To be sparing of your energy

My husband is recently geeking out on Iaido, the Japanese martial art of drawing the sword.  So we have a bunch of library books on this all over the house.  Thankfully he's not practicing with kitchen knives or garden tools.  But he did find a wonderful piece in a book:  Training the Samurai Mind: A Bushido Sourcebook, edited and translated by Thomas Cleary.  In it, there is a piece by Hakuin.  He talks about maintaining one's energy.  I believe these are Taoist healing principles.  Despite sounding like a spa commercial at some points, this is a very interesting take on conserving energy, and where to place awareness.

From "Instructions to a Samurai" by Hakuin Ekaku

If you think dead sitting in silent awareness is enough, you'll waste your life and deviate greatly from the way of enlightenment.  Not only will you deviate from the way of enlightenment, you'll neglect worldly truth too.  Why?  If the lords and grandees gave up government to sit deathlike in silent awareness, if the warriors ignored archery and horsemanship and forgot martial arts to sit deathlike in silent awareness, if the merchants closed up shop and broke their abacuses to sit deathlike in silent awareness, if carpenters discarded their plumb lines and tossed away their planes to sit deathlike in silent awareness, the nation would wither, the people would weary, robbers would rise up repeatedly, an the state would be in peril.  Then the people would indignantly say that Zen is extremely inauspicious.   

There are two kinds of selflessness.  Suppose there is someone who is always timid and weak in body and mind, afraid of everyone, mortifying his feelings so that in dealing with myriad situations he does not become angry when hollered at, doesn't mind if he's beaten, is always absentminded, and doesn't learn from experience, but he thinks he has attained selflessness and considers that sufficient.  This is being a broken rice bag, a fat-bellied pig in the mud, as if entirely ignorant and void of intelligence.  It is not true selflessness.

~~~

If you always have your mental energy filling your navel sphere, ocean of energy, elixir field, and the space between your waist and legs, and you do not let it recede for a moment even when you are busy working or meeting guests, then basic energy will fill the elixir field, and the lower abdomen will be slightly rounded like an unribbed ball.   

If people can cultivate this state, they can sit all day without tiring, recite all day without wearying, write all day without fatigue, speak all day without getting worn out.  Even if they do myriad good deeds day in and day out, they never show any sign of flagging.  The mind becomes broader, the heart becomes bigger, energy is always vigorous.  Even in the hottest summer one does not sweat, even without using a fan; even on the coldest winter night one does not need to wear socks or use a warmer.  Even if one lives to be one hundred years old, one's teeth will become even firmer.  If one does not slack off, one attains long life.

~~~

There are three places in the body that are elixir fields.  What I refer to as the elixir field is the lower elixir field.  The ocean of energy and the elixir field are both below the navel, as if they were one reality with two names.  The elixir field is two inches below the navel, the energy ocean an inch and a half.  When pure energy always fills here, body and mind are always equanimous.  Even if you live to be a hundred years old, your hair won't thin and your teeth won't loosen.  Your vision will get clearer and your skin will gradually become lustrous.

~~~

Spirit is like the ruler, vitality is like the ministers, and energy is like the people.  Now then, caring for the people is the means of keeping the country intact.  To be sparing of your energy is the means of keeping your body intact.  When the people flee, The country perishes; when energy runs out, the body dies.  For this reason, a sage ruler always focuses his mind below, while a mediocre ruler always indulges his heart on high.  When the heart is indulged on high, the nobles rely on personal favor, the officials are arrogant with power; they never pay attention to hardship among the people, while importunate ministers greedily skim and cruel officers deprive by deception.  There may be plenty of vegetables in the fields, yet people are collapsing from starvation in the countryside.  The intelligent and the good go into hiding, ministers and commoners are angry and resentful, the masses of people are ultimately reduced to abject misery and so the pulse of the nation dies out forever. 

When the mind is focused below, never forgetting the toil of the people, the populace is well-nourished and the state is strong; no ministers or commoners violate the law, while no enemy states invade the domain.  So it is with the human body.  The perfect people always have mental energy filling below, so the emotions do not act within, while the material world cannot invade from without.  With the camp guard fully supplied, the mental spirit is strong.  Ultimately, the body doesn't know the sting of acupuncture or moxabustion, just as the people of a powerful nation don't hear cries of alarm.  

