BEING PRESENT WITH ILLNESS

Below is a transcription of the podcast episode, “Being Present With Illness":

What I'd like to talk to you about today is the topic of illness. More specifically, how we can deal with the illness of those around us. By illness, I don't mean someone who's got a cold or has broken a finger, although these principles that I'm about to discuss will apply to those, but I'm talking about more serious chronic illnesses. The things that scare all of us. When a friend, when a colleague, when someone we know has a serious chronic illness, is dealing with cancer, is dealing with a serious autoimmune disorder, long-term panic disorder, Lyme’s disease, things that are difficult to deal with.

Before I get into some “Dos and Don’ts,” the basic thing to remember is that the biggest gift we can give someone who's dealing with such a hardship is our undivided attention. Truly that's the biggest gift that we can give to the other, as well as ourselves, because we ourselves are never, or rarely, ever present with someone with that undivided attention. Our minds are all over the place, and because of that we can actually lack the presence to perceive what we can offer to be of help to someone who is suffering. So first and foremost, we have to be present. And we have to learn to tolerate seeing the other person in their suffering. We do this without trying to fix them or deny the fact that they're ill, because we really can't do anything but show up and be present.

So the way that starts, and this is one of the first “Dos,” is to check our own anxiety. Nothing brings up anxiety like seeing somebody else in their illness. It kicks up all kinds of conscious and unconscious fears for all of us. And if not all, I would say 99% of us. Because for most of us, we haven't really dealt with our own anxiety around death and dying. So when somebody comes up to us or we come across someone who's dealing with a serious illness, it scares the bejesus out of us because it brings up all of our fears around mortality.

So first and foremost, again, we just check our anxiety. We're about to walk into a hospital room or we run into someone on the street who's lost their hair, whose color is gray because of the chemo they're going through, who can barely walk because of the Lyme’s disease they're suffering from. Whatever the issue is, we check ourselves. And remember, as I've talked about over and over, the best way to do that is to drop into the physical body. So you see someone, you check your breathing, drop your breathing down, feel your hands and feet, ground yourself.

The next step I would do is to learn how to hold space. And really all that means is learn to be in your own body, and then listen. It's very hard for us, culturally speaking, to listen. This again ties into the anxiety. And it's not a malicious thing, many of us want to be helpful - we want to offer something - because helplessness is really, really difficult. So we have to hold our helplessness here, and hold space and just listen. Really listen. What are they going through? Ask to really explain to you what's going on. So, their joint pains or how nauseous they get after their chemo, or the fact that they can't sleep or the anxiety is so profound that they're actually paralyzed and they lie awake at night.

Soak it in. Don't take it on, but actually listen. And because this is something that's invisible, it might feel like, "What the hell am I doing? I’ve got to do something”. Just the opposite. Know this for a fact, the person who is telling you these things might have said the same thing to 20 other people, and most of the other 20 would not have listened. They would have jumped into some of the things that we're going to talk about in a little bit: in the “Don't” column. So listening while being in your body is really, really powerful.

As you're listening, another “Do” is to ask them how they are. Not a leading question because they need to be told that they're doing better or they're fine. "Truly, how are you? How are you doing? How are you dealing with this?" So these three things: checking our anxiety, learning how to hold space and listen, and then truly asking them how they are - not to jump in with the interjection of, "Hey, this is a great thing to do, here's something you should do” - just holding those three would be more than most people get when they're dealing with something.

Then this fourth one is really, really important, which kind of connects to asking how they are. When you have finished listening, when actually they have stopped talking, and then you're done with the listening part, if you have any suggestions: ask permission. Ask permission before you throw the suggestions out there. This is a very common thing. It can come from a good place, that we want to offer some healer, a diet, a book, something that might be helpful to them that they may not have thought of. But we have to ask if it's okay, because sometimes people are overwhelmed. Sometimes they've turned over millions of stones and nothing has happened. So be very conscious.

