How to Be Sick

by Toni Bernhard

  I vividly remember one incident in particular when I not only found myself feeling envious of one of Tony’s trips to see Malia, but I was also downright resentful. Envy arises when we want what others have or can do. Resentment is also present if we believe we’re not getting it because of some perceived injustice in the world.

  Tony had bought tickets for the two of them to go to Fiddler on the Roof while he was visiting in Los Angeles. This musical is special to me because it’s the story of how my father’s family immigrated from modern-day Ukraine to the United States in the early 1900s; they left because of the pogroms against Jews. Fiddler on the Roof was my story, and I wanted to be the one to take Malia to see it. As a result, instead of feeling happy about their plans, I felt envy and resentment — I felt like the victim of some terrible injustice because I was too sick to travel. “It’s not fair!” I protested to myself.

  With effort, I was able to turn my misery around. I started by evoking self-compassion for how hard it was not to be able to take Malia to Fiddler. Being kind to myself in this way enabled me to drop the painful stories I was spinning about how unfair life can be. It also made it easier to look at their plans through their eyes and reflect on how they wouldn’t want their evening at Fiddler to make me unhappy.

  Then I turned my attention to feeling empathetic joy. Again, at first I had to pretend, but that’s okay. It didn’t take long for that pretending to turn into genuine joy as I felt happy just knowing that Malia was going to see a musical that’s such an important part of my life. And then something special happened. The joy I was feeling made me feel so connected to them that it felt as if I were part of the evening, too — as if the two of them were there for all three of us.

  Cultivating the sublime state of empathetic joy may be an ongoing challenge but, for me, it’s been a great gift from the Buddha. To paraphrase Shunryu Suzuki’s words at the beginning of this chapter: empathetic joy has allowed me to find perfect existence, even though my heath is far from perfect.

  7

  Soothing the Body, Mind, and Heart

  May the gentle breeze and the calm sea protect your loved ones and friends on their journey.

  — “SOAVE SIA IL VENTO” FROM MOZART’S COSÌ FAN TUTTE

  METTA, KINDNESS, is the act of treating ourselves and others with openhearted friendliness. We’re unlikely to be able to love all the people who pass through our lives, but we can be kind and friendly and wish that no harm comes to them. This practice differs from compassion in that, traditionally, the latter is directed toward those who are suffering. By contrast, metta is directed toward everybody, from the mail carrier, to loved ones, to those you’d rather not see at all (including on your TV screen).

  In traditional metta practice, you settle on a set of phrases and then recite them silently, over and over. The phrases can be directed to yourself, to others as a whole, or to particular people. These are the phrases I settled on in the early 1990s:

  May I be peaceful.

  May I have ease of well-being

  May I reach the end of suffering . . .

  And be free.

  There’s no magic to these four phrases. The cadence and meaning just work for me. “Ease of well-being” is a phrase I first heard from the Buddhist teacher Sharon Salzberg. I like it because it suggests that we greet each moment of everyday life with care and kindness. It’s as if I’m saying, “May I have ease of well-being as I shower . . . as I eat this meal . . . as I lie down to nap . . . and even as I experience sickness, fatigue, and pain.” Other possible phrases: “May I be happy. May my mind be healed. May I make friends with my body. May I dwell in peace.”

  After taking some time to try out different phrases, it’s best to settle on one set. The act of listening to and contemplating the meaning of the phrases as you repeat them, over time, softens and soothes the body, mind, and heart. In fact, now I need only silently say, “May I be peaceful,” and it sets off a relaxation response in my mind and body. They know what’s coming next! Sometimes I remove myself as the subject altogether and just lie in bed, repeating, “Peaceful, ease of well-being, end of suffering, free.”

  The phrase “end of suffering” should be familiar from the discussion of the Four Noble Truths in chapter 3. When my health didn’t return, I lay in bed repeating my chosen metta phrases. One day when I got to “May I reach the end of suffering,” I became aware that I was wishing I’d stop feeling sick — that the physical discomfort would go away, that I would stop being sick. Of course, wishing for something over which I had no control only brought more suffering.

