Death doesn’t take a holiday

Just when I thought I was out….anxiety pulled me back in.

It’s been over a year since my last post here. I had exited therapy some time ago and was making decent progress in dealing with panic and irrational fear. Highly functioning for the first time in years, things were looking up.

In therapy, my doctor had worked extensively to drive home two main points. First, rather than trying to anticipate and control every possible scenario in a futile attempt to impose safety, my energy should be better spent developing tools to deal with events when they occurred. Second, understand that even though I had a rocky history involving trauma and loss, the worst doesn’t always happen, so don’t anticipate that it will.

Skeptical? You better believe it. But her advice was sound, and it made a real difference for a long time.

August 2010, on our second day of vacation in North Carolina, my wife drowned in the ocean. It was starting to get dark so we prepared to leave, and she said that she was going to catch one more wave. Two minutes became five, then ten. Frantic searching was unsuccessful. 911 was called and rescue teams screamed to the beach, already notified of an apparent cardiac arrest.

Two people, a father and son, had been walking far down the beach and had found my wife floating, lifeless. Paramedics told me she was already cold by the time they got to her. They were very sorry for my loss.

My oldest son was with me, but my daughter had taken my ten year old son back to the beach house when things got frantic. I stumbled back to the rental property and told them Lisa was gone.

It was agonizing. I couldn’t sleep or eat. I had to wait for her body to be released by the medical examiner, then travel to a local funeral home to arrange for the return of her body. I had to make many phone calls to friends and family, including Lisa’s parents.

The worst doesn’t always happen. For me, that’s not true, as has been proven countless times.

The last ten months have been spent holding the family together, and administering my wife’s estate. It’s excruciating. After years of being told that it’s not my responsibility to always look after others, I’m right back in the role I despise.

My young son struggles, as we all do, but he’s already challenged with moderate-to-severe ADHD, and this provides additional burden for him. He’s demonstrating significant anxiety responses of his own, and we’re both seeing the same psychiatrist. She’s been great. But another generation of my family has suffered great trauma. I had hoped the chain would break with me.

Lisa wasn’t there for the first day of school, or Halloween, Thanksgiving, or Christmas. We did the best that we could, but it was miserable. January would have been our 13th wedding anniversary, April her 46th birthday. Mother’s Day was difficult, teary, and hollow.

We’re coming up on the 1st anniversary of her death, and I’m not sure what that will be like. Sad and lonely certainly. But what else?

We were going to grow old together, be wonderful grandparents, travel to new places, make a difference in areas we cared about. And now she’s gone and that won’t happen. What do I do with that?

I feel like a psychological Sisyphus, rolling an anxiety bolder up the hill, sweating and grunting, doing the hard work to take me to the pinnacle, only to have the stone return to the bottom yet again. And now my young son has a boulder of his own.

So I’m back. I’d like to say it’s good to see you all again, but that’s not true.

Damn it all the hell.

Am I Cold, or Sad?

Henry Wordsworth Longfellow was once quoted as saying, “Every man has his secret sorrows which the world knows not; and often times we call a man cold when he is only sad.”

I’ve been thinking about that quote lately, as the world has grown topsy-turvy and I find myself in an unsafe place. One of my defense mechanisms is to withdraw, like one of those potato bugs that curls into a ball at the first sign of danger, its hard outer shell offering a modicum of protection from the harsh reality of nature.

But the potato bug is small, and the world is very big. A threat of any consequence would easily overcome the tiny armored exterior. If nothing else, the insect could be completely crushed, smashed flat by an attacker.

That reality doesn’t stop the potato bug from curling up when danger lurks. Maybe it’s just one way for the bug to make it from day to day, confident that the instinctive reaction repels the enemy every time, until of course it doesn’t, but then the potato bug would be dead, you see, and the whole point would become moot, at least to the potato bug.

Getting back to me for a moment – when I’m feeling unsafe, or unsure, and I retreat, do people think I’m cold? Unapproachable? Distant? Aloof?

