May 11, 2020: Letting It Out: Releasing Negative Emotions

rant:  to complain or talk loudly and angrily for a long time, sometimes saying unreasonable things  (MacMillan Dictionary)

I don’t know about you, but I do know that the endless days of indoor living and social isolation are getting to me.   I am more easily frustrated, irritable and restless.  It’s taken some discipline to rein those negative feelings in, and I admit to days where I am less successful than I wish I was.  What about you?  Have you felt the need to get feelings or frustration with something off your chest, the kind that keep you awake at night or gnaw at you until they’re voiced?   We know that those kinds of feelings aren’t good for our health, as confirmed by a significant body of psychological research on the relationship between emotions and health–but I learned this in earnest the hard way. Some years ago, I realized I’d  been living under extreme stress for well over a decade, triggered by  my husband’s death, a significant career transition, and a decade of major moves from coast to coast.  I soldiered valiantly through it all, but cracks began to appear in my armor. I slept poorly, and I was often impatient and short-tempered.  A few close friends expressed concern, but it wasn’t until my diagnosis of early stage breast cancer that I really understood the impact all that bottled up emotional stress had on my health.

Around the same time, I  read Opening Up:  The Healing Power of Expressing Emotions (1997), the early work on emotional inhibition and health by James Pennebaker, PhD, whose subsequent research on writing and healing set off an explosion of similar studies and inspired numerous expressive writing programs.   Pennebaker demonstrated how expressing emotions was not only good for one’s soul, but beneficial to our physical and psychological health.  The studies he cited made one thing very clear:  holding negative emotions inside, also known as “inhibition,” is detrimental to health.

Our bodies respond to the ways we think and feel.  Stress and anxiety weaken immune system function, and negative emotions can have effect on circulation, blood pressure, respiration, digestion, even hormonal functioning.  It can heighten our vulnerability to disease or manifest itself as back pain, fatigue, or headaches.   Research suggests that holding on to negative feelings may actually shorten our lives.  According to some studies, optimistic people have longer lives than pessimistic ones.  Ridding ourselves of negative emotion may improve physical health as well as the body’s power to heal.

It’s not always as easy as it sounds.  Everyone experiences strong or negative emotions from time to time, and during difficult or painful experiences like a marital break-up, job loss, or a diagnosis of cancer, heart failure or other serious conditions, those feelings can be intense. Anger, anxiety, fear or pessimism are common, but that’s not all. When we suffer a new wound to our psyches, old, unresolved wounds from the past can re-open and bleed again. Fortunately, there are many therapeutic tools to assist in the healing process, and as the research shows, writing and telling our stories of our illnesses, hardships or struggles is one of them.

Many writers, novelist Henry James once said, begin writing from a port of pain, finding a kind of release and solace in putting their deepest—and most fearful—feelings on paper, whether in diaries, journals or poetry and stories.  Port of pain or not, it’s often hard to get started, difficult to give ourselves the freedom to express all we’re feeling on the page, even though we want to. “Keep the pen moving,” I often say to the participants in my writing groups.  “Write without stopping or thinking about what appears on the page.”  The time limits imposed for different writing exercises helps, because it forces them to write quickly, in effect, silencing their internal critics.  Often, when someone chooses to read what they’ve written aloud, I hear the comment, “I didn’t know I wrote that…” after an especially powerful sentence or paragraph.

One of my favorite examples of “release” through writing is in learning to free up and write a rant, something that just “lets it all out.”  I often use a poem by   Rosanne Lloyd, a contemporary poet who combines eloquence with directness and forcefulness in her writing.  her poem,  “Exorcism of Nice,”  is one I find helpful in inspiring  writing group members to “just let it go.”  In this poem, the  poet reacts to a litany of long-time restraints, expressing anger and pain that has silenced her own voice:

Mum’s the word
Taciturn
Talk polite
Appropriate
Real nice
Talk polite
Short and sweet
Keep it down
Quiet down
Keep the lid on
Hold it down
Shut down
Shut up
Chin up
Bottle up
Drink up…

Tucked in
Caved in

Shut in
Locked in
Incoherent
Inarticulate
In a shell…

Oh, Wicked Mother of the Kingdom of Silence
I have obeyed you
long enough

(From: Tap Dancing for Big Mom, 1996)

Lloyd’s poem is a useful model for freeing up to express negative emotions on the page.  “Anything goes,” I frequently say as group members begin writing.  “Whatever is on your mind, whatever is irritating you, making you angry or frustrated–just write it.”  What invariably happens in the writing that follows is always powerful, even sometimes hilarious, and coupled with a newfound freedom to write honestly and deeply—the kind of writing that has the potential for healing.

In this time of social distancing, self-isolation and uncertainty, I know my frustration tends to surface more often than usual, and in those moments, I become irritable and negative.  It has helped me to write regularly, and I’ll confess that a few rants have appeared in my notebook, but the beauty of doing so for me, is that my list of frustrations turns into a parody of my feelings and results in  rather light-hearted and humorous endings to whatever frustration I’m  feeling.   More than a few silly poems have resulted in the pages of my notebook in these many weeks of indoor living.

Perhaps trying out a rant is something you can try writing when COVID-19 necessary restrictions on our lives gets to you.  Why not give yourself permission to “let it all hang out” on paper—to expel any anger, frustration, or pain that may be building inside as the days continue to move slowly and with increasing monotony.  It’s an exercise for release—and it can even be fun.

Writing Suggestion:

Try writing your own rant.  It can be about anything.  You can use Roseanne Lloyd’s poem as a model or write one in letter form, as in Tony Cross’s “Open Letter to Hummingbirds,” appearing in McSweeneys, 2004, or Canadian comedian Rick Mercer’s video  rants against things like winter, Tim Horton’s and some  people’s behavior during COVID-19 (available on You Tube).   Here is an excerpt from Cross’s letter to hummingbirds:

Dear Hummingbirds,

Hey, would you take it easy already? What’s the freakin’ rush, hummingbirds? I don’t get it—why must you flap your wings so damn fast? You need to chill out.    Here I am, sitting in my garden, quietly reading a book and sipping on a fruit cocktail, and all of a sudden you’re buzzing into my field of vision…

I found the You Tube video rant by Canadian comedian Rick Mercer on seasonal amnesia personally relevant this past weekend. Our balmy spring weather from a week ago turned wintry, and snow flurries completely hid the view from our balcony of downtown Toronto.  I ended up writing my own anti-winter weather rant too…the weather didn’t improve, but my mood did.

The nice thing about writing about difficult emotions or frustrations is that it helps you release them from you body to the page.  You can be honest.  No one needs to see what you’ve written.  You can tear up your rant into a hundred tiny pieces or simply hit the “delete” button when you’re finished writing.  What matters is that you write, without self-criticism, and release the frustration and negative emotions from the body to the page.   Set the timer for fifteen minutes and have at it.   Write a rant.  It can be about anything.  Exorcise those negative emotions or frustrations.  You’ll just might feel better once you do.

April 28, 2020: Navigating the Alchemy of Grief

For several days now, my thoughts have been occupied with Nova Scotia, home to me for over 13 years.  The shock of 22 innocent people shot and killed in a matter of hours has weighed heavily on the minds of so many of us.  It is Canada’s worst mass shooting since 1989, when ‎14 female students died at the hands of a  gunman at Montreal’s ‎École Polytechnique in Montreal.  Stunned, I reached out to old friends, knowing the closeness of the social networks in the Maritimes.  Some of my friends had known the young female Mountie who was killed and her mother, and together with so many others, mourning the loss of life, the senseless and incomprehensible violence perpetrated in the province.   

Ironically, perhaps, the memories of the close community of friends I experienced while living in Nova Scotia were also punctuated by unexpected losses:   my first husband’s drowning, two friends dead from AIDS and another from cancer shortly after I moved to Toronto.  Then, yesterday, as I remembered it was the birthday of my dearest Nova Scotia friend, a memory of the telephone call, one I received barely 14 years after my husband’s death, and another of my friends telling me A. had committed suicide. 