This is a tricky one because it feels like we're coming from a good place. "I have a suggestion. You've got to meet this woman. She's an amazing doctor." Wonderful. Ask permission. "I have a suggestion for you, are you interested?" "Oh, no, no, no. I'm just dealing with so many doctors now." You have to be okay when someone says that to you, you have to be conscious of not going into a manipulative place or having a chip on your shoulder because the person doesn't want to take your suggestion.

And then another “Do” that we forget, especially with more serious illnesses, is offering concrete help. Can I walk your dog? Tell me when your treatment days are. How are you feeling? Do you need someone to watch your kids for a couple hours so you can take a nap? Your joints are hurting, I know how sick you get after your treatment - can I do some food shopping for you? Now, those of you who are caretakers, you have to watch this because you don't want to go into “fixing mode”. But if you come from a healthy place, you can actually offer. You'd be amazed how so many people, because we're all so busy, actually forget that concrete help like that can do wonders for someone. And not just because we're busy, we also don't really realize that such simple things can really help someone, can really put a dent in the heaviness that they're carrying.

So those are some of the “Dos”. Sit with yourself, see what else comes up. I'm sure you'll have some ideas once you sit with it and apply yourself to see what else you can offer. But again, always remember you have to check your own anxiety. The intention of how we come at this is as important as our action. In some ways, more important. So always check ourselves.

Now, some of the “Don'ts". The first and foremost, I would say, is assuming that we know what the other person is going through. This is an automatic response. It's not a malicious thing. A very common thing my patients complain about is people who right away go, "Oh, I know what you're going through”. And the truth is, we don’t, because no two people are the same. So always be conscious. This is something that I've seen doctors do, and I've seen myself do.

And again, it's one of the ways that on a subtle level we want to assert control. By saying, "I know what you're going through" is our unconscious mind not wanting to hold our helplessness. We can not hold our helplessness, so we want to jump in and say something like that. This is probably one of the most common complaints that I get from my patients who are dealing with serious illness. When people that they love or people that they know or colleagues say something like that.

I was treating someone not long ago who was dealing with their partner going through early onset Alzheimer's. He was telling me how his husband is going through this very early onset, and a lovely colleague at his work was telling him, "Oh, I know what that’s like because my father is going through that”. Well, no. A 48-year-old man going through Alzheimer's and an 86-year-old man going through Alzheimer's are two different experiences. It sounds sweet, we want to connect with someone, but we can not assume that. So this had really hurt this person. Again, is it malicious? No. Is it unconscious? Absolutely.

So first and foremost, again, we can not assume that we know what the other person is going through. Unless I'm very conscious, I myself can fall into this. As a clinician, I look at people's color or pallor, their eyes, and I say something like, "You look great”. And it's so deadly to the other person because I'm not really checking to see how they're feeling. So instead of asking, "How are you doing?" I can say, "You look great," which is just clinical information for myself: the treatment they're doing is helping them or the herbs they're taking or the chemo they're doing, or whatever, the surgery was helpful, etc. But the person can be feeling terrible. This is another one of those common things that my patients tell me: "If one more person told me I fucking look great, I'm going to jump out the window. I feel like shit.”

Again, not a bad intent, but throwing these words out there without connecting with how the other person is feeling can be harmful. Another “Don’t” which is very common in our New Age-y healing culture, is "Your illness has a purpose, this has a reason”. I mean, this is insane, right? This is one of the most cruel things that one can say to someone, because we're not God, we have no idea of what's going on there. So we have to really stay conscious because that's a very cruel thing to say. You know the reason this person is suffering, that they're dying at 36 or 46 from this horrible illness, has a purpose? So be aware of this word that we throw out there, this “purpose" piece. We're not the divine, unless you have a direct line to the divine, which, if you remembered your true nature you would never say something so unconscious, so be aware of that. This is one of those profound ones where we can not hold our own anxiety and we barf up this little turd pile on someone who is already suffering.

