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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.

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.