Maybe. Probably not those who know me well, and that’s admittedly a rather small group. Potato bugs don’t show their vulnerable underbelly unless they have to. But do I care about everyone else? And if the answer is “no”, does that make me less human? I don’t think it does. But if I had all the answers, I wouldn’t be sitting here in the shadows, typing black letters on a white screen.

Maybe it’s the difference between being detached and dejected, or separated and sorrowful. I’ve never been a “misery loves company” kind of guy, so it stands to reason that dysphoria could often be mistaken for distance. I take a pill for that. Maybe it’s time for a new pill?

I don’t know. I should probably ask about that the next time I see my doctor.

I’m not cold.

Fear and Bad Behavior

Seth Godin, on fear:

Bad behavior and irrational decisions are almost always caused by fear. If you want to change the behavior, address the fear.

And yet we don’t.

Instead, we impose an embargo or throw someone in prison. We put a letter in the permanent file or put the employee on a performance improvement plan. We walk away from a prospect or blame a lack of sales on our advertising.

“What are you afraid of?” is not just a great line for a movie trailer. It’s a shortcut in understanding what motivates.

It Is What It Is

This may sound completely idiotic coming from an anxiety sufferer, but Murphy’s Law is generally correct. More often than not, things don’t go exactly as planned.

For the anxious control freaks among us, that’s like crack. What better way to get revved up and knee-deep in the drama surrounding something unanticipated than to slap a label on it? If things didn’t turn out like we thought they should, that’s bad. Right?

Or is it?

One of the big challenges I’ve faced over the years has been the struggle to accept things as they are, without assigning a value or judgment to them. Admittedly, that’s a difficult habit to break after 40 years. My natural response to something like stripping a bolt thread or dropping the eggs on the floor has been, “well, that sucks, dammit.” which obviously removes the need for a mind-reader to ascertain what I’m thinking at that moment.

Similarly, whining about how I wished this hadn’t happened, or feeling put upon (this always happens to me at the worst possible time) did nothing to change my situation or act to prevent something from going wrong in the future. The universe doesn’t work that way!

The world is an imperfect place. Screws fall out all the time. Why are we so surprised by this?

If anything, when something goes awry, I should take comfort in the realization that the universe is working exactly as designed. Things are supposed to break down, not work, or turn out poorly now and then. It’s my unrealistic expectation of perfection that’s the problem, not the egg yolks staining my socks.

When I moved into a new job about 18 months ago, it came with a different level of interaction with senior management, one that didn’t always make it easy to be heard or advocate for my programs. After a couple of frustrating weeks of trying to prepare and anticipate where the obstacles would pop up next, I decided to post a handy reminder on the cork board by my Cisco IP phone.

It is what it is.

Sounding like a phrase oft-uttered at the Bada-Bing club by Tony Soprano, it was the perfect cue to draw my focus away from getting caught up in making judgment calls about what was happening, or more importantly, who was causing it to happen. Rather, I began to deal with just the facts of the situation, without worrying if they were good or bad, happy or sad, positive or negative. It all depended on perspective after all – what seemed good to me was bad for someone else, and when we got caught up in trying to convince someone to change their position or outlook, we were missing the main point. It just was – so what do we do next?

Success has been mixed, but it’s important for me to stay engaged and focused, and when events occur, to not lament or wish things are different. They aren’t different. Everything is as it should be.

Image by KaroliK via flickr

Living a Happy, Anxious Life

Paul, over at AnxietyGuru, asks the question, “Can You Live A Happy Anxious Life?”

It’s an interesting question, and I had to sit down for awhile and think about what my answer would be.

Paul posits:

Relative happiness is the kind you get when you buy something, say shoes or a motorcycle or whatever. It is temporary and subject to the whims of external change. Whereas inner happiness is yours no matter what, like all those fabulous bits of information you learned in school that you can’t use anywhere else, but yours they are.

