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With a Master of Fine Arts in Creative Nonfiction degree (Goucher College, August 2014), I am looking at a new phase in my life. From 1992 to 2009, I served as Founding Executive Director of Miriam's House, a residence for homeless women living with AIDS. I left this position when Chronic Migraine Disease overtook my ability to do my job. Now I hope that a writing career will both accommodate the migraines and give me a creative, productive outlet. And soon, September 4, I will launch my Inkshares author page in a bid to hit the 1,000 pre-order goal in 90  days. The book I want to publish is "Nowhere Else I Want to Be," a memoir of ten of my years at Miriam's House.

19 December 2011

"The Power of Now" and Pain Management: The Mind

Third in a series.

This post continues the theme of my previous post about how our enslavement to the mind causes suffering, increasing our pain.  Recognizing this and developing tools to mitigate its effects are essential to pain management; the spiritual life is essential to that recognition and development.

The first chapter of Eckhart Tolle's The Power of Now is titled "You are Not Your Mind."  Surely, this is not a new teaching: haven't Buddhists been saying this for centuries - that the mind is given to delusions, and is "ultimately mistaken about the way in which reality exists"; didn't Yahweh refuse to be categorized, conceptualized or named - "I am that I am" (Exodus 3:14)?  And Zen teachings speak constantly of a false mind that leads us away from Truth due to its attachment to mental and physical constructs it mistakes for reality.

These teachings are relevant for pain management because our mind is an integral part of our response to pain.  It leaps into action when physical pain arises.  There are survival benefits to this: pain may be a signal that something is awry in our bodies, bringing our attention to what needs healing; it can indicate danger, making us jerk our hand away from that hot burner.  But when pain is constant, these natural reactions become habituated and, ultimately, unhealthy as the brain searches for ways to deal with the now chronic pain that result in muscle tension, depression and anxiety.  These, in turn, wreak their own havoc on our bodies, causing more stress and poor health, and creating a vicious cycle so ingrained we do not even know it is present.  Clearly, the solution is to turn off the mind's obsessing, and, for me, that is where spirituality enters in.

A reminder: I do not know that Tolle would use the word "spirituality" in describing his teachings: he certainly refuses to use the word "religion" or even the concept of "belief." 

If I am not my mind, what am I?  If I am not my pain-filled body, what am I?  How do I cease worrying about the way I am feeling?  How do I re-cast my identity as a migraineur, as a person whose life is circumscribed by pain?  I have in my searching found the only real answer to these questions in God, the Divine, Creator, Allah, Buddha-nature...to me, it matters not what name we use for that ineffable Source of All.  And when I base my pain management on my spiritual life and in God, the coming together of physical practice, mental ease and spiritual depth results in much more than just managing of pain: it results in a better quality of life, and, I pray, makes me a better person.

I don't want this series of posts about Tolle's book to be all theory and discussion.  So in my next post I will review some posts of the past in which I have shared techniques for easing the mind's obsessing, also putting them in the context of Tolle's work.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.

16 December 2011

"The Power of Now" and Pain Management: Thinking

Eckhart Tolle, in his now famous book, "The Power of Now," brings incisive reflection to spirituality and what it means to be human.  He purposely is not proposing a belief system nor is he espousing any particular religion.  Yet I find his writing very hopeful, because he believes that a profound transformation of human consciousness has begun, and that this transformation has to do with freeing ourselves from our enslavement to the mind.

In this series of blog posts, I do not attempt to recapitulate or review the book in the traditional fashion.  All I want to do is to share how the book has affected my spiritual life as it relates to pain management.  Thus, there is much that I will leave out of discussion, not because I do not agree with or consider it unimportant, but because I am focusing on this one matter: pain management and spirituality.

This quote from the final page of the Introduction helps put things into perspective, as far as this blog is concerned, anyway:

"This book can be seen as a restatement for our time of that one timeless spiritual teaching, the essence of all religions.  It is not derived from external sources, but from the one true Source within, so it contains no theory or speculation."

From the beginning, this blog has been about spirituality, not religion.  I have tried to call upon the wisdom of many different religions and philosophies: pain and suffering are universal and so I take a universal approach.  It's a simple as this: when I am in pain, I do not care for theological arguments or doctrinal matters, I care about relieving, managing and living with the pain.

One of the early concepts in the book gets to the heart of pain management: in chapter one, Tolle writes about how, in our enslavement to our minds, we cause ourselves suffering.  He reminds us that the Buddha's definition of enlightenment is "the end of suffering." (page 12)  An important distinction here is that between pain and suffering.  Here is how I see it: pain is the migraine - stabbing, pounding - and is physical; suffering is the contortions - worry, fear, despair - and is mental.

I have little or no control over migraine pain (behind that statement, there is a long saga of therapies tried, drugs taken, and alternative medicine explored), and that can lead to a sense of helplessness that is truly depressing.  So there is something hopeful, something liberating in the knowledge that there is one area in which I have control: how I relate to the pain, or, how my mind thinks about it.

It's the ancient Buddhist saying, pain is inevitable, suffering is optional.  For those of us with chronic pain, the physical discomfort is inevitable.  We are trying everything we can to alleviate it, and until something works for us, the hopeful news is we do not have to resign ourselves to being victims of it.

Where does spirituality come in?  For me, spirituality is the essence of being, the essential Being that is at the center of all life, and that has to do, ultimately and eternally, with Love.  Nota bene: Tolle refuses to use the word God, saying it "has become empty of meaning through thousands of years of misuse" that "give rise to absurd beliefs, assertions and egoic delusions such as 'My or our God is the only true God..." (page 13) 

We forget the ineffable nature of this concept, and so our mental constructs about God become exercises in futility that are dangerous when taken literally.

It is in our ability to choose to leave the egoic mind and turn toward Being that we become most fully and wonderfully human.  Here we find what Jesus called, "the peace that passes all understanding." (Philippians 4:7)  And here is where I have found my most effective and healing pain management practice, in a calm of body and tranquility of mind that somehow miraculously reduces in significance the pain of my body, while eliminating the suffering of my mind.

And so intersect pain management and spirituality: suffering of the mental sort that accompanies physical pain is about relieving the mind of its incessant, obsessive need to think and have emotion.  Relieving the mind of thinking and emoting is about connecting to one's essential Being.  This is the journey to Wholeness that must take into account and include our body with its pain and our mind with its suffering.  Perhaps that is the hidden blessing in chronic pain: it makes impossible the human tendency to split body and mind, thereby opening the door to our spirituality.

I would love to hear from you. Please use the Comment link below, or email me at carold.marsh@gmail.com.

14 November 2011

"The Power of Now" and Pain Management: One

Eckhart Tolle's writings have had a profound effect on my emotional and spiritual life for over a decade.  Within the past year, I realized that I am now primarily relating his teachings to the practice of pain management and the realities of living with chronic pain.  So it seems natural to begin a series of posts about Tolle's writings, in particular, "The Power of Now."

This first post will briefly (I am now on the fourth day of a migraine, and my resources are low) discuss some reasons for creating the series, as well as propose an overall structure.

When I cite quotations with page numbers, I refer to the New World Library / Namaste Publishing edition (1999) that was reprinted in 2004. 

I'll go chapter by chapter, although will not discuss every concept therein.  I'll pick out what is most relevant to my own pain management and the spirituality of living with chronic pain.

Although Tolle explicitly avoids proposing a spirituality, or religion, or belief system - and that is one of the reasons I love his writing so much - he does use examples from world religions such as Christianity and Buddhism.  But he does not expouse or proselytize for any particular religion.  Neither do I.

He also uses terminology that is as neutral as he can make it because he is speaking to all of us about eternal truths:

"This book can be seen as a restatement for our time of that one timeless spiritual teaching, the essence of all religions.  It is not derived from external sources, but from the one true Source within, so it contains no theory or speculation."  Introduction, final paragraph, page 10

This is appealing to me for many reasons, but for the purposes of this blog, the appeal has to do with the unifying nature of pain: Muslims suffer pain as do Hindi as do Native Americans and so on.  In my posts, I shall strive to follow Tolle's example - and my own habit thus with this blog - by writing in as inclusive a way as possible while still focusing on spirituality and spiritual health.

As I have said before, I do not claim to be an expert.  Nothing in this series or in this blog is meant to be taken as expert advice or as a substitute for professional care.  Anyone with chronic pain should be under the care of a medical professional.