 I felt the waves of shock and sorrow for days.  How, I asked myself countless times, could she have been so distraught to take her own life?  It made no sense to me.  I remembered how she and her husband had been steadfast in their love and offered such extraordinary support for me and my daughters after L.’s death.  To this day, I doubt I could have gotten through that period of grief without their unyielding support and kindness.    “Before you know what kindness really is,” poet Naomi Shihab Nye tells us, “you must lose things…” 

feel the future dissolve in a moment
like salt in a weakened broth.
What you held in your hand,
what you counted and carefully saved,
all this must go so you know
how desolate the landscape can be
between the regions of kindness.


 (In: The Words Under The Words ©1994)  

“How desolate the landscape can be between the regions of kindness…”  Our world has, in the past many weeks, seemed, at times, desolate as thousands throughout the world have died or lost friends, family and acquaintances during this pandemic.   We have been forced, as individuals and as nations, to re-examine many of the assumptions we’ve held about life:  no one has been immune, and new cases of the COVID 19 virus continue to emerge.  Virtually every country has been in lockdown, financial outlooks seem precarious, and fear and uncertainty of what the future holds when—or if—life returns to normal are rampant.    Yet it’s easy to forget that throughout history, losses of similar proportions have been felt by people all the around the world:  disease, wars, unimaginable hardship and cruelty, starvation, massacres, deadly earthquakes and the unimaginable loss of human life.  

In our country, we have been relatively immune to such disasters as other countries.  Yet such tragic loss of human life can ignite sorrow and grief that invade our very being.  For some, they are buried or forgotten until the next tragedy or loss, for others, the heartache and sorrow linger—even re-ignited by a calendar date, a photograph, a sound or a song—and it all comes back. We experience again the weight of loss, and we grieve.

Grief, the psychologists tell us, is the emotional state that accompanies loss, and although normal, when compounded by the unimaginable losses in life, when no explanation or rationale can be found,  the sorrow is deeper, more lasting, and we experience the kind of sorrow that resides in our hearts for a very long time. How can we make sense of these unexpected and even incomprehensible losses we suffer? 
 
I am learning the alchemy of grief, how it must be carefully measured and doled out, inflicted—but I have not yet mastered this art.” –Judith Ortiz Cofer. The Cruel Country, 2015)

Since I began leading my “Writing Through Cancer” programs twenty years ago, death has become a frequent visitor, as cancer always claims the lives of one or more of my writers.  He death of a group member has never become routine, and nor have I developed some protective layer of numbness for those times that one of my writers dies. I am humbled by the medical professionals who, by virtue of their vocation, must continually deal with the loss of human life, for each time a group member’s life is taken by this disease, I must   learn again to confront my grief as well as the collective grief of the group.  

Everyone has their way of dealing with the loss of life, but for me, it’s the reason I originally turned to writing and poetry as a way to make sense of sorrow and loss.  I’ve said before that writing, for me, is a kind of prayer.  It takes me deep inside myself and a way to remember, to mourn and yet to articulate what I feel when loss has, again, entered my life.  When words fail me in times of sorrow, and they often do, I turn to reading poetry.   

Poets have always written, about human emotion, and their expressions of sorrow and grief helps me mourn, to name what I am feeling, and to take some kind of solace in knowing the sorrow and I loss I am feeling has been understood and put into words by others.  I not only discover new insights, ways of expressing my sorrow, but a kind of solace, a way to gradually let go of the grief I feel.   If you are someone who finds comfort or inspiration  in poetry, I recommend the collection of “Shelter In” poems, https://poets.org/shelter-poems offered by readers to the American Academy of Poets during this time of pandemic and social isolation.    

I am more aware than ever now that loss is part of our human experience, something we all must deal with, something we all have to learn to make sense of.  Knowing that doesn’t make it easier, but finding ways to put it in to words or discovering wisdom in the word of others helps to make it bearable and to let it go.  As Mary Oliver so beautifully reminded us:  

To live in this world  

You must be able
to do three things: to
what is mortal;
to hold it  

against your bones
knowing your own life depends on it;
and, when the time comes

to let it go.  

(“In Blackwater Woods,” In:  American Primitive, 1983)  
 
Writing Suggestions:  
* Create a kind of balance sheet:  in one column, list the names of people you have lost; in the other, the acts of kindness you have experienced or discovered in loss.  What insights emerge?  What have you learned about loss, grief or sorrow?
* Re-examine periods of significant loss in your life.  Has your experience helped you to see things in a different life?
* Try expressing your feelings of grief or sorrow in a poem.  Stuck?  Model your poem after a poem you like or use the first line of someone else’s poem as a beginning. 

April 13, 2020: Spiritual Nourishment in Difficult Times

I cannot tell you
how the light comes,
but that it does.
That it will…

(“How the Light Comes,” by Jan Richardson, in Ten Poems for Difficult Times, 2018)

A note from Sharon:  To those of you reading this post:  It is difficult to find the words that capture this extraordinary time we are now living—no one has been immune to the crises triggered by this world pandemic, and for the foreseeable future, our lives will continue to be affected, our daily habits changed, by the impact of the corona virus.  It is a worrisome time—and for any of us who are in the “higher risk” categories, it is difficult to escape the underlying anxiety that seems to invade one’s daily life.  What gives us solace?  Offers hope? A few years ago, I wrote this blog post which follows, reflecting on the importance of our spiritual lives.  Whatever that life involves, it’s certain that Life’s hardships thrust us into what can only be defined as a deeply spiritual journey.  As we all deal with the impact of the corona virus on our lives, our loved ones, and how our lives will be change because of it, I offer this post originally published in my blog, www.writingthroughcancer.ca, in the early part of 2014.

_ . _ . _ . _

A few years ago, when I was living in San Diego, I participated in a workshop on contemplative practices that could enrich our lives.  My part in it was to invite the participants to consider the spiritual practice inherent in writing.  Like so many Americans, I’ve been a lapsed church-goer for the better part of my adult life, finding I craved a deeper spiritual practice to sustain my daily life than the Sunday morning services.   I had dabbled with other religious traditions, tried to learn meditation, but still, I couldn’t make anything work for me.  What I hadn’t realized is that I had already had the tools to deepen my spiritual life—writing.  I had always written, and during the years of a soul shattering time in early adulthood, writing was a refuge, my port in the storm, a virtual sanctuary.  I just hadn’t thought of it as having the potential become my regular spiritual practice. 

Within a year after returning to California from Toronto,  I was confronted  with the first of a series of losses and unexpected life changes beginning with my father’s death from lung cancer, and followed by mother’s descent into Alzheimer’s, the onerous and painful  task of downsizing a dying nonprofit, an unexpected diagnosis of early stage breast cancer, and my mother’s death.  In the aftermath of my first husband’s drowning a decade earlier, writing had become a refuge, a lifesaver I clung to through those turbulent times.  Writing not only helped me cope, but ultimately, became an important daily routine.  As my writing practice solidified and deepened, it became a fundamental part of my spiritual life.

My writing grew to become a daily ritual and meditation, something I practiced early each morning before the outside world intervened to pull me into its noisy demands.  Its place in my spiritual life has only solidified over the years; it is a regular practice that begins in the stillness of early morning when I first open the pages of my notebook, the same leather-bound journal I’ve written in for years.  Like the dawning of each new day, a new page awaits, blank and inviting—reminding me now, as I write, of Rita Dove’s words in her poem, “Dawn Revisited:” the whole sky is yours/ to write on, blown open/ to a blank page…”   I have no agenda when I first begin writing, no expectation. I begin with one small observation, something I notice in the present moment—the fog lifting from the canyon floor, a trio of hummingbirds at the garden fountain, the red-tailed hawk’s wings spread as he glides just beyond our deck—whatever captures my attention.  Sometimes, a haiku poem emerges; other times, what I describe is enough to trigger a memory or a feeling that begs to be written.  It hardly matters.  What matters is that I write, embracing the solitude of the morning, intertwining the external world with my internal one, going deeper into whatever I’m exploring on the page, writing myself into “knowing.”

“At a certain point you say to the woods, to the sea, to the mountains, the world~ now I am ready. Now I will stop and be wholly attentive. You empty yourself and wait, listening.– Annie Dillard, (Teaching a Stone to Talk, 1982).