Living Bodhisattva

I want to share something significant.  It's another post about a therapist-teacher in my "lineage": Marsha Linehan.  I don't use the term Bodhisattva lightly.  Marsha Linehan is responsible for decreasing suffering on a grand scale, people.  The occasion for this post is that she has now "come out" about her own history of severe mental illness.

Courageous

I have been in the field of mental health long enough to have seen how things were before her therapy, DBT (Dialectical Behavior Therapy) was widely used.  And it was ugly.    

Marsha Linehan developed DBT in the early 1990's for people with Borderline Personality Disorder (BPD).   Prior to DBT, people with this diagnosis were pretty much the lepers of mental health.  Mostly women, usually trauma survivors, some broad-brush features of BPD are:  Extreme emotional sensitivity -- like having no skin -- and the concomitant extreme ups and downs in mood, a tendency to see things in a very polarized way, engaging in self-injurious behavior and / or frequent suicide attempts.  Therapists in the past did not have effective tools to think about or deal with this high-risk, high-suffering population for whom traditional therapies often did not work.  So therapists -- in the face of this tremendous, excruciating pain, ostensibly with the responsibility to relieve that pain, and an inability to do so -- would become frustrated.  Sometimes even experiencing rage at the patient.  Unable to tolerate or even admit their own helplessness and rage, they would often blame the patient for "manipulation,"  not wanting or not trying to get well.  And reduce their behaviors to "trying to get attention."

This is probably why she couldn't have "come out" a minute sooner.

This article reveals Linehan's account of her own 2-year(!) psychiatric hospitalization in the 1960's, which included electroconvulsive therapy, hard core antipsychotic and sedative medications, Freudian therapy and isolation.  Truly the dark ages*.  Things maybe got a little better in that by the 80's and 90's they stopped keeping people with BPD in the hospital for long durations.  Though that didn't stop therapists from dealing with their own helplessness by turning people with BPD into caricatures, or worse.

I have heard colleagues on the crisis phone line I used to work for verbally demean clients, and after hanging up, feel justified and bemoan how the caller was "such a Borderline."  Also have heard of clinical supervisors end all discussion of cases because they were "just a Borderline."  Therapists in general were so hostile to people with Borderline that it became a pejorative term in the field.  Early in my career I witnessed a woman with this diagnosis in a hospital being strapped to a gurney.  There are some situations in which this might be appropriate to protect someone from self-injuring. It was the extra words that the hospital employees used, getting close to her face and saying, "There, now you made us tie you down.  Now you got what you wanted.  Are you happy now?  Huh?"  Remember, many (not all) of these people are survivors of violence, including childhood sexual abuse.  It makes my guts churn just thinking about it.

So here comes DBT treatment:  It's a Cognitive Behavioral Therapy / Zen fusion.  Marsha Linehan, a clinical psychologist and researcher had also been practicing contemplative prayer in the Catholic tradition for decades.  She had also become a serious Zen student.  She took on this patient population that others wouldn't touch with a ten foot pole, and figured out how to operationalize and teach the skills of mindfulness, step by step.

The dialectic in dialectical behavior therapy is an ongoing search for synthesis of polarities.  The primary dialectic in this treatment is Acceptance and Change.  The revolutionary part of this treatment, in my mind, was the acceptance part.  Half of the treatment is about expressing compassion, and validating the patient's experience, sometimes called "seeing the function in the dysfunction."  But this is only half.  Acknowledging and validating someone's feelings is indeed powerful but in some cases, there's an urgency and a sense in the client coming in with REAL life-or-death problems that need SOMETHING.  NOW!!!  DBT includes many many practical skills to place in clients' hands.  Oh that didn't work?  Here's ten, twenty, fifty more things you can try.

This is another primary dialectic

Mostly, though, DBT is for therapists.  It gives therapists a structure within which to work.  It requires that this work be done by team.  That there be a classroom component for teaching skills in addition to the individual therapy component.  And it requires that team to practice the skills themselves, and on each other in a regular meeting.  Marsha Linehan wrote a textbook (dense as hell), and a skills training manual.  The training manual details out step-by-step, session-by-session how to run a DBT class.  The textbook guides the creation and maintenance of a DBT program.  A handful of colleagues and I followed these to the letter in the rural county mental health agency I worked in, and no shit, it worked!  Sometimes I felt like I was emergency-landing a plane with Marsha in my headphones talking me through the steps.   