My next post will be about two concepts from the Introduction (pp 3-10): freedom from esnlavement to the mind; and consciousness without identification with form.

I am excited about beginning this series, which I have been planning for many months.  And I look forward to your comments and emails.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.


01 November 2011

Meditation for (Distracted) Dummies (Like Me): Part Two

This post is a follow-up to my October 6, 2011 post. 

A lunch-time conversation yesterday with a friend brought the subject up again: many of us believe that meditation is supposed to result in a blissfully clear mind, unfettered by thoughts, worries, or remembering.  And when we fail to acheive that, we give up on meditation, saying we can't do it right and even feeling inadequate for our failure.

Because meditation is so important a part of my pain management practice, and because it only brings me to a blissfully clear mind about 2% of the time (at best), I have learned for myself that meditation does not have to feel "right" to be effective.  It does not seem to matter whether I come out of a session feeling that it was a good one (whatever that means), or feeling that it was a flop because my mind never shut up: the benefits for pain management are none the less real to me. 

When we turn to the silence within, we take the lid off of the cauldron of worries, fears and thoughts otherwise hidden by busy-ness, noise, addictions and avoidance.  In that sense, meditation leads us to and through parts of our spirits and minds that we otherwise deny and ignore.  No wonder we don't often feel blissfully calm during meditation! 

There's another reason to persist in a daily meditation practice.  Any major world religion that I have investigated stresses the importance of meditation, although the word used may be different.  It's not just the eastern religions:
  • Christians call it centering prayer.
  • One site I saw said that Jews meditate for intellectual focus, among other things, and also to acheive a state called "eyin," or nothingness.
  • There are YouTube videos for Baha'i meditation
  • Native Americans practice meditation in many forms, all based on the sacred connection to Mother Earth and the Great Spirit.  The rituals, such as sage-buring, are beautiful, too.
  • The Sufi Muslims practice zikr meditation, zikr meaning "remembrance of God."
  • According to Wikipedia, Samayika in Jainism, means being in the moment in continuous real time.
There are, of course, many more world religions, but I provide these few examples to make a point: meditation is a wide-spread practice understood by centuries of wise persons to be essential to spiritual growth and enlightenment.  Who am I to argue with them, or to decide their wisdom does not apply to me?

In my next post, I'll write about why I believe meditation benefits me spiritually and for pain management even though I rarely have a silent mind while meditating.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.  Thank you.

17 October 2011

Painful Poetry

An Original - if Awkward - Attempt to Find Humor in Pain

How Do You Solve a Problem Like a Migraine?
(Sung to the tune of "How Do You Solve a Problem Like Maria?; from The Sound of Music)

How do you solve a problem like a migraine?
How do you stop the vomit and keep it down?
How do you find a word that means a migraine?
A pain in the left lobe, ice pick to the head, a frown?
Many a day you know you're going under.
Many a time you cancel all your plans.
But how do you make it cease,
instead of the sure increase?
How do you get the throbs of pain in hand?
How do you solve a problem like a migraine?
How do you bear it once it has began?

When I have one I'm confused,
out of focus and bemused,
and I never know exactly where I am.
Any light will make me groan,
any movement cause a moan,
I can't stand it -
this pain, damn it -
it's no sham.
I'll spend hours getting rest
blindfold, dark room, no noise; lest
I should move and feel that stabbing pain again.
Don't come near me I might cry,
though I couldn't tell you why.
Nerves aquiver,
in a dither -
Let Me Die!

How do you solve a problem like a migraine?
How can you bear it once it has began?

06 October 2011

Meditation for (Distracted) Dummies (Like Me)

I am not a meditation purist.  I employ several different methods to help me slip into that peaceful, prayerful and meditative space that so nurtures and sustains me.  Perhaps it is due to the almost constant pain in my head. Perhaps it is simply what I was born with. Whatever the cause, my mind can often be so easily distracted, so quickly caught up in the flow of thought, that I have had to find other methods than the classic one (sit cross-legged on a small cushion and stay there for an hour or so with completely empty mind) to enter a meditative state.

As a follow-up to my previous post, I'll share these methods.

GUIDED MEDITATION
Thank God, bless Allah, praise Jehovah: there are people wiser and more centered than I who have recorded meditations that I can purchase and play on my portable CD player or my stereo.  Here are a few of my favorites, and you can go to Amazon.com to find any number of CDs to buy:

** Kelley Howell and Brain Sync profess to change one's brain.  I don't know about that, I just know that her guided meditations as well as her music CDs are very helpful for me.
** Stephen Cope has a 2-CD set called "Yoga for Emotional Flow" that I just love.
** Sri Sri Ravi Shankar's CD, "A Gift of Silence" consists of three guided meditations.
** Jon Kabot Zinn recorded a 5-CD set - "Guided Mindfulness Meditation" - that present a variety of ways to meditate.

PRAYER BEADS, ROSARY
I am not Catholic, but I did spend 30 days once in a retreat (the Spiritual Exercises of St. Ignatius) at a Jesuit spiritual center in Pennsylvania.  That experience opened me to to rituals and practices of Catholicism, which, although I do not subscribe to Catholic beliefs or doctrine, have informed and deepened my prayerful and centering practices.  One of the things I learned to do was to use a rosary (a beaded necklace would do just as well) for centering.  There is something about the tactile, regular fingering of the beads that, combined with whispered, repeated phrases allows for peace of spirit and calming of mind.

SIMPLE RITUALS
Small things like the lighting of a candle, sounding of a singing bowl, or yoga assanas help center me and are a wonderful way to begin a prayer or meditation time.  I always use the breath for centering, something about which I have posted before (click on breathing in the LABELS section, to the right).

CHANTS and MANTRAS
I recently discovered chanting, and do not have many resources yet, but learned from a CD, "Five Classic Meditations" by Shinzen Young.  I cannot find this CD, even on his website, but I saw a CD called, "Chant: Om Mani Padme Hum," and that is the chant I learned from the "Five Classic Meditations CD."

QUIET REFLECTION
There are days when, despite my years of practicing centering prayer and meditation, there is something so pressing on my spirit that emptying the mind seems not only impossible, but not what I need.  Having learned from some visits to the Insight Meditation group in Washington, DC that there is a form of meditation that allows and even follows the thoughts arising from one's spirit, I now allow myself these times that clearly require reflection instead of meditation.  However, it's not simply a matter of plunking down in a chair and engaging in repetitive, compulsive thinking patterns that are anything but quiet and reflective.  I use music, simple ritual, and maybe a bit of chanting to help me center and relax before I begin reflecting.

There is more to share, but this migraine is worsening, so I will continue in another post.  May you allow yourself some moments of peace today and may these moments bless you and keep you close to God.
 
 
I would love to hear from you.  Please use the Comment link below (and note that I have been unable lately to comment on my own or any other blog, so will not be able to reply) or email me at carold.marsh@gmail.com.
 
 

04 October 2011

"Trying to Meditate" Is an Oxymoron

I have used the language myself, and so when I read it on a blog recently, I was reminded of what odd things we say and think about meditation.

"I tried to meditate but it didn't work."
"I really struggle to meditate ..."

The odd thing about meditation is that if we try, or worse yet, struggle, to do it, we are dooming ourselves to failure.  It's just so different from most other endeavors in our lives, which have been full since pre-school of exhortations to simply try harder, to grapple with, to grasp for.  Yet we might as well try to grasp Jello as to grasp meditation.

Meditation is about allowing, surrendering, accepting.  I have a meditation CD I like very much (Sri Sri Ravi Shankar's "A Gift of Silence").  In the course of one of the meditations, Sri Sri says that the minute we focus on our tension - and that is exactly what we are doing when we "struggle" to meditate - we are making it worse.  His instructions are to simply be aware of the tension without judgment or emotion: accept that it is there and continue with the meditation.

What Eckhart Tolle says is also helpful.  He uses the phrase "resistance to what is" when he talks about what the mind/ego does to create suffering. 

"The pain that you create now is always some form of non-acceptance, some form of conscious resistance to what is." 