Writing is my meditation and my prayer.  It opens me, ensures I am “paying attention” to what is before me, what is inside me. It informs my intentions for each day and ultimately, the work I do with others, helping them express and explore the material of their lives in writing.  While writing might become become a spiritual practice for anyone, as it is for me, so can art, music, dance, yoga, T’ai Chi, meditation, and prayer—anything that takes us into the quiet contemplation and deeper parts of ourselves.  As Thomas Merton wrote, “Art enables us to find ourselves and and lose ourselves at the same time,”

One’s spirituality is not dependent on a specific religious belief or theology.  We all have spiritual needs and yearnings.  What matters is that we find a way to nurture them, that we feed our souls as well as our bodies and minds.  In times of hardship, life-threatening illness, or other suffering, it’s often our spiritual lives that keep us from losing hope, that keep us whole.  As New York Times editor, Dana Jennings, diagnosed with an aggressive prostate cancer, wrote in his blog “One Man’s Cancer,” our spiritual lives sustain us through life’s most challenging chapters:

I am not a fool. I am a patient with Stage T3B cancer and a Gleason score of 9. I need the skills and the insights of the nurses and doctors who care for me. But they don’t treat the whole man. Medicine cares about physical outcomes, not the soul. I also need — even crave — the spiritual antibodies of prayer, song and sacred study.

A cancer diagnosis is nothing anyone wants to be given.  It may feel like a death sentence, and it may challenge your faith, all that you believed was right and true.  But while cancer—and many other painful experiences– may seem like a dark night of the soul and challenge you in ways you never thought possible, it may also offer you the chance to explore your spirituality by deepening your self-understanding and compassion for others.  It’s something I witness again and again in the expressive writing groups I lead:  a chance to deepen one’s understanding and compassion, an opportunity to define what is essential and important in life, even gratitude and appreciation for the ordinary gifts in each day we have.  As one cancer survivor wrote, “The community I am building with my fellow writers …is… a form of spirituality.”  

Through the exchange of stories, we help heal each other’s spirits…Isn’t this what a spiritual life is about?–(Patrice Vecchione, Writing and the Spiritual Life, 2001)

Life’s hardships thrust us into what can only be defined as a deeply spiritual journey. We may kick and scream, rail against the injustices of those events, but like it or not, we’re forced to re-examine our lives in ways we have not, perhaps, done before.  We begin to pay attention, really pay attention, to what truly matters to us—and to our lives. 

Varda, who wrote with me for the last two years of her life, died of metastatic breast cancer several years ago.  She wrote honestly about her cancer experience, her fears and her hopes, sometimes poignantly, sometimes humorously, but always honestly, voicing, so many times, what others were afraid to express.  Near the final weeks of her life, she wrote a poem entitled “Faith,” that described her spiritual re-examination during her cancer treatment: 

…My cancer has challenged my faith,

and I have found an incredible well I did not know I had. 

I have found true surrender,

 enormous peace.

I have come home to God, and we have renewed

our friendship.

(From:  “Faith,” by Varda Nowack Goldstein, in: A Healing Journey: Writing Together Through Breast Cancer, by Sharon Bray, 2004.)

Varda was thrust into a journey that can bring anyone to their knees, but she honesty, her willingness to plumb the deepest parts of her experience and to write so honestly about her life, her faith and cancer were humbling and inspiration to us all.   Her stories were, I’m certain, nurturing her “spiritual antibodies”—not a cure, but courage to face and, not unimportantly, help others face her inevitable death with grace, love, even shared laughter.  Surely this was evidence and testimony to the depth and importance of her spiritual life, and something, whatever form it takes, we all need.

And we pray, not
for new earth or heaven, but to be
quiet in heart, and in eye
clear.  What we need is here.

From: “The Wild Geese,” by Wendell Berry, in The Selected Poems of Wendell Berry, 1999)

Writing Suggestions:

  • Reflect on what nourishes your spiritual life.
  • What practices or rituals have helped sustain you during cancer, heart failure or other hardships, losses and struggle?
  • Where have you found your solace, your strength, your source of “spiritual antibodies?” 
  • In this time of the corona virus pandemic, write about the spiritual practices most important to you.

The Necessity of Small Rituals

Habit

The shoes put on each time
left first, then right.

The morning potion’s teaspoon
of sweetness stirred always
for seven circlings, no fewer, no more,
into the cracked blue cup.

Touching the pocket for wallet,
for keys,
before closing the door.

How did we come
to believe these small rituals’ promise,
that we are today the selves we yesterday knew,
tomorrow will be?

(Excerpt from “Habit” by Jane Hirshfield, in Given Sugar, Given Salt, 2002)

In the past many weeks of the corona virus pandemic, our daily lives have changed virtually overnight.  Our usual habits and the patterns have all but disappeared or at the very least, been disrupted.  It’s unsettling, because it is in times of upheaval, we need those daily routines and habits most:  they steady us and give our days meaning.   

In times that are uncertain and stressful, as anthropologists’ studies have shown, people’s rituals become more important. In a recent article by Dimitris Xygalatas, appearing in The Washington Post, he cited the early work of anthropologist Bronislaw Malinowski, who studied inhabitants of the South Pacific islands in the early 1900’s.  Malinowski had observed that the islanders were more likely to employ rituals when faced with situations out of their control, such as the danger of fishing in shark-infested waters.  But such ritual activity in the face of danger or stress is not uncommon to any of us.  As Xygalatas points out, our reliance on ritualistic behavior typically increases during stressful events like wars and environmental threats.  

“Rituals take an extraordinary array of shapes and forms,” authors Gino and Norton stated in a 2013 Scientific American article.  Performed alone or together, whether in religious or other settings, they help to reduce anxiety, alleviate grief, or boost confidence.  Even simple rituals—habits—such as making time for quiet, meditation, a solitary walk, or even the simple act of grinding coffee beans for the morning coffee–whatever calms or nurtures our lives–can serve as a source of spiritual re-fueling, essential to our ability to navigate life’s ups and downs.  Rituals, whether more formal or in the form of everyday habits, provide a sense of the familiar, constancy, and a connection to others.  In that sense, they are healing.

Not only do our everyday rituals calm and feed us, those more formal ones, created to mark life’s passages, like birth, puberty, marriage or death, do even more for us.  While important in honoring transitions from one life chapter to the next, in times of uncertainty and change, our rituals also help us cope. They offer a sense of control in the chaos of human life, minimizing the anxiety, helplessness or depression we may feel without them.  Rituals give us a way to express our deepest feelings, offer meaning and connection to what is sacred.  In a study also reported by Dimitris Xygalatas, a study of Hindu people in Mauritius measured their heart rates before and after performing temple rituals. The people’s anxiety was lowered after the temple rituals were performed, demonstrating the importance of the collective rituals and ceremonies.  They do even more, Xygalatas explained, providing people with a sense of connection, increased generosity and even synchronizing their heart rates.  Rituals, whether formal or in our everyday habits and routines, help us navigate difficult times by providing some sense of the familiar and constancy. 

Rituals give significance to life passages, as Jeanne Achtenberg and colleagues discussed In Rituals of Healing (1994), and they also help us relax, re-connect with ourselves and the little pleasures in everyday life.  They are calming and help us concentrate on positive thoughts, all important to healing.

Ted Kooser, former Poet Laureate of the U.S. was diagnosed and treated for cancer in the late 1990’s, During the aftermath of diagnosis and treatment, his usual routine of writing daily had suffered.  He wrote …During the previous summer, depressed by my illness, preoccupied by the routines of my treatment, and feeling miserably sorry for myself, I’d all but given up on reading and writing…  As he began his recovery, he began a habit of early morning walks, describing its unexpected benefit:

“In the autumn of 1998, during my recovery from surgery and radiation for cancer, I began taking a two-mile walk each morning…hiking in the isolated country roads near where I live… One morning in November, following my walk, I surprised myself by trying my hand at a poem.  Soon I was writing every day…

The result was a delightful book of poetry, Winter Morning Walks: 100 Postcards to Jim Harrison, (2001).   Kooser’s daily morning walks were not only important to his recovery, but also to his life as a poet.  He re-established, once again, the ritual of writing daily, capturing this positive outcome in the final poem in the book: 

How important it must be

to someone

that I am alive, and walking,

and that I have written

these poems.

