Using the Buddhist Practice of Tonglen to Transform and Heal the Aloneness of Grief

The funeral has been planned and taken place. The cards and casseroles have stopped coming. Friends have gone back to their daily routines. It has been a month or so since your loved one’s death. Nothing feels the same. You feel alone. You feel like no one can possibly understand the depths of your sadness and despair.

Opening ourselves to our grief, rather than hiding from it, offers the possibility of true growth and transformation. It can be exquisitely painful to lean into one’s grief. Running from it, isolating ourselves, numbing our pain in alcohol, drugs or sleep can be so tempting. How, then, to allow ourselves to feel the pain of grief, and at the same time, let go of self-pity and feelings of aloneness and begin to heal?

A Buddhist meditation practice called tonglen, or “sending and receiving” can be very healing at this time. It is a practice all can do, Buddhist or not. Sogyal Rinpoche, in The Tibetan Book of Living and Dying (1994, p. 193), describes tonglen as one of the most “useful and powerful” practices in the Tibetan Buddhist tradition:

When you feel yourself locked in upon yourself, Tonglen
opens you to the truth of the suffering of others; when
your heart is blocked, it destroys those forces that are
obstructing it….[I]t helps you to find within yourself
and then to reveal the loving, expansive radiance of your
own true nature.

The practice of tonglen involves breathing in suffering and breathing out love and compassion for all beings, including yourself. As Sogyal Rinpoche states (p. 195), states,
“Before you can truly practice Tonglen, you have to be able to evoke compassion in yourself.” You breathe in your own pain and suffering, and breathe out peace, love and compassion for yourself. One way to do this is to imagine breathing in a dark cloud of smoke, and breathing out light. Once you are able to evoke a sense of self-compassion, you can then imagine breathing in the pain and suffering of loved ones, and sending them love and compassion on the outbreath. A natural outgrowth is to extend this sending and receiving to all beings.

The practice of tonglen allows the bereaved to know they are not alone: We all experience loss and grief. It helps us drop the “why me?” of self-pity, which can leave grief stuck in place. Instead of that self-centeredness, a sense of unity and compassion for all can develop.

Leaning into one’s grief through the practice of tonglen can be extremely healing and spiritually transformative. The Tibetan Book of Living and Dying and other works, such as the writings of Pema Chodron, go into further detail about the practice. In addition, trained meditation instructors in Buddhist centers throughout the world can work with you to deepen your understanding and experience of the practice.

NYC 1976: CBGB and Me

So, here I am – a 25 year old college graduate, my socialization my socialization by music consisting mainly of such cerebral stock as beatles, byrds and buffalo springfield, and now insatiably addicted to punk rock.

Punk rock hits me where I live, that is, New York City:

A moribund venice –
with death not always apparent
in its stubborn vitality.
A decadent berlin –
degeneracy a paradox
in its will to live.

Lou Reed and his offspring really are the chroniclers of punk city, funk city. And CBGB’s is a monument and tribute to the contradictions of the Big Apple – the good and the bad, the encroaching death, and the ever-persistent life – and you know LIFE will win. Here, degeneracy is negated by the steady pulse of rock and roll.

Entering CBGB’s is like entering a weird time warp. I am thrown haphazardly from present to past to future, and back again. Here is a throwback to my second hand experience of watching Philadelphia’s hoods and collegiate catching the beat on American Bandstand. Yeah, it sure has a good beat, easy to dance to. Here is basic rock and roll, stripped of all pretensions and adornments. The frenetic, relentless rhythms of the band on stage shatter my everyday senses into fragments of psychedelia.

Tom Verlaine – whose eyes see what I cannot, in the netherlands of existence. Joey Ramone — standing at the bar, with gesturing shoulder, punctuating foot tap, as if choreographed by Jerome Robbins for West Side Story. The Heartbreakers – looking sometimes like messengers from Satan, at other times like a bunch of kids rehearsing in some suburban basement for a sweet 16. David Byrne and Talking Heads – genius meets psychosis.

Well, yeah. I’m a college grad-u-ate. But don’t hold it against me – I’ve caught the beat too.

© 1976. Beth Schillinger Patterson.

