Archives for posts with tag: acceptance

Who, what, where, how, and why are interrogatives, nouns that signal a question.

Very soon after babies start speaking words we understand, they start asking questions, “what” and “who” questions, most commonly phrased in one baby word, “Da’at?” (That, as in “what’s that?” or “who’s that?”) They are learning nouns, the names for people, places and things.

As parents, one of the challenging stages of our children’s development happens a few years later, when we are CONSTANTLY asked, “Why?” We provide the explanation, which is followed up with another, “Why?” It can be exhausting as parents often convey to me.

However, finding out “why” is not always the function of these questions. Some children are just learning that “why” is part of having conversation. Asking “why” is a way of guiding the direction of the conversation, a powerful skill, indeed. Sometimes “why” serves the function of stalling for bed, for clean-up, or for any other distasteful parental instruction that has just been given.

When I was a psychology researcher, there were a lot of questions phrased as “why”. But were they really “why” questions? It seems to me that most scientific questions are actually answering “how” questions; they address questions related to process and sequence. In treatment research, the question is even more rudimentary, “Does it work?” Treatments manipulate many many variables and as a result, it can be difficult to explicate how they work even if they appear to do so. I mean, we have ideas and models for how we think treatments may work but it is difficult to know for sure.

“How” and “why” questions can also preface statements of distress. “How did this happen?” “Why me?” Having a plausible explanation for situations, even if they are not objectively true, can be rather comforting and reduce distress.

“Why” questions are also a concentration of philosophy and religion. “Why are we here?” “Why am I here?”

As a person drawn to complexity, you might think that I would love pondering these big questions. Sometimes I do. Sometimes, I even enjoy it. But some questions are so large and complex that trying to answer the question seems to be a great oversimplification. We have enough people boiling down big problems to utter simplicity, much to the detriment of our world. Most of the current presidential candidates come to mind.

Why are we here?
Why did I get cancer?
Why is my kid having such a challenging time with life?
Why am I here?

More and more, these questions are replaced by:
“I am here.”

Most days that is more than enough.

My teen had a somewhat tumultuous weekend. The ups, the downs, and the in-betweens. Usually, during low times, she clams up, goes to her room, and doesn’t share what’s bothering her. Later, she may share but not until it’s resolved.

My child, like a lot of teens, has had trouble finding a niche. However, she’s had trouble for some years and the trouble she has now is more than typical. She is sensitive, emotional, and outgoing. She is passionate about her friends and loves belonging to groups whether it is band, her circle of friends at school, or members of her choir. Unfortunately, there’s not a lot of stability in her connections.

Yesterday, she told me that she felt sad. She didn’t tell me why but she was also asking me a lot of questions, which gave me hints into what might be bothering her. Talking to my kid is like talking to a butterfly as she flits in and out of the conversation as well as in and out of the room. I am no mind reader but I am a pretty good guesser. Nonetheless, a lot of the things I say to her are not taken well. We’d had a couple of good talks over the weekend and I thought I’d take a chance. Also, I decided to discuss things generally, instead of personally, something I know as a professional works better with teens, but I often forget to do as a mother.

I asked her to sit down on the couch beside me and this is what I said, “It is really hard in life to find a group in which you feel you belong. Sometimes, you discover a group and it seems perfect and wonderful. As time goes by, you form relationships and there are conflicts. People can try to exclude you. Then you can feel like you don’t belong anymore. This is really hard.” She nodded her head in recognition. I continued. “You will always belong in this family. No matter what.” She smiled, reached for my hand, and squeezed it. “Thanks, Mom.”

I said the right thing at the right time and place to help ease my child’s pain. It is the bittersweet spot of parenting in which I rarely find myself. I am grateful for this.

In my work as a psychologist, I work with children and teens who have disorders considered to be primarily genetic in cause. Environmental factors play a role as well, but according to our current understanding, they are mainly factors that maintain or exacerbate symptoms as well as the pervasiveness and persistence of the resulting impairment in carrying out life’s activities and responsibilities.