While I was practicing DBT in this agency, it didn't take me long to realize I needed to deepen my own mindfulness practice somehow.  Then this Zen monastery opened up in the county I worked in, and well, one thing led to another.

Marsha has some serious fans, of course, and I'm unashamedly one of them.  I often joke that I'll make a bundle off my "WWMD" bracelet line.  When she gave a training here, I was able to personally give her one of the singed-robe Jizo Bodhisattva statues made by the monastery.

I have always seen her as a manifestation of  Jizo Bodhisattva going into the hell realms to get others out.

Marsha Linehan, again, with optimism and fearlessness, has done the therapeutic community and the clients we see a tremendous service.  Thank you.


*These meds continue to have their useful place for certain diagnoses and situations, and ECT, now apparently much more refined, is reportedly making a comeback as more of a scalpel rather than the chainsaw it once was.  

The Attitude of Gratitude

Ain't just a platitude.

Experiencing life post-Sabbatical. I am so happy and grateful, it is way bigger than me. Turns out I really do enjoy my work as a clinical social worker, especially when it's not like drinking out a firehose. I used to say that I loved my work at the county, but there was just so darn much of it.

I just called my old supervisor the other day, and she said she couldn't believe it had only been a year that I'd been gone; that it seemed like 10 years. A lot happens there in a day. There's a reason people count their time in dog years.

It has been such a gift and an honor to focus on clients again. And keeping the focus on me, too.

I suspect the big changes in my diet and other health-related practices has also given me a boost to some degree. It certainly was a major change. I remember just feeling an energetic floor one day. Nice. And impermanent.

Social work is my trade, and I am very grateful that I have not had to stop practicing it. Especially at a point in my career when I have a little seasoning. I like to think it's about to get really interesting now.

I was describing the difference to someone -- that instead of treading water, it's more like water ballet.

Also I have an inordinate amount of gratitude about getting to ride the bus every day. Bus Practice is its own blog post, perhaps coming soon.

Here's a little clip from one of my top three favorite movies of all time, Stuart Smalley Saves His Family. It's such an affectionate sendup of the 12-Step programs and their wonderful slogans that only a self-depricating codependent insider could accomplish.

The attitude of gratitude -- it ain't just a platitude.

What is the Foundation of This Life?

Chronic tailbone pain has been my companion for about a year now. It began creeping up gradually, which is apparently very unusual for coccyx pain. Most people join this club by:

1. Falling on it or


2. Having a baby.

I do not specifically recall either one happening to me, though I may have fallen while on a skiing adventure January 2008 with my dear friend Stacey, who is an excellent skier, and sees only her friends' potential greatness.

I am not an excellent skier. I am a midwesterner. Stacey and I accidentally took a wrong turn and ended up on a blue-double-diamond run: Steep and impossible to go back. I went down on my bum for a lot of the way. I also cried for a good portion of it. It never helps when there are six-year-olds passing you in these moments.

Anyway, I recall needing to sit on my inflatable air zafu, on a long plane ride a year ago. The pain became more and more noticeable. Last summer I was carrying around a U-shaped neck pillow everywhere to sit on. By fall, I could not even sit on an air zafu for any length of time. Whatever I sat on had to allow my tailbone to hang with no weight on it whatsoever.

Dealing with sitting pain became a bit of a way of life, as chronic pain just does.*See bottom of post for lots of stuff I did to accommodate it.

I hoped it would just go away for months. ** See bottom of post for adventures with chiropractor and osteopath.

I wondered if there was some psycho-spiritual meaning? The first chakra is located exactly at the tailbone. It is all about survival. Feeling enough. Feeling grounded. And here I am, about to abandon my job to go on a voluntary and unpaid Sabbatical at the dawn of an economic crisis. Scared much? Now on some level, I know I am fortunate to have a partner who can be as much of a safety net as a person can have in a situation like this. I am as safe as a person can be. Indeed.

Tell it to my First Chakra.

First Chakra Muladhara originally uploaded by virtualworld360

I'm wary of those folks who believe that all illness is just a manifestation of some psychological thing. If you hold that stance too rigidly, then there's just too short a distance between that and people being responsible for "creating" cancer, MS, schizophrenia, etc. And it, well, pathologizes old age, sickness and death. What could be more normal than these?