I’m talking about inner peace and happiness. Now, admittedly you can be a Buddhist monk and never get there, but you can if you try. The fact that you can try should be, I hope, a signal that you can do more to be happy than you’re doing right now.

Dictionary.com has the following entry under happy:

1.         delighted, pleased, or glad, as over a particular thing: to be happy to see a person.

2.         characterized by or indicative of pleasure, contentment, or joy: a happy mood; a happy frame of mind.

3.         favored by fortune; fortunate or lucky: a happy, fruitful land.

4.         apt or felicitous, as actions, utterances, or ideas.

5.         obsessed by or quick to use the item indicated (usually used in combination): a trigger-happy gangster. Everybody is gadget-happy these days.

Anxiety, by the very nature of its presence, makes it difficult to achieve #3, since we anxious folk are generally skeptical of fortune or luck. But if we use #2 as our guiding light, which is what I think Paul was doing, then the answer is a resounding yes.

One of the very best things I learned in my treatment was to acknowledge and embrace the reality that things happen that are out of my control, and all of those years of pre-planning and proactive worrying didn’t change that a bit. It certainly gave me the illusion that nothing would go wrong, or if it did, I would be able to rapidly respond to the crisis. But it burned up energy and time for no good reason.

The downside of that – well, there were scores of downsides, but this is one of them – was that I was never in the moment during those times, because my mind and my emotions were perpetually skewed toward scanning the horizon for the next bad thing.

Once I began to let myself be present in the moment and feel the emotion that was appropriate for that snapshot in time, it became much easier to feel happy in an enjoyable way, not in the “if I let myself feel joy or peace, it will be crushing when it ends, because it always does” manner of my high anxiety years.

So when I stop to think about the things that make me happy, it’s much easier now to have clarity around what that means. I find great joy in time spent with my family, and I now allow this sense of calm, contentment, and happiness to wash over me like a waterfall, soaking me for as long as possible. Will this moment end, and will I eventually dry off again? Of course. But for that moment, that hour, that day, I’m drenched and soggy, which feels so much better than before.

I would call out these instances, these events, as reminders of my happiness, not happiness itself. I’m not engaged in some zero-sum game anymore, where I need to track and measure my level of joy, peace, and tranquility. I’m just me, a pretty happy guy, who often gets reminded of my happiness by people, places, and things. Other times, things don’t go as well, and rather than dwell on that, I seek out those very same people, places, and things that I know will keep me going until the dark cloud of anxiety passes over me.

Internet Psychotherapy Proving Effective

You know, there might just be one good thing that comes out of Internet webcams after all!

Anxiety Insights links to an Australian study that demonstrates online therapy can be just as effective as face-to-face sessions. What’s interesting is that patients only required an average of 111 minutes of clinician contact over an eight-week period, which is far less than most patients spend in office therapy sessions over the same timeframe.

The online program centers around treatment for depression, and 34% of patients felt they were no longer depressed after the two-month program, while 82% reported being either very or mostly satisfied with the treatment regimen at completion.

This bodes well for those who avoid seeking treatment due to social stigma, transportation, and provider availability issues, and since most of the program involves email contact and homework lessons, high-speed Internet connectivity isn’t a requirement – sorry to disappoint you webcam fiends.

Technology is opening new treatment vectors all the time, and the online experience can help with one of the sticky aspects of conditions like depression, which is the tendency to withdraw and avoid contact. Online therapy is a good middle step between no treatment and office visits.

On-line psychotherapy as effective as face-to-face therapy, via Anxiety Insights

Treating the Children of Anxious Parents

Researchers at the Johns Hopkins Children’s Center have found that when one or both parents has an anxiety disorder, therapy involving a family-based program was effecting in reducing anxiety symptoms among the kids and subsequently the risk of these children developing their own anxiety issues later in life.