THE ROLE OF THE STIGMA OF MENTAL ILLNESS AND CAREGIVER BURNOUT IN THE CONNECTICUT MASS KILLINGS

I have been viewing the horrific Newtown mass murder through my lens as a psychotherapist specializing in grief, loss, trauma and caregiver support. My professional lens was sharpened by my experiences providing critical incident stress debriefing and traumatic grief counseling in the wake of the mass shooting in Aurora.

Former Pennsylvania Governor Ed Rendell observed on MSNBC (12/16/12) that the issue is how to keeps guns out of the hands of the mentally ill. I would reframe the question as how to best treat and serve the mentally ill/developmentally delayed and their primary caregivers to prevent this type of tragedy. Despite some progress, there is still much shame and stigma connected to mental illness and to reaching out for support. The lack of ready and affordable care for the mentally ill and their loved ones compounds the problem. I can’t help but think that these obstacles to mental health care played a major role, preventing both the alleged shooter Adam Lanza and his mother slain at his hand from getting the care they desperately needed and deserved.

I was struck by the description of Nancy Lanza, Adam’s mother, presented in the front page Sunday New York Times article “A Mother, a Gun Enthusiast and the First Victim” (12/16/12) by Matt Flegenheimer and Ravi Somaiya. As we have all now learned, Ms. Lanza was divorced in 2008. Her son Adam lived with Ms. Lanza full-time. He was still living with his mother at age 20, at the time of the shooting. No one else lived at the home. Ms. Lanza was described by several people who knew her as “nervous” and “high strung.” In addition to living full-time with her troubled son, she home schooled him after she became dissatisfied with the education and care her son was receiving in the local schools.

The image that came to me as I read this description was of a woman at the end of her rope, burning out from the stress and despair of caregiving for her disturbed son. Based on statistical evidence, it is likely that the difficulties in caring for Adam contributed to the breakup of Ms. Lanza’s marriage.

When I try to put myself in their situation, I imagine an atmosphere of volatility and stress, helplessness and hopelessness. I can imagine that Adam knew he “should” be living on his own, with a full time job, or away at college. I can imagine his shame and rage at his situation. I can also imagine that he projected his rage onto his mother, not only because she was there as an easy target, but also because she was a constant reminder of Adam’s perceived failings as a young man. I can also imagine that Ms. Lanza was overwhelmed by the responsibilities of caregiving for her son, and trying to maintain some semblance of a nurturing relationship with him.

I also wonder what precipitated Ms. Lanza’s enthusiasm for guns and target shooting. Many have asked why the mother of a mentally ill son would have guns in the house. Clearly, this is a sign that all was not well in Ms. Lanza’s world, and the stress of caregiving may have clouded her judgment. Without yet knowing more about that, I can also imagine that she turned to the sport of guns and shooting as an outlet in the wake of her divorce in 2008 and being Adam’s sole primary caregiver. Did Ms. Lanza reach out for support, or was she too ashamed to do so, or did she just not know where to turn for the help she desperately needed?

As a therapist providing support to family caregivers, individually and in support groups, I am acutely aware of their needs. I hear about the sense of isolation, shame, helplessness, hopelessness and despair family caregivers experience. I also hear of the verbal and emotional abuse they sometimes have to endure. It is well documented that family caregivers suffer more physical illness, as well as depression, than others in their age group, and also suffer more divorces and schisms in relationships with other family members

We need to do more as a society to remove the stigma of mental illness, open more doors to support for family caregivers and make care for all touched by mental illness more available and affordable.

YAHRZHEIT: THE POWER OF RITUALS IN HEALING GRIEF

YAHRZHEIT: THE POWER OF RITUALS IN HEALING GRIEF

The holiday season can be particularly painful for those who are mourning. This time of year is particularly poignant for me, as I have lost a number of loved ones over the years – including this year — during the week of Thanksgiving.

Although I am a practicing Buddhist, I am never far from my Jewish roots. I turned to the rituals of Judaism (with some Buddhism thrown in) as a healing tool in my holiday grief. With the coming dark days of winter, and the annual reminders of loss I face each year, I knew that ritual could help me with my holiday grief. During this time of darkness, I lit a Yahrzeit candle – a memorial candle that Jews around the world light to commemorate the anniversary of a loved one’s death. The Yahrzeit candle burns for twenty-four hours. “Yahrzeit” means “years-time” in Yiddish.

