How to Be Sick

by Toni Bernhard

  Inquiry Practice

  When I became housebound, it wasn’t long before I started to worry about the fate of my friendships. Yet instead of examining the possible reasons why friends might not be visiting, I kept thinking over and over, “My friends should not stop coming to see me.” Each time the thought arose, it was accompanied by hurt and anger. This particular thought became an ever-present source of stress and suffering in my life until I began to use Byron Katie’s five-step inquiry practice to question the validity of the thought. Here’s how it works.

  In the first step, we ask whether the thought is true; in this case I answered, “Yes, it is true that my friends should not stop coming to see me.”

  In the second step, we ask whether we’re absolutely sure that it’s true. On this, I was not as certain: “Am I absolutely sure it’s true? Hmm. Maybe this requires a bit more investigation . . .”

  The third step in questioning the validity of a stressful thought is to notice how we feel when we believe the thought. When I believed the thought “My friends should not stop coming to see me,” I felt angry and hurt, almost as if I were being wounded physically.

  The fourth step is to reflect on who we’d be without the thought. I closed my eyes and imagined who I’d be . . . and my answer was, “I’d be living this day as it unfolds — seeing what it brings, instead of being focused on who may or may not visit.” Without the stressful thought “My friends should not stop coming to see me,” I felt liberated, as if a heavy burden had been lifted — the burden of constantly worrying about the state of my friendships.

  Then comes the counterintuitive fifth step, when Katie asks us to come up with a “turnaround.” The turnaround is a statement of the stressful thought in a way that’s opposite from its original expression. There’s no one “right” turnaround; we are to find one that we can work with. Once we settle on a turnaround, we’re to come up with at least three reasons why it might be true.

  For the turnaround, I tried saying, “My friends should stop coming to see me.” At first that sounded absurd, but the more I considered this turnaround, the more I was able to see that there were genuine reasons why my friends might not be visiting. Many people are uncomfortable around others who are unwell — they might be afraid they’ll develop health problems, or perhaps seeing someone who is sick or in pain reminds them of their own mortality. It’s also possible that they’re currently facing medical problems of their own, making it impossible for them to be in touch with me right now. Or they might not be visiting because they think it will be too hard on me, or maybe they don’t know what to talk to me about because they’re worried I’ll feel bad if they share the fun and rewarding things they’re doing while I’m stuck at home. In addition, people get caught up in the busyness of their lives; they often barely have time to spend with their own families.

  Working on the turnaround in this way led to two other unexpected insights. First, while generating all these possible reasons why friends might not be visiting, it dawned on me for the first time that just because they weren’t visiting — or even calling me — didn’t mean they weren’t thinking kind thoughts about me and hoping that I’d get better. Over the years, hadn’t there been people I knew who were struggling with a health problem, people I could have contacted but didn’t? Absolutely.

  Second, I realized that the reasons friends weren’t coming to see me had to do with what was going on in their minds, not mine. I can’t control the thoughts that arise in my own mind. What made me think I could control what my friends were thinking? No wonder when, in the fourth step, I reflected on who I’d be without the stressful thought, I felt as if a heavy burden had been lifted. As the Buddha said, with our thoughts we make our world. I had created a bitter and resentful world.

  Working with Byron Katie’s inquiry showed me that I had spun so many emotionally fraught tales about why friends weren’t visiting that I hadn’t stopped to examine what the true reasons might be. It wasn’t my friends who were the source of my suffering; it was my own unexamined thinking about them. That wound I was feeling turned out to be self-inflicted. Now it could begin to heal. I stopped blaming friends for not visiting and I no longer assumed they didn’t care about me.

  I use Byron Katie’s inquiry all the time. I even used it when I was stuck-like-glue on a stressful thought about her! Tony was planning to attend a daylong session with her at Spirit Rock. I really wanted to go. I felt as if I knew her personally from her books and from videos. On her website, I had watched her use one-on-one dialogues to guide people through the “four questions and a turnaround.”

