Mindfulness and long-term illness
Mindfulness is a conscious state of living, or being, in the present moment. That is to be ruminating on past unresolved events or fearing futures that may never happen. This state of mind is reached through the practise of specific techniques normally associated with meditation. Though to the practitioner of mindfulness the approach to life is to be present in every moment of everyday whether we are working, eating, sleeping and so on. This includes being mindful when we are ill and also when we are dying.
Illness comes in different forms. There are those coughs and colds, the sort of short-term infection that may lay us low for a short while but we bounce back from them. Then, we may be the subject of an accident with broken bones to mend or psychological scars of trauma to be healed, these will take us longer. The bones several weeks, sometimes months but trauma can be with us for years and even a lifetime. Then there are the general operations from which we need to recover, but these are mainly short term issues that may be awkward but we get over them within a reasonable period of time.
For some people illness becomes long, or longer term. We may develop ulcerative bowel issues and become the subject of a stoma, there may autoimmune problems perhaps rheumatoid arthritic issues or it may be an emotional or mental issue such as depression, extreme anxiety or the longer-term post traumatic stress. We may also develop cancer and become terminal over a long or short time.
Long-term illness requires much from both the sufferer and the carer. The carers of course are often family members, partners or close friends. Just as if the family has an alcoholic member then all the family has an alcohol problem, it is also the case that if someone in the family has a long-term illness, then all the family has a long-term illness to deal with.
Illness always has been and, always will be with us
Life, it self, is a terminal disease. For everyone in every walk of life, there is only ever one ending. You and I will both get there when our time, and our turn, comes. But, maybe that is not the point, true we are all going to die, perhaps it is how we get there that concerns us most.
Some people will add other categories to this but for me we will all die from either:
1: a cardio vascular problem
2: a dementing or alzheimer’s issue
2: a degenerative nerve or brain disease,
4: a cancer of one sort or another
5: or an accident
I just ran the list by a colleague physician in the next office and he thinks we should add in respiratory problems like COPD, Chronic obstructive pulmonary disease, emphysema and also gastric ulcerative issues. The point is that however we look at it we will all die, though it is how we do it that counts. For some the ending will be swift and sudden but for others it will become drawn out and long. So whilst accepting that not all long term illness will lead directly to death I want, in this blog, to focus on dealing with death and long-term illness from the two points of the sufferer and the carer.
Living or dying?
Over the years I have worked with many people suffering long-term illness. Attitudes vary from the amazingly positive to the completely negative. It comes down to this…
…are we living with ‘it’ or are we dying from our illness?
Illness, like death, is something that few people consider until it is upon them. We need to come to terms with the idea that we are likely to become ill, and perhaps long-term, before we die. Ideally most of us would like to die in our sleep or suddenly doing something that we enjoy.
Living in the now – living with illness
My teacher once said to me,
“you are not ready to live until you are ready to die”.
He was saying that to effectively live in the present, and not to be suffering from the forward projection (that leads to anxiety). We need to become aware of death and illness and accept it as an inevitable part of being a human being. We all have a body and bodies become damaged and eventually wear out and stop working. Along with having a body to deal with and the problems of illness, accident and old age there comes, for us all, pain and suffering. Pain and suffering are the natural human condition, but we do have a choice as to how we deal with and, respond to them.
In long-term illness for both the sufferer and the carer there will come levels of pain, anguish, frustration, anger, depression, anxiety, fear and so on. Though these are also set against such things as love and fortitude, endurance and resilience, wonder and understanding, security and comfort.
The use and development of the skills of mindfulness gives us a choice to either follow the positive path of living with illness, even when we know we are terminal, rather than taking the negative path and fearing every step of the future. Mindfulness allows us to face, come to terms with and deal with whatever is presented to us.
In Mindfulness and meditation we can learn to allow the river of life, as thoughts, feelings and physical sensations, to flow by us without the need to get into the water and swim with them. When we learn the mindful skills of being able to sit on the bank while watching the river of life flow by we learn to observe all of life, all it’s wonders and pitfalls.
Mindful practise teaches us that however uncertain the future is, we can be present in the moment. The ability to be and remain in the moment frees us from the depression of looking backwards to what was and the fear and anxiety that comes from looking forward to what might never be.
S.N. Goenka the famous teacher in the Vipassana tradition of Mindful Meditations makes the point that to the mindful practitioner all experience can be observed without attachment. So that the mindful meditator may, in peace and serenity have an experience, as in… “oh this is a new experience what is this?” or in the extreme “are so, this is what death feels like”
As a sufferer of long term or terminal illness, mindfulness allows us to live in each moment without projecting forward in fear as to what may happen next. It allows us to get the best from every minute that is available to us, with compassion for our self and for those that are caring for us.
As a carer for someone with long term or terminal illness, mindfulness allows us to act compassionately, with patience and fortitude allowing the person in our care to undergo their own journey with our support.
As either patient or carer the most powerful tool available to us is love and compassion.