In Jewish tradition, the candle flame is often thought to represent the human soul. As it is in other spiritual traditions, the lighting of candles is an important part of many Jewish religious occasions, such as the marking of the Sabbath each week, and the lighting of the menorah during the eight long winter nights of Chanukah – the Festival of Lights.
As it is said in the Book of Proverbs, like the human soul, flames must breathe, change, grow, strive against the darkness and, ultimately, fade away. Thus, the flickering flame of the Yahrzeit candle helps to remind us of not only of life’s challenges, but the impermanence of all, and of the preciousness of our human lives – concepts that Buddhist practitioners contemplate daily.

On Thanksgiving eve at sundown, I lit my Yahrzheit candle – remembering all of my loved ones who have left this particular life – grandparents, aunts and uncles, friends, beloved pets. I let those remembrances permeate my heart like waves of warmth, as if emanating from the warmth of the candle flame. At the same time, I prayed for them, seeing the flame even with eyes closed.

I then prepared my turkey for cooking the next day, and went about my life with my loved ones in my heart.

USING EMDR TO UNCOVER AND HEAL SHAME AND EXISTENTIAL DESPAIR

Shame is one of the most difficult feelings for humans to acknowledge and express.  It becomes a vicious circle:  We feel shame about an event or action in our lives, and then feel shame about our shame.  Shame causes self-doubt, depression and deep suffering and prevents us from living freely, fully and authentically.  Our shame causes us to monitor what we say and do, out of fear of saying or doing the “wrong thing.”

As a humanistic, existential and Buddhist psychotherapist, my primary goal is to help my clients uncover the truth about the cause of their suffering so that they can live full and satisfying lives. Through my work with a client I will call “Bill”, I have discovered the power of EMDR[i] as a tool in this process.

Bill came to see me complaining that he was not able to experience joy or passion in his life, and felt that nothing he was doing had any meaning.  This is an apt description of existential despair. Bill had not suffered any recent crises that would account for his angst, andon the surface, his life looked quite successful:  Bill is a brilliant scientist, in a good marriage and has a high paying job.  He is athletic and is an avid cyclist and skier.  However, Bill was unable to experience any joy, passion or satisfaction from his accomplishments and activities, saying that he had a “nagging feeling that something is missing.”

Bill and I spent many sessions trying to identify the source of his existential despair.  He described growing up in a small mid-western town.  His parents divorced when he was 16 years old, and he and his brother lived with his father.  Bill has been estranged from his mother for over 20 years.  He described his mother as having an “alternate lifestyle” as a Lesbian and artist.  It was clear to me that he was doing what we therapists call “splitting” – seeing his father as all good, and his mother as all bad.  However, my attempts to go there with him were futile.

Bill tended to describe painful experiences, like the recent death of a friend and his parents’ divorce, intellectually, factually and with little emotion. My attempts to go deeper would be met with the response “I don’t know”.  After several months together, Bill acknowledged a deep fear of expressing his emotions, saying, “what if I express myself and no one accepts it?”  Attempts to explore his fear more deeply were met at that point with more “I don’t knows” and intellectualizing.  I observed how difficult it was for Bill to directly experience his body sensations and emotions.  He acknowledged that he has always relied on his intellect as a way to cope.

In addition to Bill’s fear of rejection if he expresses himself, he came to realize his deeply held belief that “If I were a good enough person, my life would have more meaning and joy.”  We explored what this meant to him, and I asked Bill what unfinished business he might need to complete, and what he would need to accomplish if he had a terminal diagnosis – the big existential question.  It was clear to me that his estrangement from his mother was the elephant in the room, but Bill was unable or unwilling to go there at that point in our therapeutic relationship.  I believed then that EMDR (see footnote 1) would help forward Bill’s journey of self-discovery. Bill agreed to give it a try.

Our first task in preparing Bill for EMDR was to get him to feel safe feeling his body sensations and emotions, and our next task was to identify a target for our EMDR work.  He identified the target as his fear of being emotional, and described the incident representing the worst part of this issue as being rejected by a girl in elementary school after he gave her a gift.  The negative belief he took from that experience was “I will get hurt if I express my feelings”, and the positive belief he wanted to have instead was “I am safe to express myself.”  Bill was able to complete the work on this target in one session.  However, we both came away with the feeling that there was something more.  I encouraged Bill to note any insights and new memories that might arise during the week before I saw him again.