When we meditate, if we do not resist what is - muscle tension or discomfort, scattered thoughts, restlessness, the sudden rising of emotion - and replace the judgment

"Rats!  There I go again, thinking about work." 
Why can't I just meditate?  What is wrong with me?"

with simple naming

"Here is tension."
"This is scattered mind."

we are then able to allow ourselves to slip into the meditative state.  And it does not matter - it truly does not matter - if, after a meditation session, we feel as though we spent 18.5 of the 20 minutes naming tension and scattered mind.  This, too, is a matter for simple acceptance.

How does this relate to pain management?  In several ways:
  1. A regular practice of meditation or prayer or relaxation is essential to good pain management.  What the body in pain wants to do is tense up to fight or run away from it.  This may be helpful for acute pain, but it becomes quite a problem for chronic pain, as muscle and emotional tension or stress only make the pain worse.  To the extent that we can reach for the tools that quiet our pained bodies, minds and spirits, we are managing the pain at the very least by not making it worse.
  2. If we have learned to accept tension and difficulties during meditation, we have skills that can be transferred to managing pain.  I have written about this in other posts, and I think it's one of the most difficult pieces of pain management to take in: allowing, observing and/or accepting our pain is the beginning of managing it.    Having practiced this sort of acceptance during meditation or centering prayer, we are better able to use it when we are in pain.  Accept that it is and then get on with pain management practices.
  3. Surrender.  Acceptance.  These are spiritual principles that cut across religious and philosophical boundaries.  There are many, many wise ones from whom to quote, so what follows is intended only to be a short list of examples and not exhaustive in any way.
  • Buddhism: I especially like the way Tara Brach writes about "radical acceptance."
  • Hinduism: The concept of karma is the context for acceptance in this link.
  • Christianity: Jesus often instructs us not to worry, to look around and see how even the lily is clothed, even the fall of the sparrow is noted by God.
  • Native American spirituality: Simply reading the lines on this link, I get the feeling that to live as so surrendered a part of the natural world is to not even need the concept of surrender.
Speaking of accepting, my head is beginning to ache, and that means I cannot look at the computer any longer.  I will continue this post in a few days.  Now, it is time to rest.


I would love to hear from you.  Please use the Comment link below (and note that I am having trouble with my computer and have been unable to post comments on blogs lately, even my own, so will not reply), or email me at carold.marsh@gmail.com.





28 September 2011

Everyday Angels

To be independent, to gain self-sufficiency and to be in control of one's life: these are highly regarded and sought-after qualities for many of us.  They are laudable qualities.  They are also traps that potentially keep us from recognizing one of the amazing blessings of life - the presence everyday angels who are there, quietly and without fanfare, to help us when we are in need.

Recently I traveled to Connecticut for the wedding of a dear friend.  Not having traveled much without my husband - who understands and lovingly cares for my needs when I am in pain - I wondered how I would manage the trip.  But the wedding was too important for me to stay home so I went even though Tim could not go with me.  It was a beautiful and joyous weekend, one in which I re-connected with old friends, rejoiced with Stephanie and Jal and their families, and - not unexpectedly - dealt with migraine pain most of the time.  It was a weekend in which I met everyday angels at every turn.

This is, like most things in life, a mixed blessing.  I'd really rather just be able to be independent, make my own plans, do my own thing.  This part of me feels embarassed at having to ask for help and to admit that I cannot simply pick up and go like other folks.  This part of me resents my dependence on others. 

This part of me also isolates me under the guise of self-sufficiency, a wonderful concept that loses its wonder in a life of pain.  I struggled with my ego and its need to be competent and in charge while all around me, my pride notwithstanding, angels appeared.

My first angel was the bride, Stephanie, who, in response to my email full of concern about how I would get from the airport to her home town, connected me with two guests who also live in D.C.: Premila, sister of the groom, and Laura, long-time family friend.  Stephanie also ensured that I had a place to stay at the inn for out-of-town guests that also was to be the site of the reception.  Having made up my mind rather late, I might not have secured a room at the Wake Robin Inn had Stephanie not made a quick reservation for me and immediately connected me to Inn staff.

Premila and Laura proved to be wonderful travel companions, not at all concerned that I couldn't share in the driving of the rental car (air travel being a never-fail migraine trigger), and understanding of my inability to attend the Friday picnic.  Premila called me from the picnic to offer a plate of food, and Laura delivered that plate to my door. 

Saturday's wedding on a hill at Stephanie's family farm was lovely.  The bridal party arrived in a wagon towed by an antique tractor; guests were transported from the parking area to the hilltop in another tractor-pulled wagon; the setting was beautiful and the music perfect.  At the reception in a tent on the Inn grounds, I had the most fun I'd had in years.  Yet it was no surprise to wake up Sunday morning with a migraine.  The late night, loud music, flashing light bulbs in the dark venue, and food made with ingredients not on my migraine diet made for a perfect migraine storm.  And I would not have missed it for anything.  You learn to make these comprimises when you have chronic pain, otherwise your life would be just awful.

So Sunday morning I struggled up the hill to the Inn where I thought breakfast would be served at 7am.  I really needed my morning tea and a bit of food, part of my pain management regimen.  But when I walked in and was told that breakfast did not begin until 8am, my face must have registered serious dismay because Shaffin, the staff person with whom I was speaking, urged me to sit down while he went to the kitchen to see what he could do.  Making me comfortable in a corner of the room and thoughtfully turning off the light above my head, he moved away with a promise to return soon.

It's hard to sit up with unsupported head and neck when a migraine is at full force.  It's hard to be without the soothing routines of home and readily available comfort measures.  It's hard not to feel sorry for oneself, so when Shaffin came quietly back carrying a tray with teapot, fruit and a muffin, I felt tears of gratitude arise.  "My angel," I thought. 

Later, during the luncheon at Stephanie's parents' house, I was carfeully ensconsed in a comfy recliner by John, father of the bride, and checked on by Eileen, mother of the bride, and Jal, the groom.  "More angels," I thought.

It was good to lie back in that reclining chair, comforted by the breeze from the window Eileen had opened for me and listening to the chatter from the back porch.  It was sweet to hear those companionable sounds and I felt blessed to be there.  I felt blessed by Stephanie, Premila, and Laura, without whom the trip would have been almost impossible.  I felt blessed by Shaffin, Jal, Eileen and John, who made the pain easier to bear. 

I am not independent or self-sufficient.  I do not have the ability to do for myself without relying on people to help me.

I have something better.  I have angels.


I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.

06 September 2011

Balancing Botox

Late in August, I posted about waiting for a Botox treatment to work, about the suffering brought by misplaced hope, and about how emotional balance and equanimity - not healing - must be my goal.

It turns out to be a good insight: the Botox has made no difference in the migraines.  Having practiced equanimity about the outcome of the treatment, I am not now crashing down through the wreckage of high hopes - hopes that the migraines will go away, that I will have more energy, that I will be able to live normally once I am not in almost constant pain.  It is a good thing not to crash.

Yet to be honest, I do find myself in a bit of depression today.  It's the day after Labor Day: my husband, after being off work for a week, has returned to his office; the weather is cool and rainy; people move purposefully up and down the sidewalk outside my windows.  I remember how I loved this time of year.  I usually felt renewed purpose and greater energy moving in with the cooler breezes.  It's the time of year to go back to school, pick up work after celebrating summertime's last holiday, or help the family through changes in routine.

I admit to a tinge of feeling sorry for myself.  Thank God, that does not last long.  I know too many people who are also struggling: a loved one with cancer; an empty-nester feeling lost and alone in an echoing house; women living with AIDS; my homeless friends caught in addiction; a dear friend in the midst of huge upheaval; people I care about facing limb amputation, or family tragedy, or unemployment.

Equanimity balances my vision.  Contemplating the wonders and richness of my life overwhelms me with thankfulness.  Self-pity melts away, depression recedes for the moment.

Today is a day for gratitude.



I would love to hear from you.   Please use the Comment box below, or email me at carold.marsh@gmail.com.  Thank you.

26 August 2011

Suffering is Optional

Pain is inevitable.  Suffering is optional.

This unattributed Zen aphorism has been in my mind and spirit this week, while I wait to find out if the Botox treatment I had on Monday will take care of the chronic migraines that have plagued me for almost seven years now.

Since I love and try to live by the Buddhist concept of "equanimity" - which I have posted about before - my desire is to spend this waiting time in a state of tranquility with a peaceful awareness that maybe the Botox will work for me, maybe it will not. 