This morning the sun stood

right at the end of the road

and waited for me.

I confess the constant news of the continuing spread of the COVID 19 virus in Canada and the world has derailed me more than once—despite my best intentions.  Anxiety, worry, or frustration sometimes threatens to overtake me – especially if I spend too much time reading the government updates and accompanying articles in The Globe and Mail which all but demolish my regular morning writing practice.  I regained the desire to write with a “new habit,” giving myself the freedom to not write anything of substance but instead, writing humorous poems about my state of life in this unusual time.  I’ve shared those with my husband and some friends, resulting in a few moments of shared laughter.  I’ve written 4 or 5 “silly ditties” since— humor is a great stress reliever.

Social isolation meant that I was also denied my regular stop at our corner Starbucks, a frequent habit after my afternoon walks, so instead, I decided to bake—impromptu–using whatever ingredients I had.  Another habit formed as I decided to find a recipe for the perfect scone.   After turning out four batches in four weeks, baking has become a necessary habit, as it’s one I find surprisingly calming and more, requires quiet and focus not unlike meditation.  Besides, as psychologists tell us, the ritual of making something or doing creative work of any kind helps to reduce stress and anxiety. 

This is not a dress rehearsal…today is the only guarantee that you get…think of life as a terminal illness, because if you do, you will live it with joy and passion, as it ought to be lived. —Anna Quindlen

As my husband and I negotiate our now confined lives inside in a two-bedroom apartment, we’ve established little routines or habits that are comforting and helping us navigate through this time of crisis together.  We come together at 5 p.m. every evening to listen to music and talk over a glass of sherry before our evening meal.  It’s become a time that we are present for each other, one we find relaxing, and something we look forward to in this unusual time of social isolation.  We often reach out to friends and family during that time, whether by telephone or Face time.  Staying connected with each other is comforting and helps us overcome the ever-present sense of isolation and worry, and is an important activity in helping us all weather this time of crisis.  In the midst of it all, I sometimes wonder, will life be like when this is finally over?  What will have changed?  What will we have learned about ourselves and our lives? But those questions are for another time… For now we don’t think ahead too far; we take each day as it comes as best as we can; we keep our routines, our habits in place to help us manage our lives in this unusual time.

In the Middle

of a life that’s as complicated as everyone else’s,

struggling for balance, jugging time…

Each day, we must learn

again how to love, between morning’s quick coffee

and evening’s slow return. Steam from a pot of soup rises

mixing with the yeasty smell of baking bread.

For Consideration and Writing:

Whether a morning walk or run, a warm bath, meditation, a quiet time to write or simply gaze out the window, listening to music or losing one’s self in a good book, we all take comfort from our daily habits.   Whatever you find calming and comforting, your own habits and rituals can provide spiritual nourishment and healing so very necessary to our lives in this turbulent time.  How are you managing during this unusual time?  What routines or rituals are you finding most helpful? Which help to feed your inner life and navigate through this unusual and frightening time in the life of the world?     

March 18, 2020: A Practice of Managing Worry & Anxiety

…Then what I am afraid of comes. I live for a while in its sight.”  (Wendell Berry (This Day:  Sabbath Poems, Collected and New, 1979-2013 )

I admit it.  The corona virus has me on edge.  Since age and heart failure put me in the “greater risk” population, it may be part of the reason I awaken with the shadow of fear or worry close behind me.  The thing is, I know fear and anxiety are not good for my heart.  It’s a bit ironic, a kind of catch-22, because a diagnosis of heart failure is anxiety producing itself, and it’s progressive, so the undercurrent of unease never quite disappears. And when we’re anxious, it puts extra strain on our hearts, like increasing blood pressure, making us short of breath,  and in more serious cases, interfering with the heart’s normal functioning…nothing anyone living with heart failure or other cardiac conditions needs.

In Japanese, “the kanji (Japanese character) for fear, shows a leaking heart, for fear drains our spirit.                —Stephen Murphy-Shigematsu, PhD

According to Orly Vardeny, Associate Professor of Medicine at the University of Minnesota, “The corona virus’s main target is the lungs. But that could affect the heart, especially a diseased heart, which has to work harder to get oxygenated blood throughout the body…In general, you can think of it as something that is taxing the system as a whole.”  For someone who lives with heart failure, that’s a worry, because my heart doesn’t pump as efficiently as it once did. 

Fear, anxiety and worry all take their toll on my emotional and physical well-being.  While we are in the midst of this pandemic, I have to consciously work to  manage my fearful feelings. I follow all the basic health suggestions:  handwashing, sanitizing, staying away from social encounters, diet, exercise and necessary sleep.  But still, keeping my fear and worry in check requires a bit more self-discipline. Here are some of the things that have been helping me manage my level of anxiety and worry.

I’m limiting my exposure to the constant “buzz” and barrage of reports on social media and in the daily news.  Too much information increases worry, and that can result in panic.  It’s important to be in the know, yes, but as psychologists tell us, there’s a point at which information has the unintended effect of increasing your fear. 

I take a few breaks during the day to simply be quiet.  There’s a feature on my Apple watch that I now use regularly.  Every few hours, it prompts me to do a minute of deep breathing.  I pause, get quiet, and let the exercise of deep breathing for a few minutes lead me into a short period of meditation, freeing my mind of busy brain or any worrisome thoughts.  Simply be quiet, focusing on the here and now is wonderfully calming and relaxing.

There’s a sense of calm in keeping a regular routine, and my morning routine has become even more important to me as a way to quiet any worrisome or fearful thoughts. I’m up early, before my husband awakens, to claim the hour or so of solitude and quiet I crave–and need-for my writing practice.  It’s a ritual of sorts, freshly ground and brewed coffee, my open notebook, my pen moving across the page.

I place no requirements on this time, but write freely.  Whatever emerges on the page hardly matters—sometimes I vent, other times I write poetry or just write freely, staying open to whatever appears on the page.  What matters most is that it is restorative time for me. I watch the sun rise over Lake Ontario on clearer days, or simply notice life on the street below.  Sometimes nature offers a special gift, like the two Canadian geese, honking and waddling about on the rooftop next door, momentarily lost from their flock.  In those moments, I find gratitude—remembering just how lucky I am in so many ways.  And it calms me.

Today I am fortunate

 to have woken up

I am alive.

I have a precious human life.

I am not going to waste it…

I am going to …

expand my heart out to others…

(From:  “A Precious Human Life,” a prayer by His Holiness, the Dalai Lama)

 I’ve found that reaching out to and connecting with family and friends here, in Canada, Japan and the US has also helped to calm my fears.  While I have discovered that  mindfulness helps me to calm, focus, and reduce stress, so does honoring matters of the heart—connecting with people.  As Dr. Stephen Murphy-Shigematsu demonstrates in his book, From Mindfulness to Heartfulness, in worrisome times, our connection to and with one another are even more important to what we call “enlightenment.”  “The kanji (Japanese character) for mindfulness consists of two parts,” Dr. Murphy-Shigematsu explains, “the top part meaning “now,” and the bottom part meaning “heart.”   

All of us share in this worry over the impact of the corona virus, but the simple act of connection, whether online, by telephone, letters or a note written on a  greeting card, serves as a reminder that none of us are alone in our concerns or feelings.  As for my health concerns, I’m lucky to be use Medley, the smart phone app that records my weight, blood pressure, heart rate, and symptoms daily, which is monitored by my healthcare team at Toronto General’s Peter Munk Cardiac Center. This too, provides some solace, a sense of being connected to the people who provide my cardiac care.

Music is a big part of my life, especially classical, and is a necessary ingredient in self-care and inspiration.  It calms, inspires, and reminds me of the beauty and creative spirit that is part of being human.  I’ve also been moved by the inspirational You Tube videos of people in Italy, Spain and Israel, isolated in their apartment buildings because of the impact of the corona virus, playing and singing together from their balconies.  Last week, I discovered cellist Yo Yo Ma has released a series of videotapes on Facebook, the first “song of comfort” he offered was  Dvořák’s Going Home. Ma explained:  “In these days of anxiety, I wanted to find a way to continue to share some of the music that gives me comfort.” Yesterday’s  offering was  “Sarabande” from Bach’s Cello Suite No. 3, which he dedicated to the healthcare workers on the front lines.