About 90% of my patients have Attention-Deficit/Hyperactivity Disorder (ADHD), the primary treatment for which are stimulant medications, which can make an enormous positive difference in an individual who is responsibly diagnosed and treated. However, even with medication, ADHD can make what we typically see as moral and responsible decisions much harder to make. Environmental supports from parents, teachers, and other professionals can help and as children grow into adolescence, individual psychotherapy can also be useful in helping an individual who has trouble internalizing rules that are good in the long run but not salient right now and to use strategies to promote life skills and success. Nonetheless, based on current longitudinal evidence, individuals with ADHD, even treated ADHD, have a much higher rate of high school drop out, only a 5% college completion rate, and a higher rate of accidental death as well as suicidality, among many scary possible outcomes.

This is why these kids, teens, and young adults are the “it takes a village” kind of people. Actually, I believe that we all belong to the village and as social animals, we rely on one another and impact one another for good, for ill, or for nil. But these individuals are particularly vulnerable. They do not tend to be resilient. They need particular parenting and educational strategies that are often inconsistently or not available. They need effective healthcare that is often in short supply.

I consider myself to have been very fortunate for many aspects of my life that just happened to me. I inherited a strong mind, a basically happy personality, grew up in a loving family, went to good schools, and had my basic needs for shelter, food, and belonging more than amply met. I take responsibility for cultivating these gifts very seriously but I don’t for a minute take responsibility for having receiving this gifts in the first place. I got very lucky and have made very good use of what I have.

Consequently, I have a great deal of love and compassion for the individuals I see, even the ones who are honestly, not very likable. Some of them are not even very nice. Sometimes they are very likeable, nice most of the time, but do really impulsive awful things. A common characteristic of many, but not all, individuals is a lack of consistent self-awareness and a very difficult time connecting their actions to negative consequences. This is a neurological issue and it results in difficulties taking responsibility. It is made worse in that when they are aware of short-comings or consequences, they often respond with very harsh judgement of themselves. This lack of self-compassion makes it harder to own up to personal responsibility. All of this is compounded with the fact that medication often makes a big positive difference because it fuels the belief that control is external.

A common way of framing this tension is by saying, “It is understandable that x, y, or z is really hard for you but it is not an excuse. You are still responsible for your decisions and behaviors. We realize it is hard and that is why we are all part of your team to support you. But you are part of the team, too.”

Yesterday, another heinous racist hate crime, an act of terrorism against African Americans was committed in our country. Many of us are angry, grief-stricken, and overwhelmed with sadness and helplessness. We are trying to make sense of this.

I think we need to stop trying to make sense of it, at least in the usual way that we do. The easiest way to explain something horrible is to put it under someone’s control and the easiest way to do that is by laying blame at a particular person. Another easy way to deal with these kind of events is to distance ourselves from them, the “I am not that” approach. Another way we can deal with this is to feel really sad, angry, and anxious for a day or two, or even a week, and then move on to the next horrible news story, further cultivating cynicism and passivity.

It is understandable to feel overwhelmed by this, to be enraged, to feel impotent, to wring our hands in perpetuity. It is even understandable to feel paralyzing and unproductive self-recriminations about the ways that we have acted unkindly to others. It is understandable to criticize the behaviors of others, to join with others in demonizing people we don’t know who have done wrong things; with social media, we join in with the professional media in shaming people in a very intense and protracted way. It has become brutal in a way that makes me fear for our culture. The stockades of the Middle Ages come to mind. Stoning. Throwing acid in a woman’s face.

These are actions that understandably fill our need for agency at times when we can think of nothing else to do. I have participated in these public shame-fests. I have participated in cynicism in the place of effective action. I have participated in judgment that is inconsistent with compassion toward myself or toward others. I have participated in racism, some of which I am aware, and likely some that I have done without self-awareness.

I believe that I am a good person in the way that most people use the term “good person”. That doesn’t mean that I haven’t done harmful things to myself or others. It doesn’t mean that I have not contributed to a hateful culture either through action or inaction, the latter because I was either “busy” or clueless.