Equanimity.  If you click on the link above, you will find that one way to define this concept is:

"to stand in the middle of all this." 

This has to do with balance.  It means that one finds and stands in a place of steady, quiet inner strength that depends not at all on the vagaries of circumstance, mood or situation.  Losing equanimity is suffering: this has become an essential tenet of my pain management.  When I lose my equanimity, the pain that is inevitable - that of the migraines - is miserably augmented by the suffering that is optional - that of worry, or fear, or anxiety, or anger.

I would not have thought that hope could be added to that list.  Yet today during quiet time I realized that it can swamp equanimity: I hope so much that the Botox will work! I'll exercise more!  I'll find meaningful work of the sort I was doing before!  My life will be normal again!  I feel these attractive, positive and exciting thoughts lure me from tranquility by focusing my thoughts upon a future that is not at all certain.  There is inherent in them a wild plunging back and forth: It will work and I'll feel better!  It won't and I'll feel worse!  I ride the teeter-totter of suffering.   It might work.  It might not work.  It might.  It might not.

And so, however much I have heard all my life that hope is precious and not to be discarded, this week hope makes me suffer.   

Perhaps, however, it is only where I choose to place hope that causes me suffering, not hope itself.  Rather than focusing hope outwardly on an outcome that I cannot know and that will assuredly be accompanied by its own temptation to suffering, I can focus hope inwardly on my own spirit.

I can find hope in equanimity: inner balance that I choose to cultivate whether or not the migraines go away. I can hope in the power of spiritual tranquility to serve me steadily whether I am set forth on a newly pain-free life, or on the next phase of the pain-filled life. Without planning for exactly what this will be like for me, I can hope in the journey that is a moment-to-moment choice for balance.

Thus is suffering made to be optional, and hope to bloom. 


I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.  Thank you.



21 August 2011

More on Michele Bachman's Migraines

It is tempting for me to read some of the "can she be President if she has migraines?" commentary about Ms. Bachman as yet another example of the stigma of migraine or the extra scrutiny that comes with being a female Presidential candidate.  And it may well be that such prejudices are behind some of it.

But I have just finished reading - actually, listening to, since reading and migraines do not mix - a book about John F. Kennedy (An Unfinished Life, by Robert Dallek).  Besides being a fascinating, well-written and detailed narrative about JFK's life, it is a revelation of his numerous health problems and how they impacted his life and political career.

JFK, his family, staff and friends lied and obfuscated about his Addison's disease, intestinal difficulties, chronic back pain, and prostate problems during the whole of his political career.  The very real fear was that his life in politics would be over if the facts of his health and/or the amount and type of medications he was taking ever leaked out. Indeed, the book raises questions and then speculates about how the pain and the medications may have influenced his actions and decisions as Senator and as President.

Had I not been reading this book at the time of the Michele migraine discussions, I would likely have allowed my comments to devolve into decrying the deplorable prejudice - against migraineurs, against women in and with power - evident in some of what I saw.  I have enough experience on my own and have connected with enough women with migraine to be sure there is some political hay-making going on while the spotlight shines.  I recall being infuriated, for example, by the snide and sly coverage and questions asked of Hilary Clinton during her run for Presidential nomination.  So it is out there, and I know it, but that can be the subject of another post.

What I also know is that it is all too easy to cast ourselves as victims.  Being a migraineur myself, I could cite my own and my cyber friends' examples of migraine bias and the painful ways it has affected us.  To do so in the light of what has been said about Ms. Bachman would be justifiable and understandable.  But sometimes it is just not right to revert to the constant, if true, refrain of victimhood.  Sometimes it just feels right to be honest about how complicated it all is.

This is a blog about how living the limited life of chronic pain has influenced my spiritual life, and vice versa.  In the case of Michele Bachman's migraines, the chronic pain encourages a dyspeptic monologue about migraine bias, while the spiritual living encourages a step back and a casting of a glance inwardly to that place of clear-eyed wisdom that is so attractive to me.

Both are real.  And balance is what I desire, along with the peace that accompanies it, so I am compelled by my desires and my own blogging to be equitable about this.  It seems inadequate, even to me and even as I write it, though.  Aren't we supposed to take a stand and stay by it?  Don't people decide what they think about things and then trumpet incontrovertible opinions to their world?  Fence-sitters are not respected, after all.

Oh well.  With apologies to all of us who want certainty and facts and categorical statements on which to rely, here is what I can say about Michele Bachman's headaches:

It may be that her migraines cause her little enough distress that she can manage a high-powered and influential career.  It may be that the seriousness of her migraines are being shielded - a la JFK - from public view.  It may be that persons with fear of and prejudice against powerful women are using the reports of migraines to derail a career that frightens them.  It may be political.

All I can write with any certainty is that I hope - in case the migraines are truly and often debilitating - Ms. Bachman is realistic and self-honest enough, that her handlers, friends and family are brave enough, or that the terrible effects of frequent migraines become debilitating enough to end her run. 

And I hope - in case the migraines are easily managed and inconsequential - that Ms. Bachman continues her career to the best of her ability, attentive to the noble and honorable possibilities inherent in a public service career.

More particularly, I hope and pray that she allows pain she has suffered - from migraine or whatever - to bring her closer in compassion to the pain being suffered now by people in America.


Next Post: Some discussion on stepping away from victim status and the power of honest vulnerability.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com









16 August 2011

Michele's Migraines

Politics aside -- I being liberal of the bleeding-heart-on-the-sleeve kind -- I quite naturally have a lot of empathy for Michele Bachman.  Living with migraine pain gives us common ground.  Again, politics aside -- she being conservative of the I-talk-alot-about-compassion-because-otherwise-it's-assumed-I-have-none variety -- I also feel some admiration for her.  Campaigning for nomination for president is rigorous in the extreme, but to do it with WITH migraines?  The mind boggles.

Of course, there is very little information from her about the migraines, their frequency and severity, what meds she takes, how she manages pain, when the alleged hospitalizations occurred, etc.  I'm no political pundit, but I agree with Judith Warner's opinion in the July 21 NY Times: leaving the information to speculation isn't helping. 

Finally, I do not assume that my experience with migraines, which caused me to leave my well-loved work at Miriam's House in 2009 and continues to render me unable to work, gives me any right to judge Ms. Bachman.  Migraine is an idiosyncratic disease, difficult to treat partly due to the varied ways in which it manifests itself in different people.  And it is not very well researched as of now. 

All that being said, and given that I live a greatly circumscribed life due to painful and chronic migraines, I cannot imagine how Ms. Backman could even begin to conduct a nomination campaign if her migraines are, as alleged by The Daily Caller, "frequent" and "incapacitating."  If she is having a level of pain and frequency that still allows her to run for the Republican nomination, then until I hear otherwise, I have to think that her migraines are wimpy, unremarkable things that are fairly easily managed by medication.

That makes me envy her.

All that being said, and given that I forced myself to work a good five years with ever-worsening migraines because I loved my job and could not imagine giving it up, I know the toll that ignored migraine episodes take upon health, vigor, mental acuity, memory, and patience.  I know the level of self-delusion required to maintain the fiction that one is well and functioning at top capacity.  If Ms. Bachman is deluding herself in this way and trying to hide her difficulties from others as well, I have to hope that someone tells her no one else is fooled, and that it will catch up with her in a big way some day.

That makes me pity her.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.

03 July 2011

Remembering God

"If you pass by the gardens of those who remember God, sit down happily."  Prophet Muhammad


I have realized that I need to take especial care of my health and my spirit during the month of July.  The heat and humidity of Washington, DC are again taking a toll on me, as the migraines both increase and become harder to bear.  And - what is good news albeit poor timing - we'll be moving by the end of the month.

So I shall take the month of July off from this blog.  It is essential that, in the midst of the packing and planning, ill health and pain, I ensure that I have the space and time to sit down happily in the gardens of God.

I will begin to post again during August, 2011.

May you enjoy tranquility and gentle challenge this month.

24 June 2011

Knowing Pleasure

I watched Eat Pray Love twice this week.  Well, once I watched when my head wasn't bad, and once I listened, when it was.

The hot, humid summer months have become increasingly difficult these past two years, making me feel sick, extra tired, and less able to handle the almost constant pain in my head.  One of the things I do as part of pain management is listen to movies.

