump out of the way of the speeding car or fast ball, for instance. In a debate, we form responses before the adversary has completed his argument. In many conversations, our brains are busy figuring out what the other person wants to hear or trying to decide what kind of advice to offer. In many conversations, people space out, paying no attention at all. We are not listening mindfully most of the time.

Game shows are excellent examples of how we analyze, decide what to do, then jump on it before another contender presses the button. We humans are naturally impulsive. This is not always for the best.

How marvelous and rare in friendship is she or he who can mindfully listen without interrupting or imagining that the person speaking needs advice. How truly precious is a friend without an agenda or the desire to fix or cure. The individual who can simply listen, with an open mind and focused attention, is someone you want to be friends with. Those people are rare.

Vipassana meditation could be seen as a practice of mindful listening to oneself. It has nothing to do with clearing the mind. We notice what kinds and categories of thoughts are moving through our minds, after which we return our focus to the sensation of breathing: a coolness in the nostrils or throat, or the rising and falling of the chest. It's a challenging practice, very rewarding, though. It builds stamina with which we can listen more carefully to our own hearts as well as to other people.

Mindful listening is a rare but much needed skill. It goes against the grain, but in almost every case, mindful listening brings insight and healing. The next time a friend in crisis calls, try just listening. Don't get distracted, pay attention. Refrain from offering advice.

The next time you are having some kind of crisis, sit quietly and listen to yourself, to your actual thoughts. You will not regret it.


Tuesday, February 5, 2013

Too many pills.

I was appalled to read this article in the New York Times about an unfortunate but probably not that unusual sequence of events that got out of hand and lead to a young man's death. Everyone was trying their best, I'm sure of it: the doctors and therapists, his parents, and the kid himself. And yet he got hooked on Adderall, went crazy and killed himself.

I can't bear to even type his name; it is such a tragedy.

Right now I could launch into a big thing about attention deficit disorder which is not actually a disorder. I could write at length about the survival instinct, how, for millions of years, our species needed a fractured attention span in order to survive. We had to listen for predators, watch the offspring, tend the fire - all at once. Those who say multitasking is a contemporary problem have romanticized the past.

The way we live in American society, at this moment in history, does not cultivate a steady, reliable attention span. For a few thousand years, "civilization," provided a more stable, safer existence in organized communities. For many thousands of years we used the same tools, the same weapons. Few of us ever moved far away from the land of our birth or our families. What our fathers did, we did, and our children after us. We had a chance to settle down, steady our attention spans. We developed philosophies, religions, we formed world views. Then we taught ourselves to write, made records of the tales that had been told through the ages, passed from generation to generation. Myths are always based on lengthy epics that many people actually memorized. Civilization steadied our attention spans.

Now we're in a tight spot as a species. We have overpopulated and over manipulated our landscapes. Traditionally, on earth, when a species gets as overblown as we have, it means the end is near. Or at least, something big is going to have to change. Evolve or die. I believe we're on the edge of a leap in evolution and that our technology is helping further our ability to make the jump. As with all leaps in evolution, there's a whole lot of chaos attending the shift. I think of Alzheimer's, autism, ADHD and other maladies of the attention as fallout from the evolutionary change at hand. Anyway, I could go on, but that's not what I want to write about today.

I'm thinking about how unfortunate it is that modern medicine is diagnosis-based.

My point today (at last I've gotten to it) is that we pathologize everything. Everything. It's a really big problem. The truth is, we can care for people who have no diagnosis, we can keep an eye on people who are close to the edge in terms of mental, spiritual or physical health, give them a boost before things go wrong. We can see the precursors, but we're so used to thinking every situation must reach the level of pathology before we're willing to pay attention, we can't see impending doom.

The next time you notice you aren't feeling well, instead of diagnosing, try asking yourself how you actually feel. If you're in pain, where is it in your body? What quality of pain is it - sharp, throbbing, or whatever. Are you queasy? Dizzy? Warm or cold?

Be curious about how you are. Find out something you didn't already know. I promise it will help you make much better decisions about how to take care of yourself.

The standard procedure in modern medicine is to completely ignore trouble until it becomes nearly lethal, then treat it as an emergency situation. In the meantime, if patients continue to feel bad, order more pills.

If we were not so quick to pathologize, medicine would be very different. We wouldn't take as many pills, I'm absolutely sure of it.

Be well. Shalom.