As a psychologist, it is understandable for me to see yesterday’s terrorism as a mental puzzle to solve. But none of these understandable beliefs, actions, or conditions are an excuse for not taking my own portion of personal responsibility for being a part of a culture that can be hateful, cynical, passive, selfish, violent, and oppressive.

I am not responsible for the whole problem but I can take responsibility for my contributions to it. These are the steps I have decided to take:

1) I do not consider myself to be a racist person as a trait. However, I accept that as a human being, aggression and dominance are part of me and that I am not immune to the socializing impact of institutional racism. I accept that I can be a good person and person who has done racist things.

2) I accept that I have benefited from institutionalized racism due to the privilege afforded members of a dominant race

3) I will exercise self-compassion despite my moral and ethical failings.

4) I will work to be less judgmental, of people I know and of people I don’t know.  In terms of social media, this means objective criticism of ideas or behaviors but not of people and that said criticism needs to fuel a positive purpose.

5) I will work to help children and families be healthy.

6) I will work to maintain my own mental health.

7) I will work to treat cynicism as understandable, but as being incompatible with compassion and effective change, nonetheless.

8) I will work to promote unity instead of division in my culture.

9) I will work to elect individuals who promote unity and fairness instead of division.

10) I try to listen to others with different viewpoints and life experiences with an open mind.

11) I will accept that complexity is common in the very situations during which I feel the urge to simplify to make myself feel less overwhelmed.

12) I will expect myself, despite my best efforts, to fail from time to time. I will work at these times, to keep trying.

I may be wrong in my arguments, in my beliefs, and my actions. That does not make me a bad person. My imperfection and the limitations of my own mind to understand all of this is understandable. But it doesn’t take me off the hook.

It is understandable but it is not an excuse.

Stop making sense.

Start making change for the better.

Never, never, never give up.
-Winston Churchill

Yesterday was Thursday, a clinic day for me. I had scheduled an interview with a 5 year old boy, a kindergartener at one of the local Catholic schools. I went out to the waiting room to greet his mother and him. “Hello, I’m Dr. Elizabeth.”

He looked up at me and I saw a black mark on his forehead. I immediately thought of Ash Wednesday, which had been the day prior. However, this was more of a defined mark than a smudge.

“Did you get a tattoo on your forehead for Ash Wednesday?”

And he had, a temporary one, in fact. It looked like the remnants of a larger tattoo, perhaps a red race car. The boy put it there because his ash smudge had worn off before he wanted it to.

I found this to be a rather delightful perspective and one that was very different from my time smudged memories of smudged foreheads past. I remember, as a teen, feeling very self-conscious about them. Teen like to call attention to themselves but typically not when it is an authority’s idea. I was taught that it was disrespectful to take the ashes off. They were to stay on until God, gravity, or the bed sheets, rubbed them off.

I was a pretty devout child and young woman.  But I do remember taking it off once. I don’t remember quite how I did it because I would have wanted to make it look accidental or gradual. “Mom, I slipped in the bathroom and a hand towel that brushed past my forehead, broke my fall!” You know, some lame excuse like that.

Ash Wednesday is the first day of the Lenten season, which last 40 days. A strong theme of Lent is sacrifice, namely Jesus sacrificing his life to cleanse humanity of sin. As such, there are traditions of Lenten sacrifice. People “give up” meat (terrestrial animals) on Ash Wednesday and Fridays of Lent. There are fast days when people eat less, and more simple food than usual.

Then there is the question, “What are you giving up for Lent?” When my mother was a child, it was common to give up candy for Lent. She used to tell us how some kids “cheated” by putting their candy in a drawer during Lent but then binging on it as soon as Easter came. I don’t remember what I used to give up but I know that I did it. I remember having mixed feelings about the sacrifices of Lent, about giving up.

“Given up” has so many meanings. However, it typically connotes a loss or weakness.

We have given up when we make sacrifices for the greater good.