There are several memorable quotes from Eat Pray Love, one of which has stayed with me and caused me much reflection.

Liz is sitting in a barber shop in Rome with her new Italian friends.  During an animated conversation full of graceful, gesturing hands, lilting voices, musical vowels, and hair clippings, this quote emerges:


"You Americans know entertainment.  You do not know pleasure."


I usually find that when an idea sticks with me, there is good reason for it - reason that I find within myself.  So during the past several days, as I re-play the movie and think about entertainment vs. pleasure, I look at my life and, in particular, my pain management practices.

I try to steer clear of dichotomies because they tend to create opposition: to talk about the values of pleasure vs. entertainment as though one concept might vanquish the other is a fruitless conversation that misses the point.  It's more my task to understand why the words have settled into my mind than it is to decide which is better.  So here is a rough approximation of my internal dialogue this week:

"Do I know entertainment better than I know pleasure?"
"Yes."
"But entertainment is one of the things that gets me through the rough days.  Entertainment: listening to NPR or a movie or Seinfeld.  Yes, it's passive, but when I am in pain, passive is what I need."
"OK, then, gotta have entertainment.  It's not an either/or proposition."
"Fine.  So where does pleasure come into my life?"
"Walking my dog, cooking and eating, listening to music or meditation CDs.  Being with my husband.  Keeping up with friends and family.  Knitting."
"How much pleasure am I truly gleaning from these activities when I am also in pain?"
"Not so much.  As a matter of fact, it's more like I am getting through them in anticipation of being able to rest and turn to the entertainment."
"Then the question is not entertainment vs. pleasure, it's how to get more pleasure - be more present to - the pleasurable activities."
"Gratitude."

Gratitude.  That's the simple answer, the one that springs instantly to my mind.  It's part of being present to the moment, the Now.  Or maybe being in the Now - presence - is part of gratutude.  Or maybe it's really that they go magically hand in hand.

I can walk Sierra (our rat terrier) realizing vaguely how good it feels to stretch my legs while otherwise lost in thought or just getting through the walk because my head feels so badly.  I think of it as a pleasurable activity, but how much pleasure do I actually get from it?

I can sit down for a meal and rush through it because it's hard to hold my head up.  But last night, when I put the homemade pizza on the table and focused on it - no radio, no magazine, no planning for what I'd do next, no rushing - I experienced the pleasure of the textures, flavors and nurture of that simple meal; I experienced gratitude for the abundant goodness before me. 

When I walk or eat with presence, gratitude wells up in me unbidden.

I have written before about inhabiting our bodies: being fully, quietly present to our selves and the moment.  Out of this arises gratitude, and out of gratitude arises pleasure.  Deep pleasure, the kind that does not seek entertainment, the kind that is sufficient in and of itself. 

Here's the magic: pleasure itself turns out to be a great pain management tool.

For this, I am so grateful.



I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.

05 June 2011

Wounds, Stigma and Compassion: 30 Years of AIDS

The 30-year / 30-million dead AIDS anniversary has me in a gut reaction that I cannot name.  It's so complicated: there is the deep, deep sorrow over the many women I knew and loved at Miriam's House, now passed away; the horrifying numbers (30 million world-wide); my anger about the ravages of the disease itself and the ravages of the stigma, judgment and shame attached to it.  But what I want to write about today is a view of AIDS from the perspective of living with a chronic, painful condition.

No, I am not equating living with migraines to living with AIDS.  But today, as I mourn 30 years of this epidemic, I am very aware of how much more difficult stigma and shame make living with a chronic illness.  There is - as with anything that others cannot or will not understand - some stigma attached to living with migraines ("You are just letting the pain have too much power over you."), and the consequent unemployment ("Why don't you at least work part time?"), but it's really not that bothersome to me - I am able to note it and move on.

However, having lived and worked with women living with AIDS at Miriam's House, I have experienced as close to first-hand as is possible - short of actually having AIDS myself - the stigma, judgment and shame that go along with the disease.  And I can tell you this: it makes so very problematic the living with pain, the chronic reality and the endless doctors/hospitals/ERs/medications.  As if living with AIDS weren't problematic enough in and of itself.

I experience anger all over again as I remember (names are changed):
* Alexa, invited to a family reunion in North Carolina as long as she would agree to stay in a motel rather than with family, as everyone else was doing;
* Viola, allowed to live with her mother but forced to eat with plastic utensils and paper plates and cups so as not to contaminate her family or their dinnerware;
* Victoria, who moved to the States as a 12-year-old when her mother realized that the health care in her native Africa could not keep her alive, but whose aunt and uncle kept in a small room just larger than a closet, isolating her from themselves and from even a semblance of normal teenage life;
* Terri, who was terrified that her family would learn that she'd contracted AIDS because she'd seen how they treated a cousin;
* The women with whom I sat for long hours in hospital emergency departments, and who - had I not been there to advocate and agitate for them - would have been shunted aside while care was given to others.  (This, I came to believe, had more to do with their status as poor African Americans on Medicaid than with their disease, but it was hard to distinguish and just as hurtful whatever the reason.)

There's a lot more to tell, but this post cannot hold it all.

I imagine how miserable I would feel if I had to hide my illness from friends and family; how devastating it would be to live in shame imposed from without yet intensified within; how I would struggle with judgment even as I tried to accept the limitations of the migraines. 

And I remember, as I do so often, the incredible grace with which these women lived with their illness:
* Alexa, who never failed to ask me if I had a headache and who, with genuine love and concern, prescribed rest and stress-reduction;
* Viola, who eventually moved out and into her own apartment, proceeding to care through her final illness and death for the mother who had handed her those plastic utensils.
* Victoria, ill and nauseated and half-conscious in her hospital bed, asking her visitors how they were and making sure they all had a place to sit;
* Terri, with whom I spent long evenings watching gospel music shows and comic movies while being entertained by her running commentary;
* And the women in the ERs, watching me tire and telling me to go home despite their fear of being left alone in so vulnerable a state.

What am I trying to say here?

I do thank God that the stigma of AIDS is - at least in this country - not as bad as it was 20 or 30 years ago. Yet still it exists here, and is virulent in other countries. 

We all, to one extent or another, experience heightened awareness and even fear in the face of what appears to be other than normal to us.  I suppose this could be some sort of ancient survival mechanism left over from when most of the "others" we encountered might kill us.  Yet our evolution as a species has brought us to a place in which we can simply note the immediate and unbidden reaction, allow it to pass, and take a second look into our own hearts and into the heart of the different other.

What am I trying to say?

There is no different other.  There is only we.  There is only the human state, with its fears and isolation and wounds.  Perhaps my wounds are more visible than yours; perhaps your wounds are more socially acceptable than mine.  No matter: we are all wounded, we all hurt.  In that, we are no different.

We are no different in our need for compassionate understanding and forgiveness.  We are no different in that, given compassion, we blossom, we become more able and eager to extend compassion to others.  We allow that within us which we have hidden through shame and fear to become forgiven and thus transformed.  We become less inclined to stigmatize differences, and more ready to celebrate similarities.

We discover that our wounds and shame become transformed into loving compassion for self and others: still wounds, perhaps, yet also widely opened doorways.  But do not take my word for it: go make a friend of the one you consider the other.  Allow her to teach you.  Give your heart permission to let him in, to show you his humanity and how similar you really are.  Extend your hand just a small distance toward her and experience how generously she - however long it takes - reaches out to grasp you. 

Allow her to teach you that we are all the same.


I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.  Thank you.

31 May 2011

Inhabiting Your Body: Part II

In my previous post, I described how learning to "inhabit" our bodies is an essential (I think) tool in pain management (PM).  This post will briefly add to this concept because I'd just like to write a bit about yoga.

I am not a yoga expert.  But I have learned that yoga is all about inhabiting the body - just never really uses that phrase - and so also a tool for pain management.  I use what is called Iyengar Yoga, developed by  BKS Iyengar, a world-renowned teacher.  Iyengar Yoga is a kind of yoga that has made it possible for me to truly enjoy yoga even though I live with chronic pain. 

I learned Iyengar Yoga from Carolyn Bluemle, who lives and teaches here in Washington, DC.

I will not try to describe the asanas and poses, not being a teacher of yoga and not wanting to lead anyone astray.  But I will say a bit about how Iyengar Yoga helps with PM and inhabiting the body.

