Falling Back Asleep: Nighttime Relief

As calm as I may be during the waking hours, nightfall poses a unique challenge. How many of us have struggled in the darkness, surrounded by those scary thoughts that we thought we had dealt with during the day?

The darkness seems to make us more vulnerable to flying thought-gremlins. They creep in at night when our brains can’t reason them away. I’ve fought those little buggers for much of my life and they’ve been responsible for many hours of lost sleep. It wasn’t until I got serious about meditation that I developed means of protecting myself against them.

These are my best recommendations for returning to dreamland:

Drop into your bed. After waking to Dementor-esque anxieties circling you, realize that they’re flying, ephemeral creatures. And if you’re up there with them, it’s time to come back to Earth and settle into your bed. That is where you really are and you are safe. Focus on how it feels to have your body contact the bed, how the bedclothes feel against your skin. Rustle the sheets and listen to the sound. Take three deep breaths and listen to the exhales. You’re not “up there” with the swirling thoughts. You’re down here where it’s calm.

At times when there’s too much noise in my head, I will put a soothing voice in there from a meditation app like Calm, Plum Village or Insight Timer. Sometimes a guided meditation is enough to quiet the negative clamor.

Practicing stress release during the day will make it easier to do the same at night.

To support nighttime attempts at falling asleep, establish a sense of calm during the day. Practice being present — as opposed to chasing thoughts down rabbit holes. Pay attention to your reaction to various stimuli. Take conscious breaths, meditate, and use whatever tools work for you.

For instance, I have associated certain images with a calm state and I use them as anchors during the day (e.g., setting up a safe space). I have them pinned up by my bed and at work so that as I work to release stress I look at them, and as I look at them I release stress. The more I do this, the more powerful the association. I draw upon those images and feelings at times when things seem out of control. Practice during the day and you will have more peace at night.

Appreciate the nighttime wakening. Odd as it may seem, this can be a positive opportunity. Each such interruption allows you the chance to ground yourself and learn how to gently drop off to sleep. Stressing about being awake does you no favors and only adds to your wakefulness.

This doesn’t mean that there aren’t bad or frightening things actually happening in your life — sometimes there are and they can be very serious. I struggled with this when I got my cancer diagnosis. But at that moment in the middle of the night, lying in your bed, you have a temporary reprieve. Your only responsibility then and there is to go back to sleep. There’s nothing on fire.

Unless there really IS a fire, in which case, RUN. But most of the time, it’s just our fiery thoughts. And we can learn to douse those flames.

This will take practice – it’s not a one-time pill. But once you have done this enough times, you’ll find that not only is the relief wonderful, so is the knowledge that you are capable of determining how you react to things. That provides a satisfying sense of strength and a peaceful sense of control over what may seem like an out-of-control situation.

“Dropping Down”: A Meditation Analogy

One of my greatest obstacles to meditation is distraction. I’m particularly susceptible to having my mind wander off because of the drug tamoxifen that I’m taking for breast cancer, the side effects of which include difficulty with concentration and focus.

A wandering mind, however, is not limited to those with cancer medication side effects. If you meditate, you’re pretty much guaranteed to struggle with focus at some point. I use the analogy of a cave to describe what this feels like and how to deal with it.

I sit in a darkened cave, warm and comforting, the only light coming from a hole far up above, where the noisy world buzzes. There’s nothing wrong with that, but right now is the time to devote to my meditation cushion. I focus on my breath. As I sit, a thought emerges and I notice a rope hanging down from above. Before I realize it, I’ve grabbed hold of it and start climbing.

These thought-ropes are so tempting to grab onto, pulling us up and away from the meditation cushion.

The further I climb, the easier it is and the louder the world gets. My surroundings brighten, but I’m no longer meditating. I’m actively engaged in what’s going on up above, perhaps agitated, perhaps excited. I’ve lost track of my breath.

“Drop down,” I tell myself gently. And I slide down the rope, into the welcoming darkness below, until I find my place back on my cushion in this womb of Earth. One deep breath and I’m grounded again, calm and rooted.

I can’t stop what’s going on in the world above, but I can choose whether or not to climb a rope.

This experience repeats itself, like a flowing dance between the meditative breath and wandering attention. Another thought catches me and I reach for its rope, making my way back up swiftly.

“Drop down,” I tell myself again patiently. I let go and return to my place in the cave, surrounded by the supportive darkness. Another deep breath and I’m calm again.