We have given up when we view ourselves as helpless and neglect our responsibilities to ourselves and to others.

We have given up when we accept painful realities, lessening suffering.

Only one of these examples involves passivity and weakness. The other two sources of “given up” require fortitude.

I no longer follow most Lenten rituals but in my 30’s, I decided that I would use it as a time to “give up” on things that were adding suffering to my life. I have attempted to give up guilt and impatience, for example. I knew that I really couldn’t totally give these things up but what I realize now is that I was working on being my mindful, less judgmental of myself and others, and thereby more accepting of myself and others.

Cancer is by no means a gift, but it certainly is a time for reflection on suffering and acceptance. When I decided to study mindfulness nearly three years ago, I had a much narrower definition and experience of it than I do currently. And currently, I believe that I have just scratched the surface.

I give up for freedom.

I give up for peace.

I give up for acceptance.

I give up to be who I am and where I am in this given moment of time.

And then I do this over and over and over. For as many opportunities that I have to repeat myself, I am most grateful.

As a person with “no evidence of disease”, I am grateful. I am also grateful that I continue to heal physically, emotionally, spiritually, and yes, cognitively. I have written of the attention, concentration, working memory, and organizational difficulties I’ve had since being diagnosed with cancer. (Some people call this “chemo brain” though I didn’t have I.V. chemo.) These difficulties have slowly but surely improved over time. A huge boost came after I completed a cognitive behavioral sleep program and then later, when I took gaba pentin for a few months to reduce my nighttime hot flashes. I have also had improvements through working to reduce my anxiety and grief through my mindfulness practice and personal psychotherapy. Last but not least, writing this blog is one of the most therapeutic endeavors I have ever undertaken. It, of course, has side effects like any therapy in that my posts sometimes worry my mother.

Although a good deal of my energy has returned, I still don’t work full time. I find that it is too hard to maintain my emotional and physical health when I do this so although I sometimes schedule a full time or slightly overtime week, my average is about 80%. Prior to my diagnosis and shortly afterwards (I had to cram my schedule in order to take off time for surgeries), my schedule varied from week to week but I worked up to 150% of what is considered full time.

Despite my reduced hours, I am quite busy. Although most of my day is meaningful and productive, a good portion of my day is being busy for the sake of being busy, doing trivial things that do not fill me up. And some of the trivial things would not be trivial if I stuck with them for more than a couple of minutes. But I spent some part of my day alighting from one activity to another in rapid succession.

I do this less than earlier in my cancer treatment. The main reason back then was fatigue, boredom, and the need for fun. Since I was having trouble with sustained attention, I flitted around lot. Although I have never written as much or as frequently in my life, I stopped reading books. There had been no time in my life since about age 10 or 11 when I was not reading on a daily basis, with some breaks for a few weeks during adulthood, when my stress was at its peak.

I’ve been doing a lot of thinking about accepting the things in my life about which I feel feel, grief, and anger. I know that a common fear for people impacted by cancer is fear of abandonment. My husband worries about losing me. My daughter, although she denies it, worries about it too, I think. She acts very much like other teen girls with whom I’ve worked, who have a mother with a serious disease. I worry about losing my family, through decreased participation in family life if I were to get ill again and through my own transition to death, which may not come any time soon, but will come some day.

I had a epiphany last week. Although I was aware of my own abandonment fears, I realized that I was continuing to give myself busy work to avoid feeling lonely. I have been filling up spaces in my heart and mind with filler. I have too often disengaged from my husband because I associate him with our fear of my cancer as well as the stress we have in parenting.