What Carolyn taught me is a very gentle process through the poses that uses bolsters and pillows so that the head is never unsupported or under any stress at all.  These poses are all described and pictured in the book, Iyengar Yoga: The Path to Holistic Health.  Thus I can gently stretch, using muscles that are creaky from the physical inactivity imposed by chronic pain, and yet - with my head supported - not bring on or make worse a migraine.  And the book is packed full of other ways to practice yoga for various physical ills and conditions.

What I have found is that yoga itself is a practice in inhabiting the body.  I am focused on being gentle in my movements, careful to support my head, and listening to my body tell me when I have been long enough in a pose.  It's all about being in and with the body, which - as I described in the previous post - is for me an essential part of PM.  For one thing, I have found that the feeling of presence to the body and its physical movements lasts well beyond the yoga session, reminding me to stay present, to breathe, to be gentle.  For another, I find that the presence of physical pain lessens in importance - not that it goes away, but that it recedes a bit into the background.

Sometimes I do yoga before my meditation, sometimes afterwards.  Sometimes I take thirty minutes with it, sometimes ten.  Often I go for days without any yoga, and when I come back to it, I am always grateful for how it makes me feel. 

Being present to my body allows me to be present to the Sacred in all of life:

 "Be still and know that I am God."  Psalm 46:10

Not think a lot and know that I am God.  Not get real busy, do alot of things and know that I am God.  Be still to come close to the Sacred, to God, to Allah, to The Great Spirit, to Brahma.  It's about a stillness of body, mind and spirit that is cultivated through yoga and similar practices, meditation and prayer. 

This is how chronic pain links to and from my spiritual life.  This is why I write this blog: to remind myself that God is present in all of my life and that my pain can be involved in leading me ever closer to that which is sacred and holy. 

May you find help and support in this post.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.  

27 May 2011

Inhabiting Our Bodies: An Important Part of Pain Management

In my previous post, I used the phrase, "inhabit your body," which I would think is unfamiliar unless you have read some Eckhart Tolle.  I have found it to be an essential tool in my pain management (PM) repertoire, having gone beyond the initial reaction of, "Inhabit my body?  With all this pain?  Why would I want to do that?"

To repeat a bit from my previous post, the thought of inhabiting the body that is causing us so much physical pain is jarring.  Yet here in this paradox is the fulcrum providing the essential balance that frees my mind and spirit to do the more creative and productive work of PM.  I simply cannot manage my pain well when my mind is screeching with frustration, anxiety, fear, and whatever emotions arise along with chronic physical pain.  And since more and more medication is not an option (not that I am averse to medication, but that the 9 pills monthly allowed by my health care plan leave me with as many as 9 migraines unmedicated), good PM skills have become essential.  Calming my mind and spirit includes calming my body, and this is best done by being fully present to my body, inhabiting it - feeling, as it were, every cell.

So, on to the phrase, "inhabiting our bodies."  Eckhart Tolle uses this phrase in his book, The Power of Now.  This book, which I have both read and listened to on CD, mentions nothing about pain, illness or PM, yet it has been instrumental for me in developing the life skills for living with chronic pain: so much so, in fact, that I will soon begin a series about the book similar to the one I wrote in April and May about Toni Bernhard's book, How To Be Sick

The Four Steps to Inhabiting Your Body in Pain Management
1. Gentle Stretching
2. Breathing
3. Inhabit Your Body
4. Pain Management Practices

Step One - Gentle Stretching
Tense muscles are a natural by-product of physical pain because the body's natural response - for survival's sake - is to flee or otherwise fight the pain.  Our muscles respond to the adrenalin coursing through our bodies in automatic response to the pain stimulus by tensing.  That aids survival in the moment, but becomes a complication with chronic pain.  So I find that a gentle stretch of my major muscle groups from whatever position I need to assume - standing, sitting, lying down - is the best way to begin this pain management practice.

Step Two - Breathing
I've said it before, I'll say it again: we all breathe all the time.  How handy a tool is that?  During and after my stretching, I make sure to breathe deeply and slowly.  There are various ways to practice conscious breathing: a few deep, slow breaths; breathing regularly and counting to ten on the inhales; sipping air through the mouth and letting it out in a sigh - there are many ways to become conscious of our breathing so to calm our mind/spirit/body.

Step Three - Inhabit the Body
In whatever position I have assumed, I then focus my attention on feeling the life in my body.  There are other ways to say this: Eckhart Tolle often uses the phrase, the inner body; Christians refer to the Holy Spirit descending; Native Americans feel a sacred connection to Mother Earth.  Though these phrases are all different and come from varied theological and philosophical places, I believe that they point to the same thing: the sacred life energy that enlivens all sentient beings.

But, philosophy aside, how does it work?  If you have never tried it before, allow yourself to begin with one part of the body.  Don't try to feel the whole body the first time you attempt this or you might become frustrated and quit.  Focus on your body and discover if you notice a warmth, or tingling, or energetic feeling in any one part, perhaps your hands or feet.  Simply focus on that feeling without judgment or expectation and letting go of the thoughts that arise.  Just feel it.  That is your practice for now: once that becomes natural, expand your focus gradually to other areas of your body until, after more practice (it does not matter how much or how little), you experience that feeling pervading all of your body. 

Step Four - Turn to other PM Practices
Now that you have gently stretched, breathed, and inhabited your body or at least part of your body, you can turn with quietly creative attention to other PM practices like meditation, prayer, prayer beads, listening to music or relaxation CD - whatever works for you.

As with all new practices, go easy on yourself.  This is obviously not meant to add to your stress, it is meant to reduce it.  If you don't "get" inhabiting your body, let it go for a while and try again later, or better yet, find a copy of Tolle's book and read it for yourself. 

May your practice lead you to spiritual freedom and reduction of physical pain.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.  Thank you.

23 May 2011

Pain Management: Staying in the Moment

For most of Friday, all of Saturday, and half of Sunday I had what a call a "crasher."  This is a super-migraine, the writhing on the bed and moaning kind of pain that teaches me the value of staying in the moment, or what Eckhart Tolle calls staying in the Now.

When pain is that bad, an essential part of pain management is simply staying with each moment as it is.  This may seem counter-intuitive: don't we want to flee the present when it is so uncomfortable?  There are contradictory answers to this question: (1) yes, a bit of distraction is a good thing; and (2) no, because remaining in the moment helps keep us from the all-too-easily accessed place of self pity and/or worry about past and future that layers another kind of suffering - the mental and emotional kind - on top of our physical pain.

I'll get to the value of distraction in a moment, mainly because the practice of staying with the present moment makes distraction more effective.  That sounds like a conundrum or at least a paradox, but embracing life's paradoxes gets me to the place in which most of my creative energy resides (I learned this from a wonderful book called "The Promise of Paradox" by Parker Palmer). 

Staying in the present moment is a life skill that I am learning from two main sources: my Buddhist readings and Eckhart Tolle, who has written the books "The Power of Now," "A New Earth," and "Living A Life of Inner Peace," among others.  Without trying to sound like an expert, which I am not, I'll share how what I am learning about living in the moment enhances pain management.

Staying in the moment wards off the temptation to worry about past and future.
It is bad enough to be in severe pain.  Why would we want to make it worse with our thoughts?  Yet we do, adding the frustration of anxiety about things over which we have no control make us more tense; tense muscles add stress to the body; added stress means more pain.  So there we are, not only in the miserable physical pain that comes with our illness or disease, but stuck in a mind-set that both adds to the physical pain and slathers all over it a generous layer of mental pain.  Being aware of this temptation to add to our pain helps us catch ourselves when we begin to fret.  "What about dinner - I can't cook today."  "I haven't finished that [insert task, responsibility or other activity that has been aborted due to the pain] - what will happen now?"  "What if I can't go to the fundraiser on Friday?  Those people are counting on me."  Etc.

Not that these are not legitimate concerns: they may well be, but during the period of debilitating pain, their legitimacy becomes irrelevant in the face of the need to manage the pain that is happening right now.