  So, as Katie would have suggested, I wrote down the thought that was causing me so much stress: “I really want to go to Spirit Rock on Saturday to see Katie.” Then I subjected the thought to her five-step process. Not only was it true that I wanted to go but, unlike my example with friends not visiting, this time I was sure it was “absolutely true.” Katie says that starting with these two questions — Is the thought true? Are we absolutely sure it’s true? — forces us to commit one way or the other. Then we can watch how the mind acts to defend our response: “Don’t tell me I might not want to go to Spirit Rock. I absolutely do!”

  Then I moved to the third question and asked how I felt when I believed the thought “I really want to go to Spirit Rock on Saturday to see Katie.” I felt anger and resentment. I felt like a victim in an unfair world. But when I moved to the fourth question and asked who I’d be without the thought, I immediately saw that I’d be a person living in the present moment, which happened to be a beautifully sunbathed Tuesday — days away from the Saturday event.

  Working through these four questions was helpful, but, as can happen, the stressful thought persisted until I got to the magical turnaround. I turned the thought around to “I don’t want to see Katie on Saturday.” Then, following Katie’s instructions, I looked for at least three reasons why the turnaround might be true. I came up with five. First, it would take me a week, maybe several, to recover from the trip. Second, the event was going to be extremely crowded, so I might not be able to find a comfortable place to sit or lie down. Third, I might catch a cold or the flu from someone who was there. Fourth, by seeing Katie in person I might not improve my inquiry skills any more than I would by continuing to watch her videos on my computer. Fifth, she could be a big disappointment! (I know from watching her video dialogues with others that Katie would have enjoyed that last turnaround.)

  After putting all this down on paper — as she suggests we do because of the power of the written word — I was fully content not to go on Saturday. I had let go of the stressful thought and it never returned, even when I saw Tony off to the event.

  One day I wrote down a thought that, understandably, was a great source of suffering: “I hate being sick.”

  It was true, and I was sure it was absolutely true. How did I feel when I believed the thought? Bitter, frustrated, singled out by the world. Who would I be without the thought? I’d be a woman, lying on a comfortable bed in a quiet room, enjoying the exquisite play of sunlight on the tail of the squirrel who was visible outside my window. Katie says she isn’t telling us to give up the stressful thought but to drop it for long enough to see who we’d be without it.

  Then I turned the thought around: “I love being sick.”

  Could I possibly come up with three reasons why this turnaround might be true? I thought not, but I let ink from my pen flow onto the page anyway. When I was finished, I’d come up with twelve reasons. Here’s what I wrote, unedited, and in the order I wrote it:

  1. I don’t answer to an alarm clock.

  2. I have the perfect excuse to avoid events and people I don’t want to be with.

  3. I have lots of time to be with Tony and Rusty, our dog.

  4. I’m getting to know Bridgett, my daughter-in-law, really well for the first time.

  5. My life is pretty quiet and peaceful.

  6. I’m never stuck in traffic.

  7. I d
on’t have to work.

  8. There’s nothing I have to read or study.

  9. My to-do list is very short.

  10. Most of my day is unplanned, so in summer, I can lie down in the backyard before it gets too hot and in winter, wait until it warms up to do so.

  11. I’ve met some people I wouldn’t have otherwise known.

  12. Being home sick allowed our elderly dog, Winnie, to live another year since, in that last year, she couldn’t be home alone.

  I can’t say that since performing this inquiry I haven’t again believed the thought “I hate being sick” and suffered as a consequence. I have dozens of times — this work is not necessarily about ridding oneself of stressful thoughts but rather about examining their validity. But the work I did that day on “I hate being sick” is right there, on paper, and rereading it is always helpful.

  Then came the day when I tackled this stressful thought: “I am sick.”

  I was surprised at the number of genuine reasons why the turnaround was true: “I am not sick.”