Bill came in the following week saying that after our EMDR session, he started experiencing profound shame about his parents’ divorce and his feelings about his mother’s lifestyle.  We discussed how painful shame is, and I validated his difficulty in acknowledging it.

My experience as a therapist, and as a former client in therapy, has taught me how unbearable the experience of shame can be.  We will do almost anything to avoid it – risky behaviors, blaming others, acting out in any number of ways.  Shame unacknowledged can lead to deep depression as a result of internalizing the negative messages we received earlier in life.  In acting out his shame, Bill made his mother the “bad guy” and was unable to take pleasure in his life, a form of self-punishment.  He had internalized his family rules “don’t air our dirty laundry” and “don’t express your feelings” to such an extent that he was living an inauthentic life, leading to his existential despair.  Bill’s fear of feeling the full panoply of life’s emotions resulted in his dissatisfaction and belief that his life lacked meaning.

Bill’s nascent awareness of his shame placed him in what Naranjo (1993, pp. 52, 63) has called “a limbo where the surface games of the personality have been dropped and self-awareness has not [yet] taken its place.  Shame… [is] not [a] pure experience[] of reality, but the outcome of attitudes in which we stand against that reality, denying or resisting it, fearing to perceive it….Shame  [is a] mind-created curtain that we interpose between ourselves and the world.” [ii] This curtain of shame prevents us, like Bill, from fully and directly experiencing life and all of its riches, whether painful or pleasurable.

Bill asked to do another EMDR session around this issue.  The negative belief he has carried about his shame was “I am insignificant” and the positive belief he wanted to have instead is “I matter.”  The emotions that he felt were grief, despair and shame.  Through the EMDR process, Bill discovered that he has spent an inordinate amount of time trying to avoid his feelings and be “perfect”, and that he projected his shame on his mother and others who he perceived as not good enough.  He also felt tremendous guilt about the way he treated his mother.  After processing the disturbing feelings, Bill discovered that truest positive belief for him was “I forgive myself.”  This was a deeply moving session for both of us.

Bill came in to our next session saying that he felt that our work was complete for the time being.  He said that he had blamed his mother for everything, in his black and white thinking, and was in the process of writing a letter to her to acknowledge this and hopefully begin a relationship with her.  Bill said he had a tremendous sense of relief about this, and he felt more appreciation for his life. I encouraged Bill to use “I forgive myself” as his mantra when he felt the tendency to retreat behind his curtain of shame. Bill knows that he is on the path to continued healing, and, with his newly gained tools, is not afraid or ashamed to meet the challenges that lie ahead.

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[i] EMDR is a scientifically proven therapeutic protocol for overcoming trauma and other life difficulties.  EMDR utilizes “bilateral stimulation”, i.e., sensory stimulation alternately on both sides of the spinal cord to release traumatic material from the brain in a way that makes it workable. Trauma that is locked in the brain leads to the “fight, flight or freeze” response. EMDR helps release traumatic images, transforming them into memories that no longer have a deleterious hold on the individual.   In addition to this physiological response to trauma, the traumatized individual also develops negative beliefs about him or herself (such as “I do not deserve love, “I was at fault,” etc). EMDR allows the individual to replace negative cognitions about him or herself with positive ones (such as “I deserve love”, “I did the best I could”, etc.).  EMDR also works on a somatic level, with the therapist guiding the client to feel the traumatic images and negative beliefs in the body, thus further facilitating the transformation of the images into non-intrusive memories, and also transforming the negative beliefs into positive, useful ones. Therapists need to be trained to practice EMDR, and follow a standardized protocol in EMDR work with clients. (The foregoing is a brief summary of EMDR, and is not intended to be a full explanation of the process.)

[ii] Naranjo, C. (1995).  Gestalt Therapy:  The Attitude and Practice of an A-theoretical Experientialism.  Gateways/IDHHB Publishing:  Nevada City, CA.

THE MYTH OF PERFECTION: A BUDDHIST PERSPECTIVE

Many of the clients in my psychotherapy practice come to see me for depression and anxiety caused by self-criticism and negative self-talk. I have discovered that these clients are caught in the trap of perfectionism. Perfectionism has been defined in psychology (Stoeber & Childs 2010) as “a personality disposition characterized by an individual striving for flawlessness and setting excessively high performance standards, accompanied by overly critical self-evaluations and concerns regarding others’ evaluations.”