Newswise has the details of the study, which although small in sample size (40 kids between the ages of 7-12), seems promising. From the study:

Within a year, 30 percent of the children in the no-intervention group had developed an anxiety disorder, compared to none of the children who participated in the family-based therapy. Parents along with researchers who evaluated the children and their parents independently reported a 40-percent drop in anxiety symptoms in the year following the prevention program. There was no reduction of anxiety symptoms among children on the waiting list.

That seems like a statistically significant percentage to me. Not just the children benefit from the therapy, either. Parents were able to develop coping mechanisms and modify their behaviors in several areas, such as “overprotection, excessive criticism and excessive expression of fear and anxiety in front of the children.”

Hopkins is now hoping to expand the study to 100 families. For more information, email CAPS@jhmi.edu .

When Adult Patients Have Anxiety Disorder, Their Children Need Help Too , via Newswise

CNN Discovers Mindfulness

You know that eastern practices are becoming more mainstream when CNN starts reporting on them. Heck, I would expect Glenn Beck to begin railing against yoga and meditation now, as both exercises clearly discriminate against the mindless hordes.

All political humor aside, the mere fact that the concept of mindfulness is catching on in these odd and confusing times shows that perhaps the philosophy of quick fixes and pharmaceutical intervention is becoming antiquated as the populace discovers that much like Dorothy in the Wizard of Oz, they had the power all along.

I’ve written about mindfulness here, here, and here, and the longer I practice, the more beneficial it becomes. Certainly, attaining a mindful state isn’t something that happens quickly, or easily. Thoughts and feelings intrude incessantly at the beginning, and it can be difficult to push the head full of busy out of the way and refocus.

But the mere act of recognizing a lack of focus and the presence of intruding chatter and chaos is itself therapeutic, as it helps to frame the amount of noise with which we’re normally dealing and provides a sense of empowerment and calm when we begin to have success at reducing the bedlam to white noise.

The CNN article discusses various “mindfulness” techniques as solutions for stress-busting, but that’s become a sort of catch-all, a default description for anything that helps someone to slow down and feel better. Breathing exercises, stretching, yoga – all are part of plucking yourself out of the rat race and pushing the reboot button to reset your level of tension and anxiety.

Think of your muscles, mind, and body as a rubber band. Visualize that rubber band being stretched when you’re stressed and tense, and then watch it as it grows slack, returning to its natural state. Over time, this rubber band continues to stretch, growing tense, but often fails to fully return to its original loose form due to the underlying tension that never quite goes completely away.

Therefore, our rubber bands end up being partially stretched at all times, so when we do relax, we don’t do it in the manner that we did before – we only return part of the way to a non-stretched condition.

Practicing mindfulness and stress-reduction helps us take that rubber band and relax it the rest of the way, so that it’s both easier to notice the disparity between the stressed and non-stressed self, but also to fully grow limp from an emotional, physical, and spiritual perspective.

I’ve actually seen great benefit to proactive mindfulness – doing a bit of deep breathing and mind-clearing prior to entering meetings or situations that are typically stressful, so that I’m much more relaxed at the beginning and my stress thermometer is starting from a much lower reading.

Mindfulness – catch it!

Mindfulness training busts stress , via CNN

Meditation Helping Troubled Veterans

The Seattle Times details a new “mindfulness-based stress reduction” therapy for veterans experiencing Post Traumatic Stress Disorder (PTSD). Once thought to be applicable only to hippie freaks and David Carradine fans, meditation and mindfulness are rapidly becoming the go-to tool for therapists as they search for ways to assist soldiers and sailors who have been witness to unspeakable havoc and human destruction.

Mindfulness treatment asks participants to be aware of their thoughts and physical pain without judgment. It’s easy to stew over negative thoughts, which can cause more stress and frustration.

By simply pausing to pay attention, people can notice patterns in their thinking and put thoughts into perspective to improve their lives. Deep breathing, meditation and yoga help with this process.

