Practicing What I Preach

VA Hospital - Seattle

This evening my nephew Keith McMahon brought his family up to Whidbey from Seattle for a visit, and gently pointed out to me that it has been a week and a half since I made a blog entry. Point well taken. As I come into my summer season of explorations, I'll try to include more regular entries, and also add some podcasts from the field as I hike, bike and paddle around the Puget Sound basin.

Meanwhile, one day a week through most of this winter and spring of my Circling Home year, I've been making the long commute by bicycle and bus from Whidbey Island to the VA Hospital in Seattle's Beacon Hill neighborhood. I've been teaching an eight-week course with Dr. David Kearney in Mindfulness Based Stress Reduction (MBSR). The class meets for three hours every Thursday morning, with veterans who often travel several hours distance to attend the class. These are patients referred to the course because of chronic pain or post-traumatic stress disorder (or both), who have tapped out the conventional medical resources and are often trying this class as a kind of last resort. We also have nurses, psychologists and mental health counselors routinely enrolled in the class. We make no distinctions between patients and staff participating in the program. In fact, in our opening introductions we ask participants not to mention their profession or role at the hospital when they share their reasons for enrolling in the class. Our habitual ways of dividing ourselves by profession or rank are set aside right from the beginning. It is amazing what a relief this can be all the way around.

David is a gastroenterologist at the VA, and a Professor of Medicine at UW Medical School, who came on one of my Inside Passages kayaking meditation retreats in Alaska a couple summers ago. Both of us had studied with Dr. Jon Kabat-Zinn, founder of the MBSR program, and David had been looking for a partner to help him institute a course at the VA using this powerful teaching model. It has been an enormously satisfying experiment for both of us. Nothing like this has ever been done at the Seattle VA, and the need and demand for the class is huge.

Basically, MBSR is an intensive course in meditation and yoga as tools for stress and pain management. The class meets once a week for three hours over an eight week period, and students make a commitment to work with these practices an hour a day at home as well. It is a big commitment. Our goal is not to "fix" their problems, but to offer practical tools to help them live more creatively and intelligently with those problems, and to learn, through mindfulness practice, how to gain more control over their reactivity to stress and pain. The core of the program is the mindfulness practices themselves, rather than academic study or group therapy. And as we have discovered, the medical professionals who participate in this program are often as hungry for this kind of inner restoration work as the patients themselves.

On Saturday we had our day-long retreat at the VA that comes near the end of each class series, during which we spend seven hours in intensive, silent meditation. It is not supposed to be easy, and it isn't. Many of these patients and staff alike have never engaged in formal meditation practice a minute in their lives before coming into the course, and even though we have worked up to this gradually, a full day of practice is almost always a big stretch. But they do it. With dogged determination they do it. Some are in wheelchairs, some have walkers, most live with some kind of chronic pain that is a constant reality in their lives. Some can't do even the simplest yoga postures, but we each do the best we can with whatever capacities we have. Sitting and walking meditation, yoga, Qi gong, and mindful eating of their lunch in silence - few of them would have been caught dead doing this prior to coming into the course. But if there are no options left, they will try anything, and I am always moved and inspired by the tenacity of their efforts once they realize the freedom and power that these practices offer them to change their relationship with their own suffering. It is humbling to watch people who have been given up on by the system waking up to this freedom they didn't know they had, a freedom to live into the reality of their lives just as they are, a freedom that is not dependent on circumstances. This is a radical experience for them.

At the end of this unorthodox day of mindfulness, buried in the bowels of the VA Hospital, as the group broke silence and shared about our experience of the day, several acknowledged that it had been very hard at times to stay with the effort. It was one thing to hold silence for half an hour at a time, as we've been doing in our class, interspersed with conversation and teaching. But no one in the class had ever done anything like this for a whole day. 

Yet one by one, the stories came out about how moving this had been for them. "The day went much faster than I expected." said one. "Even though it was hard, I've never felt this calm or centered before. I really get how this works much more now. Sitting at home for a half hour a day will be much easier now." Another said, "The pain in my back is always there, and it was sure there today. But it didn't bother me nearly as much. There were times during the day when I forgot all about it. During one meditation I realized I'd forgotten all about the pain, like the pain had disappeared from my mind completely, even though I realized it was still there. I didn't think that was possible for me." Another said, "I live with anxiety all the time. The smallest things can set me off. There were times today when my anxiety almost overwhelmed me, but when I looked around and saw everyone else doing it, I just came back to my breath like you've been teaching us, and I got through it. I've been seeing this happen more often in my daily life too. When the anxiety attacks come, I don't react to them nearly as quickly. Sometimes I don't react at all. I see it for what it is, and I let it just be there until it passes. This is a new thing for me, and today really helped me gain confidence that I can live with this anxiety a lot better than I have before."

Being invited by David to help him launch this program at the VA has been a real privilege. As I head into my summer of explorations around the Sound, I won't be able to continue with this work for several months. But I look forward to returning when the year is over. It has been a grounding experience for me to be with people who live with obvious suffering every day, and to see the courage they are finding to face into the suffering in more creative, self-compassionate ways. I know for sure that I've learned as much as any of my students. Watching the sincere efforts of these vets, I always come out feeling more hopeful about our human capacity to face into the difficulties of our lives. And this capacity is something we need now more than ever. Practicing alongside these vets pulls the plug on any of my own excuses when I feel tempted to give in to discouragement or despair. It is a great reminder that I need to practice what I preach, and start over with a fresh mind in each new moment of my own life.