So many thoughts, so many tempting opportunities to climb out of my cave too soon. Some days, I swing from rope to rope, only hovering over my cushion, never quite managing to ground myself. On other days, it’s easier and the path to a peaceful meditation session is straightforward. The darkness of the cave soothes me and reminds me that I am safe, and that I can choose whether or not to cling to a thought.

My distraction is a constant, but that doesn’t matter as long as I can drop back down. And I can always drop back down.

Making Peace with Street Noise

Is it possible to re-imagine annoying city noises?

At the least, living in an urban area with a high level of noise pollution is annoying. At worst, being subjected to car alarms and emergency vehicle sirens at any time of the day and night is very jarring and stressful. And I’m speaking from personal experience here, as following our last move, we ended up with a bedroom overlooking a very busy Southern California street.

The stretch of road outside our apartment unit is one of those that give cars enough distance between traffic lights to really accelerate as they blast by. It also leads to one of the major hospitals in the area (hello, ambulance traffic), and this being a big city with big city issues, there’s no shortage of opportunities for the police to be called out, sirens blaring.

There are many days that I wish I weren’t where I am. But wishing doesn’t change anything.

Drawing on mindfulness helps, however, and this is how:

Re-interpreting noise as different sound elements turns an “idiot street racer” into a thunder-like rumble. Much less annoying.

Much of the stress I experience from these various car noises is due in part because I know what they mean. I know that the sounds are the constant stream of cars going down the street or a high-pitched siren wail. But what if I were to accept that I’m living in a noisy city and to define the street noises as simply various sounds?

What if I were to break down the sounds into their characteristics? Would it be easier to handle the noise if I stopped judging and explored each sound as if I were hearing it for the first time?

This is far more doable than one might imagine. Yes, alarms and loud tail pipes are decidedly unpleasant, but they don’t punctuate my soundscape nearly as frequently as do the regular cars driving by. The cars speed through with whooshes of different pitches depending on the vehicle and how quickly it passes.

Sounds of passing cars transform into soothing waves – with the occasional jarring reminder that things are not entirely pleasant.

These sounds rise up and pass away like waves on the ocean – in fact, that whoosh can be soothing, just like the sounds of the ocean can lull you to sleep. Even noisier cars and motorcycles take on a rumbling quality, like thunder. Allowing oneself to re-interpret these sounds, to let go of annoyance, makes even the more jarring noises easier to handle.

When you can’t run away from the noise, make space for it, invite it in and accept that this is what’s happening now. Inevitably, it will pass, to be replaced by another noise and another opportunity to re-imagine it.

Sanctuary: Creating A Safe Space

There have been times when things in my life have gotten intense and I feel the walls closing in on me (cancer, I’m looking at you). Those are the times that I need to back off and give myself space to breathe. Being a very visual person, one of the methods I’ve employed is finding an image and associating a calm mind with it.

This becomes my safe space. Whether you prefer to call it your “calm space”, “sacred space” or even the oft-ridiculed “happy place”, the idea is the same. Find the visual elements that you find soothing and comforting — perhaps a place in nature, a place from your past where you felt safe, even a fantasy land that you create for the purpose. Real, imaginary, familiar or visited only in your mind, it doesn’t matter. What matters is that it resonates with you.

When I did this most recently, in the preparatory phase for Eye Movement Desensitization and Reprocessing (EMDR) therapy sessions to help with anxiety that I’d never been able to shake, I made a new Pinterest account to collect images.

I highly recommend this for anyone going through stressful times. We all need a buffer between ourselves and this hectic, unpredictable life, and this is one way to do that. Collecting and pinning these images is relaxing in itself!

I have always been drawn to natural settings with lots of greenery, so I searched for elements such as gardens, greenhouses, water, hanging vines, flowers and fish. This is a place created exclusively for me.

As if from another time, this space offers vines, a beautiful pool, elegant architecture and the feeling of a hideaway. https://www.pinterest.com/pin/701998660650066569/

It is is easy to find many images that capture the feeling I’m after: a sense of closeness and security in a place of natural beauty, where I can be alone (unless I chose to let someone else in), a space impenetrable from the outside.

There’s nothing quite like watching koi to bring peace to your day: https://www.pinterest.com/pin/701998660650161590/

The sound of running water is luxuriously soothing, and the vibrant color of koi brightens everything. The above image may have been at the side of a house, but in my mind, it could be a hidden corner that only I can access.

A beautiful path, lined with flowers, that gives the feeling of being tucked away in an elegant and exclusive setting. https://www.pinterest.com/pin/701998660650067012/

Not all spaces have to be confined, as this vine-covered path above illustrates. It provides room to wander and breathe deeply while still feeling secluded.