That said, the mind-body connection is also undeniable. My friend Rebecca helped me come to some insight -- that sure felt accurate -- about what this tailbone pain might mean in reference to my taking a Sabbatical. It's been stressful just to make the decision to take off, mainly because of the beliefs I have inherited about the importance of work: Working hard. Working all the time. My identity wrapped up in work. My worth as a person because of my work. And the very idea of not working?!

Of sitting on my ass?

Unacceptable. Not okay.

~ ~ ~

Recently I attended a workshop on Compassion Fatigue. I have been to these professional workshops throughout my career, and about 2/3 of them have found me leaving some hotel conference room, blinking in the 4:00 sunlight thinking, "I have just wasted 8 hours of my one wild and precious life."

But at this workshop, by 11am, I felt I got my money's worth. I won't go into all the details, but basically, the fella who put this together has devoted his life to being a helper's helper. A Bodhisattva's Bodhisattva.

He has applied the light of his consciousness, and the energy of his life towards caregivers; how we go haywire, and how we can remain healthy amidst the suffering we willingly dive into every day.

I was surprised to learn that most of it is about living in a relaxed body. I was even more surprised to learn that how to go about living in a relaxed body means a focus on relaxing the various muscles between the sit bones and the top of the pelvis.

No clenching.

Seriously. It really was this simple. But like anything simple: Not easy. Since that workshop, it seems I can now perceive the constant anxiety and stress and clenching and holding that goes on in this body all the time. No wonder I get so tired! I took my new found anatomical knowledge, and recalled how doing one hip-opening yoga move some months ago released a flood of pissed-off for about 48 hours, and I wondered what else was stored in this area.

Breathe Root originally uploaded by plastictaxi

So, living with pain, and accommodating with my assortment of pillows, I went to a hip-opening yoga workshop a few weeks before the Lovingkindness (Metta) Sesshin. And I incorporated the pigeon pose into my morning routine. I have since learned what is obvious to anyone with a rudimentary knowledge of anatomy -- those hip flexors and all those pelvic muscles are intimately related to the coccyx and its situation.

I felt really spacey after the yoga workshop, and was confused about that response. One suggestion was that things might be getting re-organized deeply inside... maybe there's a big process of change happening.

~ ~ ~

At Sesshin, we began with primary focus on filling our reservoir of lovingkindness by giving lovingkindness only to ourselves for a few days. We did a lying down meditation for a period, in which we combined a body-scan meditation with Metta, offering lovingkindness to each and every part of our bodies.

I lay down with the front of the zabuton supporting my sacrum, and my coccyx hanging off, and a nice rolled up blanket supporting my neck. "May these feet be free from illness. May these feet be at ease. May these feet be happy & healthy...May these ankles be free from illness..." all the way up the whole body. For 25 minutes. I've done body scan meditation, and I've done Metta, but not together before. It was lovely.

I remember standing up from this to start walking mediation, and feeling a distinct ache radiating from the spot around my lower back where osteopathic adjustments had been, and also in the hip area as I stepped forward -- with kind of like a catching or snagging feeling. Something was up. Something was moving. Nothing changed in terms of the pain and limitation, but something was up.

I kept relaxing, and then the second to last day, I did another lying down body scan. After the period was over, I stood up, took a couple steps with that catching and ache, and then, felt:

*click *click *click*

at my tailbone. Did it pop itself back into place? I didn't dare sit on it. I was so scared it was just my imagination. It took me half the day to even dare to sit flat on my bed without the U-pillow. And when I did, it didn't hurt. Much. I must've looked pretty funny kind of tentatively bouncing up and down on the side of the bed with a scared-hopeful-shocked face. There was some residual inflammation, but I then tested myself on an air zafu. I could sit without pain. It had just about resolved.

I wanted to start singing about it, but I didn't want to treat the Metta Sesshin like some kind of a healing tent revival. My initial thought was that on retreat, I finally relaxed sufficiently for my muscles and ligaments to just let go.

I think the combination of everything had everything to do with the improvement. I have since learned a few other things that may have contributed:

Whale 'Tailbone' Sculpture originally uploaded by jmv

There's a website called coccyx.org which is a clearinghouse for all things coccydynia (coccyx pain). There is a section for personal experiences where people can share information, their attempts at solutions, and report on successes or failures. A woman reported that after 30 years of sacral, pelvic bone, and coccyx pain, that she found a little $30 product called... (the name is wonderful)... the Sacrowedgy.