Staying in the moment opens the way for calming the body and mind, thus allowing us to practice pain management skills

Worrying about things over which we have no control keeps us from whatever productive and more freely creative work we could be doing.  And just what is productive in the midst of pain?  The ability to relax and quietly inhabit our bodies*; the practice of dropping otherwise unproductive worries about past and future in order to free the mind; the resulting clarity that allows us to take those deep, slow breaths and relax those tense muscles; all of which leads to the ability to remember and practice other pain management skills.  From that place, we can decide to find, or ask someone to find for us, that especially helpful relaxation CD and/or remind ourselves of other practices that have helped our pain in the past; we can figure out whether or not a call to our physician is indicated, then actually be coherent when we make the call; and we put ourselves in a place where distraction is more effective.

Staying in the moment opens the way for distraction to be more effective
The value of distraction is obvious.  What might not be so obvious is the truth of the paradox I mentioned above: in order to be effectively distracted from my pain, I must be willing to be quietly present to it in my body and my mind.  This is a bit complicated, and something that I have learned only gradually, yet I know it is a fact: when my mind has ceased fleeing desparately from the pain and accepted it instead and when my body has relaxed into the pain instead of fighting it and when I am thus quiet enough to breathe deeply into the stillness then am I able to allow something to actually distract me from the pain.

We all have different ways of diverting attention, but I will share a few of mine: listening to the radio - NPR is a life-saver in this regard; relaxation and meditation CDs; DVDs of favorite TV shows - Seinfeld and Golden Girls are current favorites and I know them well enough not to have to look at them (I always put on a blindfold during a migraine due to light sensitivity); music, of course, although somehow talking usually does a better job at distraction.  I will add that I believe our distraction should be conducive to a quiet mind: upsetting news programs or violent entertainments cannot promote peace within.    

* The phrase, "quietly inhabit our bodies," is possibly not one that you know.  It's something I have learned from Eckhart Tolle and is a practice that now informs both my pain management and my spiritual life.  It will be the subject of my next post.


I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com

18 May 2011

Balancing Rest and Activity

Having chronic pain is fatiguing.  Physically, we are worn down by the pain whether or not we have been active.  And even that word, activity, is relative: if we have the kind of pain that is exacerbated by activity (usually the case for my migraines) then our idea of activity becomes pretty restricted.  Yet, as my Mom said when she had a bad case of Lyme Disease a few years ago, "You can't just lie around all the time."

Pain with inactivity is as debilitating emotionally and spiritually as it is physically.  I have felt the depression and feelings of "poor me" rise up almost automatically during a period - anywhere from two to seven days - of a migraine that won't go away, especially if I have succumbed to the pain and fatigue. 

But how do we balance the requirements of our pain - to rest, stay quiet and use our pain management skills in peace - with the requirements of physical, emotional and spiritual health?  For me, this has been a journey of discovery, of trial and error.

PHYSICAL ACTIVITY
During 2010, after I left my job at Miriam's House , I thought that lots and lots of rest was what I needed to encourage the migraines to subside, if not go completely away.  I did need a lot of rest - that was 17 years of a very difficult, although much-loved, job - but not for the migraines.  They continued as before.  The change I noticed was not in the migraines themselves but in my ability to manage the pain.  Better-rested (another relative phrase, as sleep interruption often accompanies pain) and able to take the time to experiment, I learned tools and skills in pain management, most of which I have shared in previous posts on this blog. 

I learned that when I am rested, I have more options for physical activity and health, such as a bit of gardening and walking my dog in the park.  And even though these activities often do make the pain worse, I have also learned that, for my emotional and spiritual health, it is often well to make the choice for a time of activity that may exacerbate the physical pain but is worth it in terms of the emotional benefits.

EMOTIONAL ACTIVITY
Chronic pain is isolating.  So often it just seems far too taxing to make that phone call, or check - let alone answer! - the emails, or write that post.  In order to hold the pain at bay, we choose not to reach out.  Yet friends, family and those warming, loving connections with others are major components of emotional health.  Although the temptation is to avoid these activities because they leave us even more fatigued and/or in greater pain, the fact is that developing a balanced way to include them in our lives will actually help the pain by improving our emotional health.

FINDING THE BALANCE
I think the trick is, for physical and emotional activity, to experiment and find our own balance.  For me, walking the dog and doing a load of wash may be all I can do before going back to the couch or bed for a 2-hour rest.  For you, getting up and going to the kitchen to sit at the table for breakfast may be the sum of your activities for the morning.  One phone call will leave me light-headed and needing to lie down; you might be able to talk for hours as long as you are resting as you do it.  And, goodness knows, these parameters can change day to day: yesterday's migraine that left me wrung out and weak may today feel like the same migraine, yet I am able to bake scones, put dinner in the crockpot and walk the dog without collapsing.

The key to balance is, for me, being gently understanding of the inexplicable ups and downs of life in chronic pain.  The less judging I do of myself and my abilities, the more I am able to try different tactics, not to mention to forgive myself with a wry grin when something I was sure I could handle turns out to be too much.

I think there are several benefits to this gentle understanding:
* When gentle understanding ("I thought I could handle this ... it's sad that I can't, but I'd better go rest.") replaces harsh judgment ("What an idiot I am ... why did I think I could do this?"), we are bringing into our hearts and spirits a spacious allowing that expands our creativity and our ability to love.
* With greater creativity that comes from allowing and understanding our limitations, we become able to develop pain management and life skills that enhance the quality of our lives.
* This spacious allowing pervades other aspects of our emotional and spiritual lives because the truth is that what makes us impatient and unforgiving of ourselves also makes us impatient and unforgiving of others.  This sort of healing begins in our own hearts toward ourselves.
For me, all of these things point toward greater spiritual health.  And that will be the subject of my next post.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.

05 May 2011

She Who Shielded bin Laden

Just moments before bin Laden was shot and killed, a woman - nameless, so far, but presumed to be one of his wives - rushed the assaulter.  Placing her body and the certainty of personal harm into the space between bullets and bin Laden; now in Pakistani custody; faceless. 

Just moments before bin Laden died, he watched this nameless, faceless woman risk her life for him.

And so, I wonder: does this act make an impression on the Taliban men who are gathering to protest bin Laden's death?  Do they pause to allow to arise in ther minds the image of this unarmed woman pushing her way through the fear-filled space of that room in order to die instead of or with him?

Yet she is a woman!  She is a woman - one to whom they would deny the right to education and career, to individuality, to freedom outside the walls of her home and her burka. 

She is a woman!  One of those who, in Afghanistan, is now grimly anticipating a future with the possibility of a newly-empowered Taliban; anticipating the return of a not-too-distant past that imprisoned her and her daughters, stripping them of human dignity.

Do these protesting Taliben men understand that this unworthy woman was worthy to participate and be an actor - no, a force -  in bin Laden's final moments?  Do they wonder about his thoughts as this woman - this Woman! - rushes danger with deliberate intent to save him?

Yet she is Woman!  She is Woman - is she not worthy to be educated? to know the beauty of personal dignity? to raise her daughter to live into the destiny of intelligent, intuitive, creative, loving Womanhood that is her birthright?  She is Woman, who - these men tell themselves - should be forcibly kept from sun and breeze by law, wall and cloth; denied schooling, work and access to health care; who, except for public flogging and stoning to death, must remain invisible.

Nameless.  Faceless.  Yet bloodied and imprisoned for bin Laden, this bin Laden for whom their fiercest love shouts amidst vows of revenge.

Do they feel the irony?

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.

01 May 2011

This IS My Life

Perhaps for many of us who are living with chronic pain and/or illness, there comes a time when we realize we have to stop doing what we have unconsciously been doing: waiting for the pain phase of our lives to be over and the rest of our lives to begin.

This moment happened for me during Lent - the 40-day period leading up to Easter that Christians see as a time of repentance and turning inward for reflection and prayer.  Taken from the example of Jesus' life, this time of abstinence and quiet also prepares one for the death and resurrection of Christ.

Now, I have written before that I don't indulge in theological or christological arguments, nor do I need to believe without doubt most of the Christian doctrine on which I was raised.  Yet still I love the season of Lent for its time of purposeful soul-searching, for the examination of the spiritual life, and for its sense of being in the physical world while living more intentionally from the world of the spirit.  And so, although I did not use the season for the purpose of preparing for a resurrection, I did live into it for the purpose of delving deeper into my spiritual life.