  It was then that I realized that most of my suffering came not from the physical discomfort of the illness but from my mind reacting to it with thoughts such as “I don’t want to be sick,” “I hate this physical discomfort,” “What if I can never return to work?” A shift occurred, and the end of suffering I wished for became the end of suffering in the mind. In fact, I could add “in the mind” to the end of each of my four chosen phrases, whether I’m directing them at myself or at others.

  Although I’ve settled on the above set of phrases for my basic metta practice, I use other words at times. For example, while on the July 2001 retreat I wrote about earlier, I dragged myself to a talk given by Kamala Masters because, sick though I was, I loved being in her calm and serene presence. That evening she closed her talk by directing this phrase to us: “Whether sick or well, may your body be a vehicle for liberation.” That got my attention! I didn’t replace one of my four phrases with this one, but while lying in bed I still sometimes silently repeat, “Sick though it is, may this body be a vehicle for liberation.”

  Traditionally, metta phrases are directed toward different groups of people. You start with yourself and then move progressively from those for whom it is easiest for you to evoke feelings of kindness and friendliness to those who are the hardest.

  First, direct the phrases at yourself. This opens your heart to the practice. It’s difficult to feel kind toward others if you’re not feeling kind toward yourself. If you feel resistance at first, that’s okay. Many of us have been conditioned to be our own harshest critics, making it hard for us to speak kindly to ourselves. If this is true for you, I suggest you think of that cliché, “This is the first day of the rest of your life,” and imagine a blank slate in your mind. Begin to fill that slate with thoughts of kindness, benevolence, and friendliness toward yourself. Repeat your phrases even if they don’t feel genuine at first. They will work their magic anyway, transforming your heart and mind.

  After taking some time to direct the phrases at yourself, call to mind someone for whom you feel deep gratitude and address the phrases to this person. Then move to a person you love but toward whom you might also have some conflicting feelings (such as a close friend or loved one). Then pick a person you don’t have an opinion about one way or another (such as a cashier at the supermarket).

  Finally, address your phrases to a person whose name alone gives rise to anger, judgment, and other thoughts and emotions that are a source of suffering for you. This last category is called “the difficult person” and is one of the most powerful aspects of this practice. It can be hard to direct thoughts of kindness toward a person who is a source of difficulty for you. He or she could be a family member, a doctor who doesn’t take your illness seriously, or even a public figure. Wishing for a person who is a thorn in your side to be peaceful and to be free from suffering may be a challenge, but it’s an antidote for anger and ill will, which turns this practice into a liberating one.

  For the difficult person, I usually pick a politician — someone with whom I vehemently disagree — to be the object of my kind and friendly thoughts. First, recognizing that my reaction to this person is a source of suffering for me, I begin by directing kind thoughts toward myself: “May I be free from the suffering that my aversion to this person gives rise to.” Then I turn my attention to the person: “May you be peaceful. May you have ease of well-being. May you reach the en
d of suffering . . . and be free.”

  At first the phrases feel artificial and fake. But as I’ve trained myself to do, I persist. Soon, not only do the phrases become genuine but I also begin to see qualities in the person that I share. For instance, perhaps we both have families we love. Perhaps the person clings to his or her political views as tenaciously as I cling to mine — a shared source of suffering for us!

  After a time, it feels as if a poison has been extracted from my body, mind, and heart. Practicing this sublime state is an antidote for hatred and ill will toward others. The politician in question probably still won’t get my vote, but evoking feelings of kindness toward him or her frees me from the anger and ill will that are the sources of mental suffering and that often intensify my physical symptoms as well.

  I hope you’ll work on treating others as well as yourself with kindness and openhearted friendliness. It can soothe a body that’s sick or in pain, and offers peace to a troubled mind or a hardened heart.