So, we all ride it out, taking the necessary precautions, finding ways to stay connected, keeping our fear in check, and weathering this crisis, alone and together.  I find I’ve been thinking of my mother, whose admonitions and homespun prescriptions often had my siblings and me giggling behind her back. Yet she’d suffered more than a little hardship in her younger life, and looking back, I realize her many “mantras” was her way of coping and getting through tough times.  We were too young to understand it then, but we suffered from pain, illness or even an adolescent broken heart, she repeated one favorite mantra again and again:  This too shall pass, she’d say And yes, so too will this crisis, but for now, my challenge is to do all I can do to remain healthy and not be swept up in panic or fear. And frankly, that requires a little practice every single day.

When despair for the world grows in me
and I wake in the night at the least sound
in fear of what my life and my children’s lives may be,
I go and lie down where the wood drake
rests in his beauty on the water, and the great heron feeds.
I come into the peace of wild things
who do not tax their lives with forethought
of grief. I come into the presence of still water.
And I feel above me the day-blind stars
waiting with their light. For a time
I rest in the grace of the world, and am free.

(“The Peace of Wild Things,” by Wendell Berry, in:  Selected Poems, 1998)

For the Readers:

What is helping you get through this time?  How are you managing your worry or fears?   What resources or suggestions can you offer to others?  Feel free to comment on this post with some of your suggestions.   For now, stay safe; stay well.

Dec. 29th: One Guiding Word for the Year Ahead

For the past week or so, I’ve been playing around with words, exploring meanings and synonyms, consulting dictionaries, thesauruses, poetry and other books for the single word that will serve as my guiding intention for 2020. It’s a practice introduced to me by a friend nearly ten years ago, and one I have embraced wholeheartedly.  Unlike the old practice of making new year’s resolutions, choosing a single, guiding word has become an enduring annual practice that has stuck.  It takes time, thought, and patience, but I find the process of choosing the one word that will frame my intentions forces me into much deeper thought and consideration than the many new year’s resolutions I used to write, which often were forgotten by February.

Choosing a single word to frame the practices or actions for the coming year is not, I’ve discovered, an easy task.  Each year, sooner after the busy holidays, I begin the process.  I review words I’ve chosen over the past several years, remembering what I wanted to achieve, why the word captured my intentions.  Then I think about what’s changed in the current year or what I would like to do differently.  I spend time writing, fooling around with words, as I brainstorm, consult the dictionary, thesaurus, books from my shelves and favorite poems, hoping “the”word will suddenly be discovered.   Yet it never happens quite that way.

What happens is an inevitable process that leads me into deeper territory, forcing me to articulate how I want to live or what I hope to accomplish in the new year ahead, reflect and reconsider my choice of a word.  Several pages of my notebook now have several words listed on different pages, quotes from poets and writers, musings on the past year, as the intentions I have for the year ahead.

Last year, my word was “flourish,” which emerged after a year of preoccupation with my health and my husband’s.  I look at it now as I write, feeling a sense of having been true to my intent:  volunteering, leading workshops, traveling, and ensuring my days were active as much as possible.  At the same time, the past year had its stresses:  having our apartment flooded three times in the summer by with leaking caused by a forgetful tenant living above us, thus prompting yet another move, the third in three years, and despite looking forward to a different apartment, moving is simply a source of stress.  I spent much of December with an aching back, packing and unpacking, irritable and tense, eager to put my life back in order and restore some sense of calm.

Several days ago, I began the process of choosing my word for the coming year, writing each morning before dawn, when I have the quiet and solitude to truly think and reflect.  Words like balance, quiet, stillness, serenity and peaceful appeared on my growing list.  I turned again to the book, The Art of Stillness (2014), by writer Pico Iyer.  Stillness, he reminds us, is taking the time to be fully present in the moment, a time to clear away the static,  clarify and discover what is truly important.  As Iyer says, taking that time “isn’t about turning your back on the world; it’s about stepping away now and then so that you can see the world more clearly and love it more deeply.”

Of the little words that come                                                                            out of the silence, like prayers
prayed back to the one who prays,
make a poem that does not disturb
the silence from which it came.

― Wendell Berry, “How to Be A Poet (To Remind Myself,” in Given, 2006)

I kept exploring, writing, and reflecting on what I want for the year ahead.  More words appeared on my list, then this notation:  “A state of calm is what keeps cropping up for me as I consider these guiding word possibilities for 2020.  Calmness, breath, quiet in heart and in mind…”  “When you are calm…still,” Buddhist teacher Ticht Nhat Hahn wrote, “you see things as they truly are.”  His words were similar to those of the Dali Lama:  “The greater the level of calmness of our mind, the greater  our peace of mind, the greater our ability to enjoy a happy and joyful life.”

Last night I shared my word search with my husband.  “I keep returning to the sense or state of calm,” I said, then listing some of the synonyms I’d been exploring.

“Calm sounds like a good word,” he said.   Yes, I thought, but is it calm or is it stillness?  I went to bed last night with the words playing in my head.  “Breathing in, I calm body and mind,” Ticht Nhat Hahn said.  “Breathing out I smile.”

This morning, I returned to my list of words once more, finally settling on “calm” as my word for 2020.  Its synonyms include stillness, tranquility, and serenity.  I have typed it out and placed it it in a small two-inch frame that sits on my desk next to my computer, a daily reminder of  the peacefulness and quiet I want to incorporate more fully in my daily life–particularly on the heels of some very stressful months.  It is that calm, the quiet in heart and mind, that is so important, not only to my creative life, but to my life as a whole.  I am reminded of Wendell Berry’s wisdom, expressed in his book of poems, The Timbered Choir (1999)

…“Best of any song
is bird song
in the quiet, but first
you must have the quiet.” – p. 207

As we celebrate the passing of another year, I wish you a year of peacefulness, healing and new joys!  Happy New Year, 2020!

Writing Suggestion:

  • Do you practice the “one word” exercise for the year ahead? If so, why have you chosen the word you have for 2020?  Write about your process of choosing your single word.
  • If not, why not try defining your intention for the new year in the “one word” exercise. What one word can serve to guide your intentions for the year ahead? It may take more than a few attempts, but enjoy the process of finding that single word that crystallizes your hopes and intentions for 2020.
  • Once you have chosen your word, then write for 20 or 30 minutes and explore the “why” behind your word.
  • What meaning does it hold? What memories or images spring to mind?  I invite you to share your word choice and a few sentences about it in reply to this week’s blog.  Frame or post your word where you can see it on a daily basis.

The Way It Is

There’s a thread you follow. It goes among
things that change. But it doesn’t change.
People wonder about what you are pursuing.
You have to explain about the thread.
But it is hard for others to see.
While you hold it you can’t get lost.
Tragedies happen; people get hurt
or die; and you suffer and get old.
Nothing you do can stop time’s unfolding.
You don’t ever let go of the thread.

By William Stafford, from The Way It Is, 1998

December 19, 2019: Waking in Dark Mornings

I live in a place where the winter season can stretch well beyond the calendar date for spring’s arrival.  Wind, snow, and freezing cold have already forced us into parkas and snow boots, thick scarves wrapped around our necks and knitted toques pulled down over our ears.  It is not a time one relishes stepping outdoors to run errands or walk the dog.  The light has changed, as has the angle of the sun moving across the sky.  Days are shorter;  nights are longer, and darkness descends like a curtain in the late afternoon.   

