Archives for posts with tag: minfulness

As many of you know, breast surgery often results in a lost of sensation. I had a right side mastectomy. I would make sense that in removing all of that tissue that nerves would also be removed. Now my grasp of physiology is better than the average person, but by no means expert. What I can tell you, though is for nearly two years, I have had no sensation at all in the area where my right breast used to be.

This means feeling no pressure, no heat or cold, and although it is delicate to say, no sexual response. Actually, if I want to be really clear, there is no response at all. No affectionate response. No, ”ow, you just accidentally elbowed me in the boob” response. My husband could hold a hot coal to this breast and I would not feel it. No one warned me of this side effect but I had read about it myself. So prior to my second lumpectomy when my husband asked about whether a bilateral mastectomy was indicated, I responded by spelling out the implications for our love life. I had already completed a literature review on my risk of contra-lateral breast cancer, learned about the Gail Index and so forth. I knew that my estimated risk of cancer in my left breast was at a level low enough that I found personally acceptable.

In the last few months, I’ve noticed something. The numbness in my tissues has subsided to some point. I am starting to regain sensation, at least around the edges of my mastectomy site. But what I am feeling is the occasional itch. Sometimes it is deep down and unreachable. Most times it is on the surface of my skin. I am allergic to wheat and when I do eat it I get a flare of eczema within two days and it takes about two months to clear. If I cook all of my own food, this does not happen. But over vacation last August, I ate out, had a salad, and there must have been some wheat in the dressing because I am still waiting for my skin to clear. At one point, I could see that I had an eczema flare over my breasts. We also had family photos taken at the time. It looked like I had acne. Oh well. In any event, I could feel the itch of the eczema. However, when I scratched it, I felt no relief. As my internist told me when I described it to her, “That’s just not fair!” My rash, however, got worse.

In addition to itch, I have also had the return in a sensation that can only be called, “uncomfortable”. It is the mildest of pain, though still noticeable. And it is, again, felt around the edges of my mastectomy, which was performed in August of 2012. It would not be until March of 2013 that the major part of my breast reconstruction would be completed. I am no surgeon but in my own logic, it seems likely that more digging around and transplanting that occurs, the longer tissues take to heal or as my plastic surgeon describes it, “settle”.

I have numb parts. They are starting to awaken. To what extent they will awaken is unknown. But what I do know is that the awakening is uncomfortable and at times, a bit painful. This has called to mind the numbness that can happen to each of us emotionally and cognitively. I consider myself to be above average in self-awareness. However, I have neglected parts of myself, the parts that are numb. And numb parts get that way through damage, through loss of trust, emotional baggage, past trauma. Our mind protects us from many scary and lonely thoughts and feelings. The problem is, however, that it can do too good of a job.

Sometimes the parts of us that are most important, most in need of attention, are the parts that we just don’t think about or feel. The parts that are tired, afraid, and numb.

As you know, I have been digging deep and trying to feel what I need to feel and process it all through. It is a painful but productive process. In keeping with my mindfulness practices, I have tried to keep with my thoughts and feelings throughout. This has guided my decisions. At times, I move forward, full steam ahead. At other times, I take breaks. At these times, I catch my breath, assimilate new learning, and observe a new way of looking at my life.

There are parts of me that are coming alive. At this point, there is discomfort but I believe that in time there will be continued healing and awakening.

You may have heard this. A complaint about one’s life is followed by the statement, often expressed apologetically, “Well, that’s a first world problem.”

I realize that the intention of the phrase is to provide perspective, to encourage people to count their blessings and further, to appreciate the poverty and unhealthy living conditions that are typical for people who live in poor countries.

I want to let you in on a secret that I have told no one until now. I strongly dislike that expression.

Perhaps for many of you, it helps you gain perspective, a reality check combined with a big dose of empathy.

To me, it sounds like an invalidation of one’s own thoughts and feelings and a kind of intended short cut from point A, being distressed to point B, feeling calm.

I know for me, this kind of short cut doesn’t work. I tried invalidating my feelings for years. “You shouldn’t feel, angry” I would tell myself. “You shouldn’t feel sad.” “Stop feeling guilty. You are always beating yourself up.”

By not allowing myself to feel what I felt, I found that it took me a great deal of time and energy to calm myself down. And I remember a number of years when my normal state was one of a roiling anxiety in my gut and in my brain. My twelve years of chronic neck pain happened during this period of time as did my two episodes of depression.