  8

  Using Compassion to Alleviate Your Suffering

  When the heart at last acknowledges how much pain there is in the mind, it turns like a mother toward a frightened child.

  — STEPHEN LEVINE

  COMPASSION, the third sublime state, is described in Buddhism as the quivering of the heart in response to the recognition of suffering. Once we recognize the presence of suffering in ourselves and others, our practice is to look for ways to help alleviate it. In this chapter, I’m going to focus on cultivating compassion for ourselves because, for many of us, this is harder than cultivating compassion for others.

  The four sublime states are not mutually exclusive; I may call upon more than one of them at a time to help me through a difficulty. Recall the story about how I cultivate empathetic joy when Tony and my granddaughter Malia call while they’re out and about in Los Angeles. Sometimes that call comes on a day when I’m feeling particularly sick or mentally down because of my limitations. Although I seldom feel envy when they tell me what they’re doing, it may be too difficult for me to feel joyful. When this happens, I evoke compassion for the emotional pain I’m experiencing at not being able to join them. This never fails to ease my suffering.

  Before I became chronically ill, two teachers helped me “recondition” my mind so that compassion became a natural response to my own suffering. The first teacher was Thich Nhat Hanh. In his book The Diamond That Cuts through Illusion, he describes how the body responds naturally — without thought — to its own pain: “When our left hand is injured, our right hand takes care of it right away. It doesn’t stop to say, ‘I am taking care of you. You are benefiting from my compassion.’”

  Indeed, when I fell and broke my ankle, before any thoughts about it arose in my mind, my hands had already reached out to care for the pain. With practice, we can condition the mind to respond compassionately to our pain and suffering, just as our hands do.

  The second teacher who helped me learn to cultivate compassion for myself was Mary Grace Orr. On a Spirit Rock retreat in the late 1990s, she told a story that had a profound effect on me. She was describing a harried day in which she had too much to do and too little time in which to do it. (Sound familiar?) At one point, while in her car, she realized she was talking to herself in a way she would never talk to others. I don’t remember her exact words, but they immediately resonated with me because of their similarity to the way I used to talk to myself:

  “How stupid of me to take this route; it’s always full of traffic.”

  “I’m so dumb, I forgot to bring my notebook.”

  “You clumsy idiot — you dropped your drink again.”

  Would I ever call Tony “dumb” or “stupid” or an “idiot”? No! And what’s more, if I ever heard someone talking like this to someone I cared about — or even to a stranger — I would at least feel the impulse to intervene. Mary’s story was an eye-opener for me. From then on, when I’d catch myself using that language, I’d stop and reflect on how I’d never talk to others that way. After a few months, I had “reconditioned” my mind to treat my own difficulties with compassion.

  Then I got sick and that reconditioning unraveled.

  I blamed myself for not recovering from the initial viral infection — as if not regaining my health was my fault: a failure of will, somehow, or a deficit of character. This is a common reaction for people to have toward their illness. It’s not surprising, given that our culture tends to treat chronic illness as some kind of personal failure on the part of the afflicted — a bias that’s often implicit or unconscious but is nonetheless palpable. I was helped by Tony and by Spirit Rock teacher Sylvia Boorstein, who kept reminding me that this illness was just this illness, not a personal failing on my part. In the end, it took an intense moment of physical and mental suffering for me to finally reach out to myself with compassion.

  It happened on Thanksgiving. At that time I’d been sick for a year and a half, but I was still not willing to accept that I could no longer travel to family events. So I agreed to go to Escondido where, for years, my daughter-in-law’s parents, Bob and Jacqueline Lawhorn, hosted us for Thanksgiving. I planned the trip to accommodate my illness. Tony would drive down from Davis; I would get a ride to the airport and take a plane from Sacramento, which would shorten my travel time; and I’d only stay for two days.