In these winter mornings, I awaken to darkness.  An early riser, I tiptoe into the quiet and peacefulness, embracing the solitude as a time to write and reflect.  Despite the grayness of the winter months, I am often greeted by the sun rising above Lake Ontario in the distance, the dawn a palette of brilliant gold and rose hues painted across the far horizon, one of Nature’s most beautiful gifts before the sun disappears into a curtain of grey cloud.  I cherish these dark mornings, unlike my ancestors of long ago.  Darkness was not something they took comfort from.  As the days grew shorter as winter approached, they watched the sun sink lower into the sky, fearing it might completely disappear and force them into permanent darkness and unending cold.  You can almost feel their primitive fear of winter’s darkness,  in the first stanza of “Winter Solstice” by Jody Aliesan:

When you startle awake in the dark morning
heart pounding breathing fast
sitting bolt upright staring into
dark whirlpool black hole
feeling its suction…

Although the darkness of winter will continue for some time, this Saturday, December 21, marks the arrival of the winter solstice, the shortest day of the year in the Northern Hemisphere with the fewest hours of sunlight.  Winter solstice is a time our ancestors associated with death and rebirth. Even though winter continued for many weeks, the solstice was a time for celebration because it signaled the return of the sun and warmer seasons to come.  The winter Solstice was widely celebrated in many different cultures in the world.  In fact, anthropologists believe they may go back at least 30,000 years. Think of those at Stonehenge, where even today, people dress as the ancient Druids and pagans to celebrate the arrival of the winter solstice, or the “Yalda” festival celebration in Iran and other countries, the ancient Romans’ Saturnalia festival and the Scandinavian “Juul,” when Yule logs were burned to symbolize the returning sun and warmth.  Even our Christmas and Hanukkah celebrations have been influenced by the ancient rituals marking the winter solstice.  It is a time of the year important to many different cultures, as Timothy Steele acknowledges in his poem, “Toward the Winter Solstice:”

…Though a potpourri

Of Muslims, Christians, Buddhists, Jews, and Sikhs,

We all are conscious of the time of year;

We all enjoy its colorful displays

And keep some festival that mitigates

The dwindling warmth and compass of the days…

It’s comforting to look up from this roof

And feel that, while all changes, nothing’s lost,

To recollect that in antiquity

The winter solstice fell in Capricorn

And that, in the Orion Nebula,

From swirling gas, new stars are being born.

(From:  Toward the Winter Solstice, 2006)

The Solstice promises rebirth and offers a sense of hope even though I realize another year is ending.  Perhaps that “death” of the previous year is one of the things that spark so many memories of Decembers past and the people in them.   It is not only a time of celebration, but a time of remembering people past and present in our lives,  family traditions, and gratitude.  It’s a time to look toward our hopes for the year ahead.  For now though, I treasure the gifts I find in the beauty of winter’s darkness: a winter moon rising, the dawn of a winter’s morning, the solitude and time to reflect.  Just as my ancestors, I feel the promise of rebirth, which the Solstice signifies, also captured in Aliesan’s final lines:

already light is returning pairs of wings
lift softly off your eyelids one by one
each feathered edge clearer between you
and the pearl veil of day

you have nothing to do but live.

(From:  Grief Sweat, Broken Moon Press, 1990)

As winter solstice approaches this weekend, take time to remember nature’s cycle of life–birth, death and rebirth.  It is humankind’s cycle  too, and woven into our holiday celebrations.  It’s a cycle repeated in times of darkness or struggle, moving into light, from illness, loss, pain or suffering  into healing.  The symbolism of the winter solstice offers a rich metaphor to think about our cycle of life, health and illness, aging, loss and love, times when hope may have faded or we feared little but endless darkness.   Yet, somehow, there is always rebirth, and in that cycle, there is hope. You have nothing to do but live.  

Writing Suggestions:

  • Using the metaphor of the winter solstice, write about your own journey through of a kind of “death” and rebirth, a journey of darkness into light, or discovering a sense of life renewed.
  • Take Aliesan’s phrase, “You have nothing to do but live” and use it to trigger your writing.
  • Recall a memory of winter or the December holidays that stays with you.  Write its story.

I wish each of you the warmth and joy of the holiday season.

Sharon Bray

Heart Failure as Teacher

…two roads diverged in a wood, and I — 
I took the one less traveled by, 
And that has made all the difference.

(From “The Road Less Traveled,” by Robert Frost)

It’s a familiar poem, one you were likely introduced to it in a high school English class.  Frost’s portrayal of a traveler choosing a direction as he comes to the fork in a road is a metaphor for life. We make choices daily, between one thing and the other, weighing one possibility against the other, assessing the benefits, costs, and risks.  Sometimes, our hearts wage war with our minds, our dreams with reality; other times, old habits, patterns and drives learned in childhood play repeatedly, pushing us toward old ways of being, even when our hearts cry “no!”  Ultimately, we have choices, deciding on one course of action over another.   Whatever we decide, we live out our choices, and our lives are changed by the choices we make.  Call me a slow learner, but my heart is winning that persistent battle between old ways of being and the way that, now, I am trying to live. 

     How we spend our days is, of course, how we spend our lives. –Annie Dillard

Living with heart failure has made me more aware of mortality and the relative shortness of life.  “It’s not that we have a short time to live,” the Roman philosopher, Seneca wrote in his treatise, On The Shortness of Life, but that we waste a lot of it…life is long if you know how to use it.” 

Being a patient with heart failure has forced me to consider the “busyness” of the life I’ve led for the bulk of my adult years. Busyness driven by the need to achieve, something drummed into me early in life, and, when I don’t, feeling guilty or somehow inadequate.  It’s meant that for much of my life, as my husband and daughters would tell you, I have a very difficult time saying “no” to other’s requests for my participation in activities, initiatives, committees and the like, often pushing my desires aside to meet other obligations and living with more stress than is healthy.  It’s hardly a surprise that years of New Year’s resolutions to make more time for fun, relaxation, and even family, have rarely been successful for long.  Again, Seneca: “learning how to live takes a whole life.”  Perhaps I’m starting to understand what he meant. 

Some of my greatest teachers, as it turns out, are the cancer patients who join my expressive writing groups.  Week after week, they write, sharing their fears, questions, and lives through their stories and poetry.  They write with honesty and authentically.  Writing is the mechanism by which they release all the feelings–many of them conflicted–triggered by a diagnosis of cancer.  For some, they come to the group to write knowing they’ve been given a certain death sentence.   The suffering is real; the treatments often debilitating with surgeries that permanently alter their bodies. 

Two weeks ago, I led three workshop sessions for a group of young adults who had survived childhood cancer.  Survived, yes, but many who still bear the evidence of an aggressive and unforgiving illness, and who already are experiencing serious and long-term health issues from their disease and its treatment.  The clarity with which they write about the lives they intend to live–and are living–inspired and, at the same time, humbled me.  I came away grateful for their honesty, awed by their courage and determination to live life as fully–and meaningfully–as they can for however long they might live.

When I first returned to Toronto after several years living in California, I was eager to get involved in the work that I’ve found so meaningful, and Gilda’s Club welcomed me immediately.  But I was also inspired by discovering a vital and growing community for heart failure advocacy.  Besides, I have one very inspiring cardiologist in Dr. R., and when she asked if I wanted to be engaged, I said, “absolutely.” 

That’s still true, but it’s taken me the better part of a year and a half to define how I want to be engaged.  And that requires choices.  I slipped, all too easily, into old ways of being, saying “yes” to committee involvement, reading research like a graduate student, becoming a patient partner…and my life was, for a few months, dominated by heart failure.  That involvement had the effect of making me think more about it–not always in ways particularly beneficial to my fear of progression and my life ending sooner than I assumed.  In short, I was leaning toward depression, or at the very least, a case of the good old-fashioned blues. 

I began writing about it, and this blog was birthed.  But it’s been a challenge at times ( because of all the reasons I’ve written about in the past few months) as I’ve tried to figure out if what I write is helpful or interesting to other heart failure patients.  My “Writing Through Cancer” blog is, by comparison, relatively easy for me to write, but I have years of leading writing groups and hearing cancer patients’ stories as a source for inspiration. Perhaps my struggle in writing this blog has helped me gain clarity, although in ways I have yet to fully articulate, about how I want to live for however long that may be.  Maybe Seneca was right: it does take nearly a lifetime to learn how to live.

As I write this, I recall a poem I used many years ago in a class on writing and healing. Entitled “What Matters Then,” the poet asks the question of the reader and, beginning with a single gardenia on a branch, moves us to the essential, from bush to branch to the single flower.  It’s a winnowing down, something that resonates with me now as I am gaining the clarity to live each day engaged in what truly matters to me.