It also didn’t make me feel any better about other people. It wasn’t like I wasn’t a nice person or that I was not kind but it took a great deal of work. Sometimes, kindness and compassion would just flow from my being but lots of the time, it didn’t. I had to at least a little digging. And then because I was anxious, I would sometimes worry that I hadn’t done the kindness or compassion “right”.

This is the way I feel about the “first world problems” expression.  I don’t deserve to be angry, annoyed, sad, worried, anxious, etc because I live in a wealthy country.

Feelings don’t have to be deserved. Feelings just are. We have them. They happen.

Stress can make our brain misinterpret situations; it can get biased toward interpreting the world in a negative way, being on the alert to find threats to our safety such as rejection and danger. Stress and anxiety can also impair our brain’s ability to differentiate between meaningful and trivial threats.

First world life is fast-paced, over-saturated with information, competitive, and demanding. In other words, it provides genuine stress. And that stress can produce feelings that we think we “shouldn’t” have.

And aside from stress, people feel stuff. We just do.  For myself I know that if I am mindful of my distressing feelings, they lose power over me. And when I validate my patients’ parents’ stress and frustration with a basic problem such as potty training, they can stop feeling stuck and ridiculous in their feelings of powerlessness as a parent.

I live in the first world and I enjoy its benefits unlike many in my country who live in poverty and unhealthy conditions. I am no more important than people who live in the rest of the world. However, I am not less important, either. When I feel happy and calm, I find it easiest to be charitable and compassionate. Being happy is not the same as having things. However, for me, it frees time for me to exercise my good will rather than perpetually questioning the validity of my petty irritations, fears, and sadness.

I met him in the waiting room of my private practice office, a bright eyed preteen, a patient of one of my colleagues. He started talking to me as soon as I passed through the front door. He wanted to play a record for me, an actual vinyl record, on a record player he carries around with him the way another child might always have a smartphone with him. He was very enthusiastic, not so much about the music per se, but the way the record player produced the sounds. During that meeting, over a year ago, he also told me that the big tropical plant that’s in the corner of the waiting room needed to be re-potted. He explained that it was root bound and needed  a larger pot. I told him that I agreed and planned to re-pot it.

The first visit was over a year ago. He has reminded me to re-pot that plant every time I’ve seen him. When I don’t see him, he often asks my colleague to write me a note letting me know that he watered one of my plants or that one of the plants has a new leaf. In the winter, I told him that I would re-pot the plant once it got sunny so we could do it outside.

It took me awhile to get all of the re-potting supplies to my office but I did it last week. I asked him if he wanted to help and he enthusiastically agreed. On Monday, I asked my colleague when he would be back to see her. He was scheduled to come in on Wednesday. He used to come in every Tuesday, which was a clinic day for me. Wednesday was not. I asked her for the appointment time and saw that I had no appointments or meetings at that time. I told her that I would come into work so that he and I could re-pot the plant together.

The plant had been given to me by our building landlord. It was too big for his apartment. It was obvious that he was not familiar with growing houseplants. It was placed in an ovular pot with no drainage hole. The main problem, however, was the fact that the opening of the pot was narrower than the rest of the pot. We would have to break the pot to get the plant out. I grabbed a hammer and drove to my office.

A couple of minutes after I started setting up the supplies outside of the front of the office, I heard his excited voice, “Elizabeth, perfect timing! I just got here!”

We were able to borrow his mom’s sunglasses for eye protection. I taught him how to carefully use the hammer to break the clay pot into pieces without destroying the plant. He worked carefully and systematically. We got the plant in the new pot, surrounded it with new soil, cleaned up the mess, and brought the plant back indoors.

His mother came out briefly and said, “I wish I had a camera. I’d take a video.” She knew how much her son loves plants. She could also see what a wonderful time he was having. His daily life is not easy and he is particularly stressed about having just started middle school. He had the best time helping me re-pot that plant. I am guessing that he will look at it proudly every time he comes to the office. Yes, I came in on a day I don’t typically work in the office. But my small act of kindness, which took up no more than 45 minutes of my day, made a difference in the life of a child.

Small acts of kindness can mean a great deal to other people.

And sometimes they require use of a hammer.

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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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