Since that epiphany, I have made some changes. Trivia is okay but not as a main course. And trivia is much better when enjoyed with a loved one. I also realized that a lot of my life is serious and difficult. I have a serious job as a child/adolescent psychologist. I have personal psychotherapy, our family class on mindfulness and emotion regulation, and couples therapy with my husband. Between my job and my appointments, I spend the majority of my waking hours in a mental health facility. Last Friday in couples therapy, which we have been attending weekly I said, “I want less therapy and more fun. John, I want to spend more time with you having fun.” Our psychologist thought this was a great idea. John agreed, reluctantly, because this scared him. But we’ve been spending more time together. Yesterday, I received a note from a childhood friend. Her husband “out of the blue” told her that he is divorcing her, on the day before their 27th wedding anniversary. This has also reinforced my resolve to continue to work on my relationship with my husband. Too often people live separate, lonely lives, full of activities, suffering in silence.

I am not by nature, a lonely person. Cancer has a way of whittling away at security, even for those of us with “no evidence of disease”. Breast cancer also has a way of striking women at the prime of life in terms of professional and family responsibility. Many of us have full careers, children who are not yet independent, and elderly parents who may need support. It is easy when juggling these balls, to feel fragmented and flittery, to feel engaged with everything but intimately connected with no one, not even with ourselves.

Balance right now means more fun and more depth.

My Wednesday “learning to keep my shit together” class reconvened this week after a holiday break. The topic for the evening was acceptance, a mindfulness practice. The purpose of mindfulness is to reduce suffering. Acceptance is one process by which suffering is reduced.

I am working very hard to accept some hard truths about my life, some about my present and some potential truths in my future. These are truths about my life as an individual, as a wife, and as a parent.  As I was thinking about this, one of the instructors wrote two equations on the white board:

Pain + acceptance = pain

Pain + non-acceptance = suffering

I think of pain and suffering as synonymous.  But this is not a dictionary course or a vocabulary test. And I have to admit that “suffering” sounds worse than “pain”. Suffering sounds like pain with a large side dish of something nasty. Perhaps the space between pain and suffering, within this framework, is filled with a roil of self-inflicted things. Another way to say this is that suffering may result from coping with pain in a way that enhances it and perhaps makes it last for a longer time. Everyone does this from time to time.

There are “hot button” issues for me. There are experiences that I have for which I have an immediate, negative response. They push a fear button, an anger button, or a grief button. And as I am having the response, I often know that it is out of scale. I have gotten upset too quickly and too intensely. There are also times when I feel stress in the back of my mind and it wakes me at night or invades my dreams. I think these are examples of suffering.

Acceptance is a process, a continuum. I am trying to work my way. So far I am learning that there is a cognitive part. In order to accept something I need to acknowledge it. I need to name it. I need to reason with it. That is what I have mostly been working on for the past couple of years. The acceptance that takes place in my mind. On Wednesday, our homework was to think about what acceptance would look like for each of us as behaviors. If we accepted the aspect of life with which we were struggling and suffering, how would our behavior be different?

Changing my behavior, making it consistent with acceptance, is really hard. I have been making a concerted effort on this for the past month or so. I have seen changes. I have experienced shifts to a more positive place. My anger and fear are reduced. My pain and sadness are still there but the suffering is getting less.

 

You may have heard that it rains a lot in Seattle. It does rain more than average, there’s no getting around it. But there are a lot of much rainier cities. We don’t even make the top 10 rainiest U.S. cities, by a long shot. The entire eastern seaboard of the U.S. gets more annual rainfall than Seattle. Here’s the deal, though. We get primarily light rain. And it’s spread over many many days. While a significant portion of the nation has the rainiest time of the year in the summer, we have our rainiest time in the winter. Here, up north, it’s really dark, too. Seattle knows how to pile on the dreary during winter.

But even in winter, there are beautiful days. Yesterday, Christmas Day, was one of them. My husband and I walked down to the beach. The wind was gentle and the sky was blue. I spent a good bit of the walk stripped down to a short sleeved t-shirt. Granted, I had a Lupron shot last month and the furnace usually kicks in about this time but still, I was walking on a Seattle beach during winter in a t-shirt. What a glorious day.

I happen to think that the contrast between how our city looks on a sunny day versus a cloudy or rainy day is one of the reasons that we have a reputation for being a wetter city than we actually are. It’s disappointing to visit Seattle after seeing all of the glorious photos of the mountains and the sea only to be drizzled upon. But I don’t visit here. I live here. I know that the sun will come out again and that I will see it.