…What matters then?

A single gardenia broken

from the dark-leafed branch.

What matters then?

The dark leafed bush.

What matters then?

The gardenia.

–Margaret Robison, Red Creek, A Requiem

What matters to me?  That I live as fully as possible each day.  That I have time with my family, husband, daughters and grandchildren.  Especially the grandchildren; they are the best medicine of all for my heart.  That I give back–it’s why I continue to volunteer in leading writing groups for cancer patients and what motivated me to become a patient partner.  That I make time for art and creativity:  writing, poetry, reading, music, art.  That I stay as physically active as I can.  That I practice humility:  there are always new things to learn.  That I recognize and accept my limits.  And not unimportantly, that I practice gratitude as my daily mantra.

What has living with heart failure taught me?  I think it has taught me how to live.  And that’s something, isn’t it?

Waking up this morning, I smile.

Twenty-four brand new hours before me.

I vow to live fully in each moment

and look at all beings

with eyes of compassion.

            -Ticht Nhat Hahn, Buddhist teacher

Writing Suggestions:

  • What have you learned about yourself from heart failure?
  • How has your life changed–in ways that are positive?
  • How do you want to spend your days–to live your life?

August 25, 2019: What Do We Talk About When We Talk About the Heart?

“Are you still writing?” Dr. R. asked as my appointment was ending.  I had admitted, several weeks earlier, that I was struggling with writing this blog.

“Oh yes,” I said, “both blogs, but it’s much easier for me to write the Writing Through Cancer posts than it is for my heart failure site.”

She laughed a little and said, “I think it’s funny that you find it more difficult to write about heart failure.”

We spent a few minutes discussing why that might be so, and that led me to telling Dr. R. about the young woman I had met last weekend.  I was leading a series of expressive writing workshops for a three-day retreat with YACC (Young Adult Cancer Canada).  In my introduction on Day One, I had mentioned my cancer treatment of 20 years ago was believed to be a likely factor for my heart failure condition.  On the final day, the young woman approached me and quietly thanked me for telling them I live with heart failure.  She then said she had been diagnosed with heart failure after her chemotherapy treatment ended several months earlier.  No one, she said, talks about it, not even in her support group, and she experienced a sense of isolation, the same feelings I had when I was diagnosed–and the initial motivation for writing this blog.

Despite the “epidemic” proportions of heart failure, running neck and neck with deaths from cancer, I was surprised, after my diagnosis, of the lack of psychosocial support resources exist for heart failure patients, something I have written about before in this blog.  While I find no shortage of research studies on heart failure or cancer, there are real differences in the “other” literature:  poetry, stories or memoir available those affected by cancer vs. those living with heart failure.  The arts also play a greater part in the broader treatment of cancer, recognizing the healing benefits of the creative self-expression. Not so in heart failure.

“Heart patients don’t talk,” Dr. James Pennebaker commented in an email to me a couple of months ago.  I’d reached out to try to unearth some expressive writing research conducted with heart patients, but the results conducted with individuals vs. those writing together, and were largely concerned with autonomic responses, e.g. lowered blood pressure. He referred to an early study he and his associates conducted in 2000, “Who Talks?” appearing in the February issue of American Psychologist. They looked at different patient illness groups’ (e.g., AIDS, cancer, chronic fatigue, alcoholics, heart disease) use of online support groups.  They found breast cancer patients were among those with the highest use of online support groups, participating at 40 times the rates of all heart patients.  At the same time, the researchers noted additional research was needed on both internet-based support groups as well as the social context of illness.  One benefit of expressive writing groups is that they provide social support, and social support helps to decrease social isolation and depression that often accompanies serious illness.

Yet I cannot help but return to the metaphors we use to describe cancer and the heart.  The most common metaphor for cancer is as the “enemy” or the “invader,” which encourages the sense of battle, even fighting together to combat and destroy cancer.  Think of the many walks and 5 K runs to support cancer research where participants show up in teams and costumes and the sense of solidarity that results.  The heart, by comparison is no invader.  It is one of our vital organs, the engine, and the pump that keeps us living.  The very nature of how we describe and think about the heart may influence how we talk about it–or if we talk about it–with others when it is impaired or failing. 

Cancer patients do talk, and in the expressive writing groups I lead, they delve deeply into topics like fear, the altered body, anger, faith, meaning, loss, or mortality.  I remember when I was leading a writing group for medical students and physicians at Stanford Medical School and during the same period, an expressive writing group in the cancer center.  For several months, I found the medical group was more guarded, less willing to take a deep dive into those difficult life questions, while, from the beginning, the cancer patients wrote openly, poignantly, fearlessly and were more willing to share their words aloud.   

In part, what makes it “easier” for me to write a blog for those living with cancer is related to the willingness of those patients/survivors who write so courageously and deeply of the emotional, psychological and spiritual aspects of a life-threatening illness.  Their narratives and poetry, frequently shared aloud, are a key aspect of what continues to inspire my exploration of the shared themes defining diagnosis to recovery or death.  In a very real sense, the men and women who have written so honestly and bravely out of illness have been my greatest teachers.

The shared experiences, the stories that come from life–joys, sorrows, trauma, illness, loss– are at the heart of being human, how we connect with one another and build a sense of community.  I have found some sense of connection with other heart failure patients since returning to Canada, thanks to Jillian Code and The HeartLife Foundation, and the few heart failure committees where I’ve been “the patient voice.” Nevertheless, I still wrestle with how to dig deeper into that realm of what the “lived” experience of heart failure means:  those emotional, psychological and spiritual questions it ignites.  Maybe I am rolling that proverbial stone uphill, I confessed to Dr. R., but as one who grew up in  gold rush country in California, I still believe “there’s gold in them ‘thar’ hills.”  And I’m still digging for it.

What do we talk about when we talk about the heart?   I would like to hear what you think.

Writing Suggestions:

Writing can help you express those moments when fear, worry, sorrow or other strong emotions arise. 

  • Have you found a support group of other heart failure patients?  If so, describe how it helps you navigate the ups and downs of living with heart failure.
  • What are the questions or concerns you have since you’ve been diagnosed with heart failure?  Do you experience moments of fear?  Depression?  How do you deal with those feelings?  What helps?
  • Do you keep a journal?  Research has also shown that writing in a personal journal or notebook can help you sleep better, reduce fatigue and adjust emotionally and psychologically to illness and other hardships.  There are many different types of journaling.  There is no “wrong” way to journal.  If you decide to begin a writing practice, buy a journal that you’ll use only for the purposes of your    personal writing.  Here are some tips for getting started.
    • Gratitude journalingWrite down everything you’re grateful for. This focuses your attention on positive aspects of your life. A list of five things daily can help boost your mood and spirit.
    • Blog:  A blog is a website that you can easily update by writing short posts. Caring Bridge (www.caringbridge.org) is a health journaling site for posting one’s writing online specifically for those experiencing medical illnesses/conditions. 
    • Stream-of-consciousness writing: Write down everything that comes to your mind. This unstructured, unedited writing will reflect your raw thoughts and observations.
    • Art journaling:  Combine words with drawings, multimedia, doodles, a scrapbook, etc. to express what you are feeling and thinking.
    • Line-a-day  journaling: Limit yourself to a single line or sentence for the day.

As little as 15 – 20 minutes a day for 3 months can produce long lasting benefits to your physical and emotional health.  However, be aware that if you find yourself beginning to ruminate, that is, writing the same negative thoughts repeatedly, stop.  Rumination is not healthy and can make you feel depressed or anxious.  If journaling about experiences and emotions leaves you more upset than relieved, it’s wise to meet with a therapist or social worker to talk about what you’re feeling.  Your journal can be a tool to introduce what feelings, concerns or worries related to living with heart failure.

July 18, 2019: How Writing Helps Us Heal

(Preface:  I began this blog nearly one year ago, and, as the anniversary date approaches, I am looking over my posts and revisiting the motivation that initially prompted me to begin exploring the lived experience of heart failure.  I have always written, whether for myself or for publication.  It’s the way I make sense of life’s difficult chapters, the way in which I discover what I’m really feeling and why, something I have discovered to be healing and the reason why I lead writing groups for cancer patients.  My experiences and teaching prompted me to begin this blog and hope it might also inspire other heart failure patients to write from their experiences.  But have I managed to encourage others like you to write?  I don’t know.  So this month, I’ve changed the name of my blog to “Writing the Heart” and am re-visiting why writing and how can help us heal.)