  The moment Tony picked me up at the San Diego airport and we began the forty-five-minute drive to Escondido, I knew the trip had been a mistake. We checked into our hotel and drove to the Lawhorns’ house. After ten minutes of visiting, I felt so sick that the room began to spin and I couldn’t focus on people. I told Jacqueline that I needed to lie down. Except for sleeping at the hotel at night, I spent that day and the next on the Lawhorns’ bed. I felt no compassion for myself. I was ashamed of being sick and I blamed myself for everything my mind could come up with: undertaking the trip in the first place; taking over the Lawhorns’ bedroom (which they graciously gave me, of course); not visiting with family and friends; ruining Tony’s Thanksgiving. The list was long because, as Jack Kornfield likes to say, “The mind has no shame.”

  On Friday, Tony dropped me off at the San Diego airport. The flight was delayed two hours. I propped myself up in the chairs near the gate as best I could. I’d arranged for the Davis Airporter, a minivan service, to pick me up at the Sacramento airport. I walked outside the terminal to find that Sacramento was socked in with tule fog — a cold, wet fog that descends on the Central Valley in winter. The van wasn’t there yet, so I sat on my suitcase in the fog. Since getting sick, this was the closest I’d come to collapsing on the ground. When the van pulled up about fifteen minutes later, the driver told me that he had to wait for two other planes to arrive before he could drive to Davis. I got in the van and lay down on the seat to wait. It was cold and damp. Ten minutes. Fifteen minutes. Twenty minutes. My physical suffering was matched only by my mental suffering in the form of the hatred and blame I was directing at myself.

  Then suddenly, unexpectedly, there was a turning of the mind, and my heart opened. Maybe, on a subconscious level, I was recalling Mary Grace Orr’s story, and I knew I’d never treat another person the way I was treating myself. Maybe I was finally ready to receive Tony and Sylvia’s compassionate reminder that this illness was not a personal failing on my part. I’m not sure what caused this change of heart and mind, but I got out of the van, explained to the driver that I was sick, and asked if he could please call the dispatcher and get permission to take me to Davis. He called, got permission immediately, and drove me home. That experience marked the beginning of my ability to treat this illness with compassion.

  One of my favorite compassion practices is tonglen, which comes from the Tibetan Buddhist tradition. Chapter 11 will explore that practice in detail. Here I’m going to offer five other practices I use to cultivate compassion for myself.

  Disidentify from Your Inner Critic

  Most of us have been conditioned from childhood to be our own harshes
t critics. That inner judge can shadow us, scrutinizing our every move and giving us negative feedback that makes us feel bad about ourselves. When I first became sick, the inner critic was in charge. For several years I’ve been working to turn that inner critic into an inner ally who will refuse to disparage me, just as I refuse to disparage those I care about. Taming the inner critic is truly an act of self-compassion.

  The practice that has been most helpful is called disidentifying — that is, not treating the inner critic voice as an authentic, fixed feature of yourself. Disidentifying in this way can take several forms. For instance, you can give the critic a name: “Oh, it’s Ms. Nag again.” Doing this keeps you from identifying with the voice as an immutable part of your personality.

  Another effective disidentifying technique is to imagine that the inner critic is a voice on a stage and you’re in the audience, watching the performance. Here’s what I do: When I become aware that the inner critic has shown up, I put it on stage and imagine myself in the balcony of a theater, listening to it go on and on about how Toni shouldn’t have gotten sick and how she shouldn’t have gotten breast cancer. As a member of the audience, I hear the absurdity of that voice’s criticisms — does it think this Toni has the ability to control everything that happens in her life, including the ability to make sure that all her experiences are pleasant ones? When I disidentify with that voice by putting it on a stage, I find myself thinking, “Someone should show that critical voice the Buddha’s list from the first noble truth!”

  Then I (as an audience member) consider what would make for better “onstage” viewing and listening. The answer is easy: a focus on the positives in Toni’s life, despite her health problems. For starters, she has a roof over her head, a loving partner, and a cuddly dog. There’s a lot of lovely stuff that could be showcased on that stage instead of incessant nagging criticism.