People in my city, especially natives, such as myself, often remark that our part of the world would not be so beautiful without the rain. This is true. We have some of the most beautiful summer weather I have ever experienced. And there is so much sunlight with very long days. Without the rainy, dreary days, though we would not have the abundant greens, the trees, bushes, mosses, and lichens. Winter is a time when plants focus their energy below the ground. The rain is essential for root growth, the foundation of plant life. Without precipitation, there is no snow on the mountains. We are so lucky to live in a city bound by two snow-capped mountain ranges. The winter snow on our mountains is also our water supply for the dry months of the year.

We need the wet and dreary days for life. It’s not just that the bad weather makes us appreciate the sunny days more because of the contrast. We actually require it. I’ve been thinking of this a lot in terms of how it relates to life, in general. Are sadness, disappointment, grief, and other painful emotions and experiences necessary for life? More so, do they enhance our lives?

I don’t know. I am pretty sure that seeking out suffering is a bad idea. Let’s not look for trouble. And denying suffering in oneself or others is invalidating. I am working a lot on acceptance of the things in my life that weigh on me heavily on a daily basis and are sometimes terrifying. Okay, it’s not “things”, it’s a thing. The thing is parenting my 16 year-old brilliant fireball. A few weeks ago, I had an epiphany followed by some meaningful adjustments in my behavior.

I realized on a deep and visceral level that I can’t protect her from the world or from the consequences of poor judgements that she makes. I didn’t abdicate responsibility but I relinquished the fantasy of control. I am still as busy parenting as I’ve ever been but my efforts are less frenzied and whirling. This acceptance was also accompanied by deep sadness. But the sadness was grounding instead of frenetic and anxious. I’m not going to kid myself and announce that acceptance is my new permanent state of being. My state of being, especially as a parent, will continue fluctuate. But this is an important shift.

I don’t know the future so I really don’t know how to end this post. What I do know is that every sunny time is to be celebrated and that the dreariest times cannot be wished away. I am learning more and more not to manufacture suffering; why would I want more of that? I am learning more and more to accept this as how life should be simply because that’s the way life is.

Christmas at the beach.

Christmas at the beach.

Yesterday, on my way to the car after work, I saw a woman in the parking lot. She was perhaps in her late 50’s or early 60’s and was significantly over weight. She was facing away from me, bending over to get a bag out of her car. Since she was wearing quite a flimsy pair of stretchy white pants, I was easily able to ascertain that she was wearing thong style underwear!

Although I had to salute her for the zingy way she was living her life, I must admit that my first thought was, “Eww, is she wearing a thong?” I was also not impressed with the pants or the cellulite that could be seen through them.

Then I felt guilty. I thought, “Look, she’s parked right next to the yoga studio. She’s probably going to a class there. She’s taking good care of herself. You are so very shallow.”

Then I started thinking, “But that is really gross.”

Then I started feeling guilty again.

Then I started to feel guilty because I didn’t feel guilty enough.

Then I started thinking about aesthetics. Why are things, living and non-living, beautiful? One could argue that overweight people are not considered beautiful because being overweight is not healthy. But being overweight is considered attractive in many cultures and in the past was associated with being wealthy, not having to do manual labor, and having ample food to eat.

Now this woman was also older and youthfulness is part of our cultural ideal. Now if I imagine a younger woman, of the same size, in the same outfit, I can’t say I would have been positively impressed.

So instead of offering this woman some of my famous granny panties, or riding on this sling shot of guilt I’ve created for myself, I have one thing to say to this woman.

Namaste.”

All people are worthy of my respect and this is not contingent on something as trivial as underwear choice.

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George Lakoff

George Lakoff has retired as Distinguished Professor of Cognitive Science and Linguistics at the University of California at Berkeley. He is now Director of the Center for the Neural Mind & Society (cnms.berkeley.edu).

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