Balancing on sand
Applying physical lessons to mental health in coping with chronic illness
There are people whose physical challenges are the worst part of their chronic illnesses. I think of those who aren’t lucky enough to get CPR immediately after going into sudden cardiac arrest. Their brush with death may lead to lasting brain dysfunction and complications with other organs. There are also those who live in constant pain. In the months of 2022 when I struggled with chronic migraine, my sole problem was the pain itself. Whatever caused it (and we’ll never know), everything in me was focused on escaping the oppressive assault.
With other types of chronic illness, the worst part can be emotional. Not knowing if today will be a good day or a bad day. Not knowing if we should sign up for events and activities. Not knowing if we’re ready to commit to working again. Not knowing whether we’re still enough.
For a lot of last year, “Trying” by Porridge Radio was my theme song:
And what if I never get it right?
What if I don't come back to life?
It’s hard to explain what I was so upset about, having beat all the odds and survived to write about my experience. I could function or at least semi-function reliably since leaving the ICU. Heck, I was working full-time the first six months after my cardiac arrest, and I didn’t embarrass myself professionally or get fired, even at the lowest point of my existence. But I knew I wasn’t coping, and I dearly missed who I used to be. I wasn’t ready to accept the stifling parameters of my new life. Every day was fearful and every physical challenge was a fight.
Contrast that downtrodden mentality to the three-legged dog I saw on the Luray Greenway the other day. This furry little beast was hop-skipping and half jumping through the grass, as happy as any four-legged canine. His gait was wonky, but he could get around just fine. He could sniff the grass. He was outside in the warm air with his owner, and he was glad. This dog exuded contentment. It actually brought tears to my eyes to realize that he didn’t worry about whether he was enough. His freedom in the face of disability would have felt like a foreign concept, not long ago. This, I thought, is the best definition of health: to accept your physical reality, do what you can do and let go of what you can’t, focusing outside of yourself on the beauties of the day.
I have moments when I’m a similar picture of health. During a week at the beach with my husband—eating fish every day, walking for miles along the shore, watching deer and dolphins, doing yoga—I was as carefree as that three-legged dog, someone who’d been through a lot but who no longer misses anything. My muscles stretch far enough around my subcutaneous defibrillator (S-ICD) so that I can lay on my left side in bed at night. My heart can beat hard enough for me to play pickleball. A recent five-day holter monitor showed a drop in PVC burden and no serious rhythm problems, even on minimal doses of my beta blocker and MRA. I can have a glass of wine with dinner and suffer no alarming consequences.
Still…what happened did happen. I am prone to migraine and seizures, so I can’t just live like the average American and expect to make it very long. I can’t dive into a super stressful job with lots of overtime and travel. I can’t watch Netflix all day and eat McDonalds. I can’t take driving a car for granted. But at least it doesn’t feel like a burden anymore to take basic care of myself. I’m in a nice rhythm with my physical health.
I can’t credit this gradual change in mindset to meditation or talk therapy. As important as talk therapy is for so many things humans face, I was surprised how little it helped in the aftermath of my cardiac event. Meditation helps me in many ways, but lonely stillness can also make depression and PTSD symptoms worse in the immediate term. Sometimes, fixing a mental block isn’t best accomplished using only the mind.
Mental/emotional wellbeing can also, it seems, be accomplished through physical means. Take EMDR therapy, for example. Using the lateral eye movements and tapping of EMDR can drastically improve PTSD outcomes. This was discovered by a psychologist who happened to be moving her eyes while thinking about a personal trauma and noticed a decrease in negative thoughts afterwards. How weird is that?!
My body went through something my brain can’t remember; but I still went through it. All of me. So simple physical habits, performed daily, have tremendous power. The marching of time, marked by the turnover of billions of cells and the formation of new neural pathways, helps further. Down dog by down dog and lunch salad by lunch salad, my physical health improves and I start to notice that things won’t always hurt. That things aren’t only scary. My mind and heart soften to the world.
I still suffer the dips and dark corners of my hyper-present mortality. I still get overly frustrated by a bad palpitation or long-lasting headache. It’s just that I also stumble on more glimmers.
Glimmers refer to small moments when our biology is in a place of connection or regulation, which cues our nervous system to feel safe or calm.
I strode into midlife believing that I was supposed to aim for happiness. I wasn’t sure whether happiness was an end goal or how I was supposed to feel along the journey, but I believed that it was the point. Well, I hope it isn’t. I never reached any kind of permanent, stable happy place. In early days after my cardiac arrest, I wondered if I was supposed to become happier in this second life. I would experience a passing glimmer, recognizing how good the sun feels on my skin or appreciating the new growth on a plant in my garden. I’d feel great for a few hours, and then have an argument with my husband or receive bad news in an email or get a small injury. Glimmer over. Trigger activated. The roller coaster continues.
A life built chasing an emotional state (any emotional state) is a life built on sand. The emotions shift and pile up and wash away. Luckily, my brain is armed with the physical work I’ve put into just this problem—balancing on one foot. In the pose shown above, uthitha hasta padangustasana, the key is to first stabilize the standing leg. One must wait to stretch out the uplifted leg until the standing leg is firm, still, and straight. But what if your standing foot is not on a quality mat on the hard floor of a yoga studio, but sinking into the sand on a beach? And the sand, by the way, is not flat but on a slight incline. It’s damp and sticky, clinging to the towel, your hands, and your ankles with every vinyasa. You see a passerby approaching out of the corner of your eye. The breeze picks up.
This instability is why I like practicing yoga out in the world, such as in my back garden with the bugs; on the porch in a summer thunderstorm; or on a sandy beach. In a sense, I’m practicing yoga all the time. The goal is always and everywhere to balance. My entire infrastructure must work together to keep me upright, tensing and easing in just the right ways at just the right times, remembering that I am mostly water and air, blending into the elements around me until they effortlessly support my stance.
This work used to be purely physical. The payoff, though, has been largely emotional. Modern American culture often treats happiness like something we control and have a responsibility to pursue. A favorite song lyric from “Stay Loose” by Belle & Sebastian goes, “happiness is not for keeping, happiness is not my goal.” I now believe that “the passing pleasure of happiness is secondary to living a good life” (BBC.com, Why Our Pursuit of Happiness May Be Flawed) and not a goal unto itself. A good life consists of calmly balancing on sand. Glimmers and triggers come and go, and those in balance have an inner sense of purpose that spans these emotions. It’s that inner sense of purpose that gets us up in the morning to practice, to build habits that feel good for our bodies, and that drives us to do the boring repetitions that build strength and stamina.
It’s taken a while to be able to say this and I often thought I never would, but I’m actually in better physical health than ever before. I’m not sure how much of that is physical recovery (due to a mixture of lucky circumstances, good genes, and hard work) and how much is my newfound comfort with the fact that nothing lasts, that nothing is stable. I focus on doing the right things, following my internal compass…and just let the rest happen. I am increasingly tolerant of the constant mini-adjustments and mild discomforts of holding these poses in real life. I wouldn’t say it’s easy, but it does seem like the task I’ve been given. In between the glimmers and triggers, a subtle satisfaction grows in my ability to rise to this task.