Interestingly, what has come out of my Lent is the phrase that I used for the title of this post: this IS my life.  During Lent, it slowly dawned on me that what I have been doing - since leaving my job as Founding Executive Director of Miriam's House in late December 2009 - has been mainly waiting for the migraines to ease up and go away so that I could get on with the rest of my life.  Yes, there was the benefit of much-needed rest after seventeen years of work that I loved yet had taken so much of my physical, emotional and spiritual energy.  I was able to live a more quiet life - wonderful for an introvert like me - and pursue beloved hobbies such as knitting and gardening.  And all the while, living each day with its pain and fatigue as though by dint of rest and rest alone would I turn the corner toward health and some day, an actual job.

But this IS my life: the quiet days, enforced both by pain and by my own choice because I love the quiet; the frustration of postponing outings, activities or visits due to a migraine; pain management and learning how to eliminate the suffering that I often layer on top of the physical pain (more about that in my next post); and the narrowing of my circle of friends. 

This IS my job: to learn more about living peacefully with chronic pain; to allow the pain and my responses to it to deepen my spiritual life and broaden my approach to all of life; to practice patience when the pain is so bad that I want to scream in your face; to rejoice in the small things that are actually great blessings; to spend more time in the silence and stillness that nurtures me; to pick up again the journaling that I abandoned years ago; to explore as I love to do the religions of the world and allow them to teach me new practices, ideas and spiritual truths.

This is my life.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.

23 April 2011

Equanimity About Pain is Not Giving Up

Yesterday was Good Friday, it was Earth Day.  I knew it was coming and yet I missed it completely: I spent the day on my bed - with, thank God, my little dog curled up against my knees - the blindfold on, listening to a Golden Girls DVD for diversion.  I had my quiet time and a nap on that bed and behind that blindfold, was there when my husband left for work and when he came home.

Those sentences are statements of fact.  However much they may sound like complaining, they are really just a description of my day.  I don't remember thinking much about the significance of the day, I remember staying in each moment and accepting it for what it was: a day spent managing the pain of a migraine.  As I recall it today, I am a bit bemused - where was the impatience? the anger? the feeling sorry for myself with the ice pick stabs above my left eye?

 When we are facing another day full of pain, natural regrets and even anger arise - how could they not?  It's no one's idea of a good day to lie on the bed in the dark trying not to move lest the throbbing worsen.  We have all complained bitterly about such a fate; I have tired myself out with my own whining.  Yet if the pain is happening anyway, and we know that our mental state can affect the pain, why not accept it? 

Perhaps I am learning acceptance - if yesterday is any indication, it seems to be sneaking up on me.  You'd think that wouldn't be a surprise, given the months I've been writing this blog and the number of books I've read and CDs I've listened to, all of which tend to be about relaxation, acceptance of reality, and the gift of the Now.  If I know myself, I'll be swinging back and forth between this new-found equanimity and the more habitual complaining for a while.  But hopefully, the equanimity will win out.

It is hard to give up the struggle against the pain: it seems to indicate an overall resignation to having an illness that causes chronic pain.  But yesterday's quiet and blessedly peaceful moment-to-moment calm has not made me any less determined to ask my neurologist - I have an appointment on Tuesday - whether I can try again the class of medications that often prevent migraines.  I am optimistic that the side effects may be easier to handle now that I am not working.  And I have an article about surgery, plus notes on the pain-filled 4-month regimen that was supposed to reduce the migraines and didn't.  Accepting yesterday's pain has not diluted one bit my energy for and interest in finding relief.

Think of it as the grace of God, or what Jesus said about anxiety and the sparrows; what the Buddhists call equanimity; what Byron Katie calls loving what is; what Eckhart Tolle calls the power of Now.  In how many ways have I been receiving this message for most of my life?  It finally seems to be sinking in, and there is no giving up about it. 

No, it doesn't feel like giving up.  It feels more like courage.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com

18 April 2011

Reading How to be Sick: Pain Management III

This is the tenth in a series of posts about Toni Bernhard's book, How To Be Sick - A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers.

When we live with chronic pain, we go through stages - as in most of life - of learning how to live with it, struggling against it, wishing or praying it would go away, and, hopefully, a kind of creative acceptance of what is.  For the past several weeks, the migraines have been particularly unrelenting except for a couple of blessedly low-pain days last week, and so I have had to come to a new level of understanding my pain and how to cope with it.  There is a chapter in Toni's book that is good for me to read and review at this time, entitled "What to Do When (It Seems) You Can't Do Anything."  (pp. 121-125)

I include this post as part of the pain management series because, while I practice and espouse many different methods for pain management (PM), another and just as important aspect of PM is about relieving the mental/emotional/spiritual suffering that goes along with physical pain.  Again, Toni's explanation of Buddhism and a certain practice have made a difference in my ability to learn to live with these migraines.

"... we need to look at another practice on the Eightfold Path - wise action - because it has a lot to teach the chronically ill [and I would add, those chronically in pain] about how to take care of themselves.  Simply stated, actions that lead to the cessation of suffering are to be cultivated and actions that enhance or amplify suffering are to be avoided.  Wise inaction can thus be thought of as simply not engaging in those actions that make our condition worse."  p 121

I am reminded of the 12-Step understanding of powerlessness - that accepting and naming we are powerless over some aspect of our lives or personalities is the first step to healing. 

We accepted that we were powerless over our addictions [in this case, our pain] - that our lives had become unmanageable.  (Step One)

Similarly, Toni's chapter on wise action/inaction is built upon the concepts of acceptance and equanimity, by way of powerlessness:

"I'd been getting despondent when a treatment didn't work and becoming angry when a doctor didn't live up to my expectations.  I was trying to control the uncontrollable."   p 81

I just love the synchronicity of the world's religions and philosophies: here is a very 20th-century phenomenon, The 12-Step Program with its foundational concept of powerlessness, echoing and redefining in our time the ancient wisdom of the Buddha.  (Not to mention the wonderfully surprising discovery of my 30-day retreat on the Spiritual Exercises of St. Ignatius, which reminded me at every turn of the wisdom, challenge and comfort of the 12-Steps.)

Acceptance.  Powerlessness.  Equanimity.  To a 21st-century Western adult living in a culture of just-do-it accomplishment, these concepts can seem like giving up.  But as Toni, Buddha, St. Ignatius and Bill W. (one of the founders of the 12-step Program) knew, there is great courage and wisdom in the acceptance of life as it is, in understanding our powerlessness to change most of it, and in thus coming to a place of creative action/inaction that ends the futile fight to change the unchangeable.

So it is with pain.  Our understanding of our powerlessness and our subsequent equanimity clear the way for a kind of creative inaction.  With pain as the backdrop - not denying or arguing with it but simply accepting that we cannot change it - we move gracefully into a renewed ability to choose wisely what is to be done or not done in every moment.  For me, this state - when I allow it - gives me freedom to choose among the many tools I have for pain management, none of which come freely to mind when I am un-accepting pain's presence.

The paradox that freedom can come from admitting powerlessness, from accepting what is, is a marvelous help when we are living with pain.  It leads me to remember all of the many ways I have developed over the years for managing my pain and suffering, allowing me to choose which is best in the moment.  I can:

- conduct a body scan and deep muscle relaxation
- stretch my beleaguered body a bit
- make a cup of tea
- take pain medication
- meditate and/or pray
- practice deep breathing and breath-focus
- take a warm, comforting bath
- lie down with my blindfold and a cool compress
- play one of my favorite DVDs - Seinfeld or Golden Girls 
- listen to NPR, especially Car Talk (I know nothing about cars, but just love Click and Clack)
-  listen to audio books, usually non-fiction or inspirational (Eckhart Tolle, Pema Chodron, Jack Kornfield)
- if the pain is not too bad, knit
- if the pain is not too bad, walk my dog and throw the Kong for her in the back yard.

The point is that the peaceful state of my mind and being when I have accepted my powerlessness over the pain and come to equanimity allows me to access this list of comforts which would likely otherwise be hidden beneath the layering of denial, anger, fear, or physical pain.  In a previous post, I talked about all of this in another context - "there is pain here, but I am not in pain": reviewing that post makes me realize again how much of pain management is in our spirits. 

In my next post I want to write about acupuncture and pain management.  In the meanwhile, may all persons who read this post allow peace to flood their hearts and spirits.

I would love to hear from you.  You can use the Comment link, below, or email me at carold.marsh@gmail.com.