I looked it up. The Sacrowedgy was developed by an osteopathic physician, and now marketed by his daughter. It is a hand-sized piece of plastic that mimics the kind of adjustment her dad used to do for people with tailbone pain. The patients would lie on their backs on the table, where he'd support their sacrum with this hand, allowing the tailbone to hang, and the body to relax -- for 20 minutes. Here's a video demonstration.

I was struck in watching the video that her dad would say that within that 20 minutes, he could feel "a war zone" under his hand with all the muscles and ligaments moving and resisting and releasing.

This is essentially what I did during the lying down meditations! Miracle cure or not, this experience has caused me to reflect on First Chakra issues.

What is the foundation of this life?

During Sesshin, after the Sacred Fool got in on my formal tea service, I observed my mind doing its reacting thing: Replaying the incident over and over, and rehearsing what I would be saying about it after Sesshin was over.

I observed this while taking a shower. Rehearse, replay, rehearse, replay. Past, future, past, future. I watched this boring ping pong game, and realized... maybe for the millionth time, maybe for the first time, maybe with my body, but really realized that None of it, NONE of it was real. I was completely missing the shower. In that moment, only my experience was what was real.

And now THIS moment of typing on a keyboard is real. This moment is the foundation of my life. Which is an ever-changing foundation that cannot be grasped. Not rooted in my job. Not rooted in my husband. Not rooted in money. Groundless.

Can I allow myself to rest here?

*Pillows all over everything I sit on throughout my house, in the car, etc. I would use the U-shaped neck pillow to sleep on, because just lying down on my back would cause the coccyx to ache. I have become masterful at sitting on one cheek. ( It made me wonder if William F. Buckley Jr. had this ailment, as he always sat way sideways in his chair, which I always thought was an effort to appear erudite. I found myself in this posture at times, completely inadvertently, and feeling anything but erudite). I acquired an orthopedic wedge cushion with a little hole in the back for my coccyx to hang out at work, and I am sure my clients think I have hemorrhoids. No zafus to meditate on anymore -- just a bench, and the narrower the better. I even had to stop wearing jeans. The thick fabric just put too much pressure on my coccyx. Unfortunately another way my body has compensated for this pain is to lean forward several extra degrees when I am sitting. While this takes weight off the tailbone, it has wreaked havoc on my neck.

**Maybe I could just be snapped in line. He's a good guy, very into kinesthesiology and I have lots of colleages who love him. He took X-rays to rule out the really scary stuff. He admitted after some months that he was completely flummoxed. He had all manner of theories for my woes. Dural torque (twisting of the membranes covering the central nervous system) was one of them that I recall. He could really crack my spine and neck. But it really did nothing for the pain. Plan B for chiropractic would be a referral for an internal adjustment of the coccyx. Think latex gloves. No, thank you.

Then I realized in a routine yearly exam that my primary care doc is a D.O. (Doctor of Osteopathy). She offered to do some osteopathic adjustments. My parents and grandparents have always sworn by osteopaths. I had never had an adjustment before.

It was very much gentler than a chiropractic adjustment. While I lay on my stomach, she kept one hand the exact zingy-est spot of the coccyx, then with her other hand and much of her weight placed on my sacrum, she would find the spot that made that pain subside. Once found, she would then apply quite a bit of pressure for 90 seconds. The theory being, that the ligaments in the sacrum area were pulling the coccyx to the side. The left side, in my case. The applied pressure was giving it slack again, allowing the coccyx to move back towards its normal position, and lo and behold, providing some temporary relief. The hope would be that with repeated adjustment, the body would remember where the coccyx was supposed to be.

Tangent:
I learned in the course of this journey into healthcare that chiropractors and osteopaths have a hillbilly grudge against each other. This ever since the osteopaths went along with the American Medical Association in the mid-1800's. The chiropractors didn't, so the AMA started calling chiropractors "quacks" until the Supreme Court made them stop in the 1970's.

Nothing against the chiropractors, but the relief was accumulating just a little bit after a few weeks of osteopathic manipulation. My D.O. taught me how to teach my husband how to do this adjustment, and insisted it was not magic. Though I still needed all my pillows everywhere, I at least felt a bit empowered to do something. Plan B for the osteopath was a series of saline solution injections called prolotherapy. No, thank you.