Scientific studies have shown the technique can help patients with a range of issues, including anxiety, depression, chronic pain and rheumatoid arthritis. Kearney hopes to add PTSD to that list.

“I quickly found that people with PTSD sought out the class to find additional ways of dealing with this problem,” he said. “We’ve had many patients report to us the ability to be present in the actual moment helped their PTSD.”

Learning about the Buddhist concept of mindfulness and how meditation can be used to facilitate the mindful state was enormously beneficial to me when I began to grapple with my anxiety disorder. The easiest way to explain it is that the combination of mindfulness and meditation gives my fears a “time-out” where, for that period of time, I’m in charge of my thoughts and emotions. By forcing myself to use my mind in a reasoned, practical, intellectual manner, I’m effectively disabling the runaway thought processes that often lead to the anxiety reactions and behaviors.

I’ve never had much use for the formalized exercises or chanting that often accompany meditation, but repeating key phrases and/or vocalizing my emotional state while clearing my brain of extraneous thoughts has evolved through practice and is now an essential part of my coping mechanism toolbox.

Kudos to the VA Puget Sound Health Care System for their innovative approach to helping our vets.

Seattle hospital teaches meditation to troubled vets

Suffering Sucks

I hurt my back the other day by sneezing. I wasn’t pushing an elderly lady out of the way of a speeding, out-of-control truck, or wrassling a bear. I was walking across the parking lot at work, my laptop bag slung over my left shoulder with my umbrella held up with my right hand, ineffectively deflecting the nearly-horizontal raindrops, when I felt that familiar itchy-tickle of a ker-choooo that would seconds later erupt.

Ker-choooo. Ouch.

So I’ve spent the last couple of days enjoying my new regimen of Tylenol and Advil, alternating between shiny red tablets and adobe-hued caplets, and it still hurts. Muscle spasms are a bitch.

It’s not the first time I’ve experienced lower back trouble – more like the 73rd. Fully supportive of the Buddhist concept of impermanence, I know the pain and tremors won’t last forever. Unless they do. And it’s only truly excrutiating when I walk or stand a certain way, so I’m trying to avoid the curse of being upright. Sitting is bearable, and luckily, my sitting position creates a nice shelf for my laptop so I can wallow in my discomfort and tell you all about it.

Didn’t this just turn out to be your lucky day?

Anyway, as I was walking the (seemingly) three miles from the parking lot to my son’s flag football game this morning, each step a reminder of my sneezy ways, I decided to follow my own advice and let the pain and discomfort in. No more fighting it, embracing it, calling it by name. Pain. I feel you. You hurt me with each stride. Come in and make yourself at home. I know you won’t stay long, and there’s no use denying you or wishing you were elsewhere.

It still hurt. A lot. Embracing pain and suffering sucks, man.

What a great reminder of mindfulness and a gentle rebuke of elevated expectations. Why was a part of me anticipating the pain to lessen simply because I acknowledged its presence? That’s not how this works, Boddhavista.

It’s reminded me that I’ve been a bit impatient and easily frustrated of late. Petty annoyances and meaningless inconveniences have bothered me, a cause-and-effect mentality developing where I was feeling put-upon. This has led to me spending way too much time thinking about me, with little regard to the troubles and suffering going on around me. Certainly not right-thought or right-action.

A lesson exists in my back pain, as I’ve struggled with simple tasks like putting on my pants and getting in and out of the car. It’s a lesson that entails understanding suffering in all of its forms and realizing that when I’m having a bad day, feeling all whiny and cranky, I need to look around and observe the pain and tribulations of others.

Rather than feeling sorry for myself, I should continue on my path to compassion and work to ease the suffering of others, because it is only by continuing my growth and healing during difficult times that I demonstrate my knowledge of the role of suffering in our lives.

The Buddha’s teaching on suffering is that we need to accept the things we can’t control, such as loss, sickness, aging, and death. This has been my reminder.