  My mind isn’t sick — I’m able to do this inquiry. My heart isn’t sick — I can express love and be of help to others. Not all my body is sick — I can walk, I can type, I can see the birds, I can hear music. I came away from that exercise truly not feeling like a sick person. In fact, I realized that the more I believed the thought, “I am sick,” the sicker I felt.

  By offering us a systematic method for examining thoughts that are a source of dukkha (suffering, stress, dissatisfaction with our lives), Byron Katie’s inquiry takes us to the Buddha’s first and second noble truths: we create dukkha when we believe we must get our way. I wanted friends to visit. I wanted to go to Spirit Rock to see Katie. I didn’t want to be sick. Subjecting stressful thoughts like these to Katie’s “four questions and a turnaround” gives us a tool for making peace with our life as it is.

  13

  The Present Moment as a Refuge

  When we settle into the present moment, we can see beauties and wonders right before our eyes — a newborn baby, the sun rising in the sky.

  — THICH NHAT HANH

  WHEN PEOPLE FIRST realize they have a chronic condition that’s going to severely restrict their activities, they’ll try just about anything to get their old lives back: off-label use of prescription drugs, homeopathic medicine, esoteric mind-therapy techniques, nutritional supplements, oxygen chambers. When the Parisian Flu settled into a chronic illness, I scoured the Internet looking for possible treatments. (I have a large box that I refer to as the “Box of Rejected Supplements.”)

  My online wanderings revealed that many people, regardless of their religious affiliation, find that starting a meditation practice is the most helpful treatment they’ve tried. So, Buddhist or not, many people turn to meditation when they become chronically ill. This devoted Buddhist, however, turned away from it.

  When I got sick, I had a mindfulness meditation practice that I’d been doing consistently for ten years. I meditated twice a day for forty-five minutes each time, following the traditional instruction to rest my attention on the physical sensation of the breath as it comes in and goes out of my body — sometimes called “following the breath.” When my mind wandered to other things — perhaps to thoughts about all I had to accomplish the next day — I’d gently bring it back to following the breath again. The purpose of mindfulness meditation is to keep returning to the experience of the present moment. (More detailed instructions can be found online, in Buddhist books, at meditation centers, and at many medical clinics in the form of mindfulness-based stress and pain reduction programs.)

  I was so disciplined and stubborn about my meditation practice that it had become part of our family lore to recall — and to tease me about — how on our daughter’s wedding day, I still managed to get in my two formal sittings. What made this remarkable was that, although Mara and Brad lived in Washington, DC, the wedding was in Davis, where Mara grew up. She and Brad arrived in Davis two days before the festivities. I have never been one to throw parties; Tony and I had twelve people at our wedding. Nevertheless, here I was, putting on a traditional wedding for over 150 people! Needless to say, I was overwhelmed by my responsibilities on the wedding day. But the family knew: whatever else happens on this day, Mom is going to meditate, not once, but twice.

  At the Spirit Rock retreat in July 2001, when I awoke on the third day and realized that some form of the Parisian Flu had returned, I raised it at my next teacher interview. I reported that I found it difficult to meditate because I was physically ill. I was told that being sick was the very best time to meditate because it would prepare me for when I was approaching death. I should “follow my breath” and note the illness-related body sensations as they arose. I returned to my room and lay on the bed, trying over and over to meditate, but the sickly body sensations were too unpleasant for me to keep my attention on. I couldn’t do it on the retreat and, upon returning home, to the surprise of my family, I discarded that ten-year meditation practice that we all thought was set in stone. I felt like a failure whenever I’d read online how helpful meditation was to people who were chronically ill. But when I would try, the discomfort of my illness was overwhelming.

  It took me fourteen years to take up mindfulness meditation again, but I do it differently now. I no longer have hard and fast rules. I lie on the bed and pay attention to the physical sensation of the breath as it comes in and goes out of my body — one of many meditation techniques. This anchors me in the present moment. Of course, my attention drifts now and then, usually to thoughts about the past or the future. When I become aware this has happened, I gently return my attention to the sensation of the in- and out-breath. I do this for between twenty and forty-five minutes. And if I’m too sick or in too much pain to meditate on any given day, I don’t do it. Allowing myself this flexibility works for me.