From a Buddhist perspective, perfectionism is kept in place by an attachment to the “self” as a separate, unique and real entity. In addition, forgetting that we are human beings living in samsara (the endless cycle of birth, old age, sickness and death and its attendant suffering) further solidifies perfectionism.

Human beings in the “human realm” of samsara all experience anger or aversion, jealousy, grasping, ignorance or lack of understanding and pride – known in Buddhism as the “five poisons.” Those with perfectionistic tendencies forget this, and believe that they are uniquely deficient when they experience these afflictions. Some feel so much shame, or have such a strong need for others’ approval that they try to hide behind a mask of perfectionism – covering up mistakes rather than owning up to and learning from them, overindulging in food, drugs or sex to numb the pain, giving in to others’ needs rather than expressing their own.

Instead of trying to deny or hide imperfections, acknowledging them mindfully can lessen perfectionism’s control. The first step is to mindfully notice your thoughts of self-judgment. The goal is to acknowledge those thoughts as soon as they arise and then let them go, dispassionately and without judgment. It takes a lot of practice not to get caught in the web of those thoughts.

One important tool in overcoming perfectionism or other dysfunctional tendencies is to recognize where you feel the associated feelings in your body. For example, if you experience jealousy, you might feel a hot, tight sensation in your chest. Exploring the sensation further, you discover that it would be red if it had a color, oval if it had a shape, and about two inches long if it had a size. Precisely describing the bodily feeling, as in the above example, is very effective in recognizing and letting go of self-critical thoughts as soon as they arise.

Then, breathe into that physical place with compassion, instead of immediately trying to avoid the feeling. You can’t turn it off like turning off the radio, and the more you try, the more intense it becomes. In the vernacular of the ‘70s human potential movement, “what you resist persists.” As you breathe out, breathe out light and space.

Continuing to breathe in and out in this way leads naturally to the Buddhist practice of tonglen, or sending and receiving – taking in the heavy, dark negative feelings, and sending out light, spacious healing feelings. This practice is first done for oneself, and then extended to all beings who suffer from perfectionism’s grip.

The benefits of this practice to counteract perfectionism are many and powerful. First is the engendering of compassion for oneself and one’s human foibles. Extending this compassion out to all who are suffering from perfectionism leads naturally to knowing that you are not alone, separate and distinct from all others.

We are perfect in our imperfection. Acknowledging and leaning into our imperfections with compassion and without judgment leads to tenderness and openness. As Leonard Cohen sang, “There’s a crack in everything. That’s where the light gets in.”

Experiencing Physical Pain

I have practiced working with chronic pain for many years, using my mindfulness meditation practice as an aid. However, nothing prepared me for the experience the acute pain I recently endured.

I tried to relax around the pain, experience the physical pain directly without adding thoughts about it that lead to suffering, etc. – all the things that I tell my therapy clients and mindfulness meditation students. However, while in the throes of the most intense and excruciating moments of the pain, it was almost impossible to remember to breathe and relax. The following tips are intended as a reminder for myself , and an offer to others, when experiencing acute physical pain:

• Breathe and visualize creating space around the pain. Imagine soothing water or an elixir bathing the area in love and light.
• Listen to soothing music. Music can be so healing. Allow yourself to enjoy its beauty.
• Have someone rub your back, hold your hand, simply be a caring presence. It is so easy to isolate ourselves when we are in pain of any kind. Remember to reach out for support.
• Take a bubble bath, get a massage. Be kind to yourself.
• Listen to the song of a single bird. Notice the beauty of a single flower. Focusing on one thing helps calm the swirling emotions that accompany pain.
• Banish negative self-talk. This pain is not your fault or bad karma!

• Know that everyone experiences pain, and use this opportunity to develop compassion for yourself and others.
Of course, follow your doctor’s advice. When you are experiencing unusual pain, it is important to speak with your health care providers. Emotional and spiritual care are complements to physical care. As I have learned, pain is global – physical, emotional, social and spiritual. It is therefore important to support ourselves in all of these domains when experiencing physical pain.