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When the body breaks down, so does life.  Medicine may fix the body but it doesn’t put one’s life back together. — Arthur Frank, At the Will of the Body, 2002

            You’re lying in a hospital bed as the cardiologist enters the room.  He’s come to explain the results of the tests you’ve had since you collapsed while walking your dog, the reason you’ve been under observation for three days.  He is kind, with a gentle manner that calms you. Then he offers his diagnosis, his words strange and unreal.  “Heart Failure.”

” What?  You mean a heart attack?”  You recall that one of your uncles died of a massive heart attack in his fifties.

“No, heart failure…” and the cardiologist calmly explains that your heart, your pump and life-giving engine, isn’t working as well as it should.  He says something about dilated cardiomyopathy, atrial fibrillation and ventricular tachycardia, unfamiliar terms you’ll ask him to repeat and even then, look up again later. You’re hovering somewhere between the real and the unreal, feeling as if the universe is playing a terrible joke on you.  Your heart.  Failing?  How can it be failing?  You’re thrust into a whirlwind of disbelief and confusion, and, like Dorothy in the Wizard of Oz, feel as if you’ve been dropped into some strange new territory where nothing makes sense.

You’ve just become a heart failure patient.

The doctor speaks again, detailing the specifics of your diagnosis.  He says something about an implanted cardiac device, a defibrillator.  A what?  He may as well be speaking a foreign language.  You listen without really hearing as your world begins to spin out of control.  What you feel is fear — and lots of it.  However, your feelings are not unique.  Any serious or life threatening illness reaches far beyond the physical.  It affects every aspect of your being, including your mind, emotions and spirit.  There’s no cure for heart failure, and most of us are not heart transplant candidates.  ICDs, medicines, even surgeries, can help manage the condition for some time, yet we all must come to terms with what it means for our lives, how we can live for as long and as fully as we can and how we adjust to an altered physical self and navigate the emotions that accompany heart failure.

It’s why I write.

I write about illness to work out some terms in which it can be accepted…experiencing it fully, then letting go and moving on.  — Arthur Frank, sociologist, writing about his heart attack and prostate cancer, At the Will of the Body, 2002)

I’ve written since I was a young girl, sorting through the emotional ups and downs of my teenage years, and later, as I matured,  through young love and broken hearts. Then, thirty years ago, my husband drowned, and my life changed overnight.  I turned to what had always been my lifeline in times of change and struggle:  writing.  Several years later, I was told I had cancer, and writing was my refuge, a way to safely express my turbulent emotions, translate them into words and make sense of them.

Give sorrow words,” Shakespeare wrote in Macbeth. “the grief that does not speak/whispers o’er the fraught heart and bids it break (Act 4, Scene 3).  I was experiencing what poets and novelists alike had long acknowledged. Writing helps us make sense of trauma, illness and loss.  Then, over two decades ago, psychologists began to study the effects of writing on health in earnest.  As psychologists James Pennebaker and Joshua Smyth described, expressing difficult emotions on paper and getting them outside the body, had measurable health benefits (Opening Up by Writing It Down, 2016).

Writing…about traumatic experience …can produce measurable changes in physical and mental health, … can also affect people’s sleep habits, work efficiency and how they connect with others.  –Dr. James W. Pennebaker, PhD, University of Texas

The psychologists gave this kind of writing a name:  Expressive writing, defined as personal writing about a difficult or stressful event without attention to form, grammar or spelling.  It’s a process of pouring out one’s emotions and thoughts on the page,  less about what happened and more about what you feel about what has happened.  Now, over 400 studies on the effects of expressive writing have been studied with many different populations, demonstrating its various health benefits such as lessened anxiety, improved quality of sleep, lowered heart rate and blood pressure, and strengthened antibody responses.

But writing does even more for us.  It helps us deal with strong or difficult emotions, express and describe stressful and traumatic events, and organize thoughts and feelings.  Writing is about meaning making.  It helps us with understanding and self-awareness.  Writing can help connect us to others.

How?  As his research continued, Pennebaker discovered that the most healing kind of writing did more than simply express difficult feelings, something novelist Anais Nin had noted many years earlier.  “When we see our suffering as story,” she wrote, “we are saved.”  Simply venting emotions doesn’t do enough to relieve stress and improve health.  But when you make connections between what you feel and why, your writing begins to take on shape and form.  It becomes a coherent narrative– a story– and that’s the kind of writing that Pennebaker and his colleagues found is the most healing.  Stories are the way we communicate with one another, and they are the currency in medicine shared between doctor and patient.

In the telling of our personal lives, we’re reminded of our basic, human qualities—our vulnerabilities and strengths, foolishness and wisdom, who we are…, through the exchange  of stories, we help heal each other’s spirits.           — Patrice Vecchione, Writing and the Spiritual Life (2001)

The power of writing to heal is something I witness repeatedly in the writing groups I lead for cancer patients.  In the few weeks together,  participants move from the raw, emotional writing typical of the first meeting, and gradually, begin to write stories into stories, poetry, or personal narratives that express and explore their illness and lives.  Invariably, they move the writer to new understanding, insight or meaning.  Their shared stories also build connection and community between people, helping to overcome the loneliness and isolation often created by a serious illness.

Writing is healing, in part, because it is transformative.  As your stories change, so does your life. You gain new insights and perspective, not only in how you see your life, but the way in which you act on it too.  That’s the power in writing to heal.  A pen and a notebook are all you need.  What matters most is that you write, freely and honestly without worrying whether or not it’s “good enough.”  It’s your story, and as author Dorothy Allison so beautifully reminded her readers, “I am the only one who can tell my story and say what it means.”

Why not explore writing’s power to help you heal?

Writing Suggestions:

  1. Two Prompts Get You Started:
  • The moment whenThink about the very first moment you were told you had cancer. Close your eyes and try to remember as many details as you can, for example, the setting, quality of light, things in the room, sounds, where you sat, and so on.  Then think about that moment just before you heard the word “cancer.”  The look on your doctor’s face, his/her body posture, or the ringing of the telephone.  What were you feeling?  Now write for 15 minutes, taking yourself into that moment gradually by describing as much detail as you can.
  • Write a letter to your heart. Once during every series of workshops, I ask the participants to address their illness directly.  It takes the form of a letter, one in which you say what you feel about your illness directly to your heart.  Here’s an excerpt from a “letter to cancer” written by a former cancer writing workshop member:

Cancer:  You entered my life without my permission. You tried to turn my body against me, leaving pain and uncertainty in your wake… Because of you I wondered if I would see my children grow up… You made me feel like less of a woman …You took my hair and scarred my body. You made me cringe at my own reflection in the mirror… (former writing group member)

  1. Beginning to Write
  • First, get comfortable in a quiet place.
  • Keep your writing in a spiral bound notebook (or file on your laptop) so you can, from time to time, re-read old entries and reflect on your changes.
  • Set the timer for 15 minutes, and write about anything, but do it without stopping. Don’t worry about spelling, punctuation or grammar.  Just write.
  • When the timer goes off, read what you’ve written, then put it aside for a day or two.
  • Then re-read. Highlight those passages that stand out for you.  Why?  If you feel like it, you can expand on what you’ve written or even revise your first attempt, but that’s optional.
  • Find a time two or three times a week when you are able to write without interruption. It doesn’t have to be much.  Set a timer for 10 or 15 minutes and begin with anything, even “I don’t have anything to write this morning…” but keep the pen moving until the timer stops.  You will gradually write your way into what’s important.  Try making writing a part of your healing.

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Are you interested in sharing some of your writing with other heart failure patients?  I’m adding a new page to this site, “Voices of Heart Failure,” to create an opportunity for heart failure patients to share some of their writing with others.  If you’re interested, you can contact me by clicking HERE, and I’ll respond with specific information about submitting, getting permission to publish, and details about the kind of writing to be featured.– I look forward to hearing from you.– Sharon