Heal Thy Self: Lessons on Mindfulness in Medicine
By Saki F. Santorelli, Ed.D.
I have noticed within myself that helplessness sometimes comes clothed in a guise of helping that easily carries me into doing, planning, frantically scurrying about, imposing concepts on self and others. Born of fear and self-dissatisfaction, it is a trap and a subtle form of manipulation. Have you ever noticed this within yourself?
Much of the time this behavior is unconscious, escaping our everyday awareness. Yet, curiously, it is also deliberate. This is a strange and painful paradox. Because the truth of this paradox is so hard to take, we refute and reject it. In so doing we deceive ourselves. Even worse, we do violence to our tender, vulnerable hearts. Unable to hold lightly the intensity of not knowing, of not having all the answers, all the solutions; unable to hold the fragility of helping, of this human activity fraught with ambiguity, with loss, with endless twists and turns, we do what is most natural, most culturally credible. We refuse this vulnerability. Unwilling or unable to sit inside the tension, we take action.
Personally revisiting these mind states and openly discussing them with my colleagues has revealed that in most instances the source of this refusal is uncertainty. Uncertainty about ourselves. Uncertainty about what our job is and is not. Uncertainty about how we will be perceived. Uncertainty about the validity of our own existence. So we try hard to till this embarrassing, uneasy uncertainty with action. With good deeds that we hope will somehow confirm our existence, that will produce justification for our chosen profession and even, perhaps, for our very life. None of this is wrong or bad. Acting in this way does not disqualify us as health professionals or as human beings. If this were the case, we would all have to resign. But it does show us where our work is. Do you know this place? Can you sense the insatiable hollowness, the catapulting desire to fill this void? The virtual impossibility and exhaustion inherent in this struggle to do good and be needed. Much of health "caring" is based on this sense of helplessness.
This uncertainty, this helplessness, points to where we are encountering our limitations and our hard edges. This is the cutting edge of our practice as it plays itself out in our work. After all, this is all of our story. But it is not the whole story. The continuous nature of this work was transmitted to me clearly by a Roman Catholic priest participating with his fellow priests in an eight-month stress reduction program at the hospital. During a series of deep discussions about celibacy, he said, "I have to decide to be celibate every day. It is not enough that I took a vow twenty years ago when I was a young seminarian. That doesn't work for me today. Today I have to choose. Today I have to decide once again."
Like him, each of us is called to decide, today. To decide about our own slow abstinence from these long-held, reactive habits. About our own opening into the places, the situations where we cannot help. Where the best helping might be doing nothing. There is a cost for this deciding, for this willingness to resist the impulse to jump in and make things nice, right, or smooth. The cost is aloneness and the slow dissolution of self-interest.
Practice: Working with the Feeling of Helplessness
The power of conditioning-particularly in situations where we are expected or asked to "help"-has an enormous, catapulting presence in our lives. In these moments I notice that working with these driving impulses is aided by my willingness to not act, at least momentarily, and instead to settle into the seemingly inescapable tension of not having an answer, a saving response, a plan.
When I am actually able to work with myself in this way, I sometimes notice that although the sense of ineptness, incompetence, or resignation may have its momentary life, a larger field of vastness shows itself. This "vastness" is neither nothingness nor a disassociative escape but more the feeling of calmness and openness where the crosscurrents of emotion flow with less disruptive and disquieting power.
The next time this feeling of helplessness arises in your life, experimenting with nonaction might be beneficial. There is a generosity of heart in our willingness to stay put, to stop, and to allow these mind waves to wash through and over us. Oftentimes I have discovered that when I am willing to be with this turbulence with no purpose whatsoever, being patient with myself and with the motionlessness of the situation, the right action arises of its own accord. In these moments the breath and your willingness to be still and silent are most worthwhile anchors and allies.