  In the years since I’ve been chronically ill, more essential to me than formal meditation has been mindfulness outside of meditation. Mindfulness refers to paying attention to your present-moment experience. It’s as simple as that. There’s no belief system associated with mindfulness, even as it was originally taught by the Buddha. For me, fully engaging my present-moment experience has become a refuge from the exhaustion created by constant discursive thinking, whether I’m ruminating about the past, worrying about the future, or judging what’s going on around and inside me.

  I’m aware that the word mindfulness has become so pervasive in our culture that it can feel as if it’s lost its freshness and even its meaning. My goal in this chapter is to make it come alive again by offering specific ideas, rather than just telling you, “Be mindful of everything you do.” And so here are five simple practices that are easy to try. See which ones resonate with you.

  Describe Your Present-Moment Experience Objectively

  From my daughter, Mara, I learned a remarkable practice. It comes from Byron Katie. Mara was listening to a podcast of Oprah Winfrey interviewing Katie on the radio show Oprah and Friends. Katie was sharing a story about her daughter, who, years ago, had problems with alcohol and drugs. Her daughter would go out at night in her car and, in the early hours of the morning, Katie would sit and wait for her daughter to return. The later it got, the more stressful Katie’s thoughts became. She would imagine her daughter had been raped, or that she’d been in an auto accident and was dead or was lying injured on the road in agony with no one to help her. Then one early morning, as the same thoughts began to arise again, Katie realized that the only thing that was true for sure was this: “Woman in chair, waiting for her beloved daughter.”

  Mara heard this story and knew it contained a gem, because she started to free her own mind of stressful thoughts and ground herself in the moment by using whatever version of Katie’s words applied. In fact, Mara happened to share this story with me because the day before had been a particularly stressful one for her, physically and emotionally (an emergency trip to the dentist for my granddaughter Malia was but one
of the highlights). Mara said that as she was lying in bed that night, trying to read, stressful thoughts about the day kept spinning around in her mind. It was as if she were reliving the day over and over. (We’ve all done this, haven’t we?) Then she said to herself, “Woman lying in bed, reading a book.” Suddenly she was, well, just a woman lying in bed, reading a book! She’d brought herself out of painful ruminating about the past and into the present moment.

  I’ve found that this practice works best in the context of chronic illness if you’re careful to do what Mara did — make your description objective; that is, leave out emotionally charged words, such as horrible or unbearable. For example, instead of saying, “Sitting in my car with horrible neck pain” or “On my bed, feeling unbearably depressed,” simply say, “Sitting in my car with neck pain” or “On my bed, feeling depressed.” Leaving out the emotional descriptors minimizes the likelihood that you’ll start spinning stressful stories that will only make you feel worse, stories such as how the neck pain or the depression will never go away. As we know from chapter 4, everything changes. No physical or mental symptom is set in stone.

  I used Byron Katie’s practice for the first time the very day after Mara shared it with me. I was caught up in a repeating round of stressful thoughts about the previous day. I was blaming myself for not having been more disciplined about the amount of time I’d spent socializing with a friend who had come over. Of course, it’s not a bad idea to examine the effects of oversocializing on our symptoms, but blaming ourselves and feeling guilty about something that’s already happened is not constructive.

  “It’s your own fault that you feel so sick today,” I thought for the dozenth time, at which point I looked up and saw my face in the mirror of the bathroom sink and said, “Woman on stool, brushing her teeth.” It was a magical moment. It broke the hold these stressful thoughts had on me. Just to be sure, I repeated (to use Katie’s words) the only thing that was true for sure, “Woman on stool, brushing her teeth.” And I smiled, because being in the present moment is a relief indeed!