Another one that's just as wacky, but maybe not as sharp, is "You'll be fine. You're going to be okay”. Again, it can come from a good place, but if you're a person that's dealing with a serious illness, that's dealing with cancer, if you're a person that actually has gone through cancer and the surgeries and the chemo, even then you're going to be scared. It's not like, "Oh, it's over”. You're going to be going in for your checkups every three months, six months, nine months, literally frightened to death of what the result is going to be.

Just because you managed to beat it once, you're always going to be looking through the side of your eye, looking out to see if the cancer is going to return. So the fear will be there. So this thing of, "You'll be fine," or "You're all okay now because you beat it, you're a survivor," doesn't make room for the other person's suffering. They can have a tremendous amount of anxiety or fear, and by speaking like this, we actually don't allow them to have their feelings to allow whatever needs to come up to do so and be dealt with.

Avoiding the subject of illness is another “Don’t”. I watch people interact with friends or family members and they act like the person's not sick, like there's nothing going on. Now, I'm not saying you need to walk in there and look at their blood work results. Just awareness of like, "How are you?" is very powerful. This one is totally connected to our own fear of illness. The people that can not hold their own fear around mortality will act like nothing's going on. So the person will be there having gone through surgery, can barely walk, and the other person will act like there’s not even an illness. They'll act like nothing's going on. They'll talk about whatever, food, the weather, cooking, politics, etc.

Remember, holding space - holding and giving our undivided attention - is such a profound gift. So we don't need to make it just about the illness, but to act like the other person is not ill or not suffering can also be disrespectful to the process. Now, you don't have to turn into Mother Teresa. If it's a loaded thing for you, you don't need to jump into it, but don't interact with someone until you can hold space for them. At the minimum, we don't want to add to the burden that someone is carrying when they're dealing with such a heavy duty thing.

And the last “Don’t,” which connects with the New Age-y movement, is to “think positive”. When someone can barely walk because they're in so much pain, they can barely sleep because they're so anxious, to say to them, "think positive," is such an insane thing to do. It's not an issue of positive thinking. They have to deal with their suffering, they have to deal with their pain. To say to them, "think positive," is a very cruel thing because what we're saying to them is you're not okay the way you are, go into denial with your suffering and just distract yourself because that's certainly what I do. That's what we're really saying.

So, again, we have to be conscious. Be careful of the words that come out of our mouths. It's human nature, it’s not just out of cruelty. We mean well. Most of us anyway, we want good for other people. And I have talked to you about this before, back in the days when I used to work in AIDS wards and all these new meds, retrovirals, hadn't been out yet and people were dying, and they were dying young. These poor doctors would walk in and they were so heartbroken because… I buried, God knows how many people that week, and literally the person was 24, 48, 72 hours away from death. Skeleton lying on a bed. And they would walk in and what are they going to say? Instead of holding space, it would be like, "You look great. You look good today”. And you could just see the look of confusion and pain on that poor young man's face of like, "Oh my God, I need to be seen. To walk in here when I have all these tubes all over me and I'm literally like 90 pounds, how can you say I look great?" It’s the unconsciousness and the level of anxiety, where we just say things like that because we don't know how to hold space.

Holding space is a practice. So for those of you, any of you, who are around sick people, who have made these mistakes of the “Don’ts,” next time you come around them, face up to it. "Hey, I'm sorry I said that to you last time. I just want to listen. I wasn't really listening," and whatever the thing is, "I wasn't conscious. I was scared. I wasn't present enough. How are you doing?" Do that while you feel your body. Do that while you're holding your center. It's an amazing gift to give someone. And remember, our presence is the only gift we have, truly. Everything else is secondary. Our undivided attention is the biggest gift we have for ourselves as well as what we can offer to others. So be present and see what comes up. Don't try and fix it. Don't try and deny it. And just realize, "you are enough" is actually more than enough if you learn how to apply it consciously.