This could be the magical entrance to your fantasy space: https://www.pinterest.com/pin/701998660650254229/

Your calm space can be made up of different images that show different elements of it. Each space needs a portal through which you enter, so why not make it magical?

It might be enough to have a safe area from which you can look out onto the world, but still feel secure in a colorful, fragrant setting: https://www.pinterest.com/pin/701998660650066950/

Once I had gathered a variety of images that evoked the feeling of grounding and peace that I sought, it was time to name it: one word (or phrase) that enables me to conjure up my calm space. I settled on Halcyon, but realized later that it didn’t give me what I needed (I’m picky about words and their meanings). Then I came up with Elysium, as it suggested an other-worldly place in the heavens.

I thought that name fit perfectly. Except that as we continued in the preparation phase for EMDR, I had a hard time maintaining focus on one particular image. I had chosen so many! So I thought about what I really needed.

It was breathing space. A place to pause when things come at me too quickly. Ironically, after pinning so many glorious images on Pinterest, I returned to a photo that has served as the background for my two monitors at work. When I arrive in the morning and log in, this image grounds me and I find myself taking a very deep breath, like a sigh:

THIS is my sanctuary.

This image speaks to me. It combines nature with a sense of spaciousness, yet feels secluded enough to impart a feeling of security. And my name for it? Sanctuary. So simple and to the point, and yet encompassing so many different emotions and meanings for me.

The next step has been feeling into the sensations that this calm space evokes. What does that feel like in my body? And then holding onto that feeling, saying the name, imagining the setting. You can “charge” the image with meaning in this way ( à la Pavlov).

The associations that are formed in the process create a sense of calm that I can draw upon to center and ground myself during periods of high stress. It’s not a pill to end all woes, but it can be a powerful tool for dropping yourself down into a more peaceful state. I encourage you to give it a try.

Letting Go, Painfully

I try to avoid “stream-of-consciousness”posts, but occasionally I’ll let one through. This one stings a bit…

I am tired. Physical fatigue is easy for me; getting emotionally wrung out is exhausting.

Events that have taken place over the past several years have demanded a release of expectations, a relinquishing of normality, how I think life “should” be.

Cancer was the big one. I used to wake in the morning, hoping that my diagnosis had been a bad dream. That I could laugh and shake my head, thinking, “Phew! Glad THAT wasn’t real!” And then go about my day, forgetting the fear and immersing myself in blissfully boring everyday life.

But that’s not what happened. I would wake in the pre-dawn hours after sleep had left me to the darkness, coldness spreading through my belly as I remembered that I had cancer. And in the midst of the fear of dying was that wrenching feeling of having to let go of wanting things to be different. Still desperately holding on when it was too late to do so.

Attachment leads to suffering. I know this, but I cling nonetheless, stubbornly refusing to accept change.

I was given a bit of news several days ago, too disorienting for me to even define in this post. Like cancer, it caught me off guard, and I cling to wanting things to be different. To be “normal” and uninteresting. I’m compelled by my need to fix it, make it comfortable and easy to accept.

I need to get.a.grip…

Yet another thing I wish I could control. But I can only paw at it from the outside.

Now I’m engaging in emotional calisthenics, to try to find a notch on this slick surface that I can stick my finger into and get some sort of grip.

I wish this wasn’t the case. I’m disappointed that I feel the way I do. I tell myself, I should be more tolerant of what happens. But it’s the hope that things will stay the same that makes change so difficult.

I twist my thoughts into origami, trying to find a comfortable shape. It takes a lot of massaging to smooth out the edges and make this morsel easier to swallow. Every time I mull it over, it cuts me again.

At some point it is no longer the matter itself that causes pain. It’s all the emotion layered on top of it.

So I’m tired. Letting go, yes, but so slowly. You’d think that it would get easier with practice but even the process hurts.

Of course, holding on hurts more.

Two Assumptions I Wish Doctors Didn’t Make About Cancer

Cancer can turn you into a stress-ball on its own, thankyouverymuch, but there are things that healthcare workers do that may worsen matters.

While there is always room for improvement in the many subtleties of physician-patient interactions (with subtleties being the operative term here, as anxious patients may be zeroing in on the “feel” of interactions and not just the spoken words), there are two big assumptions that I wish doctors would realize that they’re making:

Eat your vegetables and you won’t get cancer? I wish it were that simple.

The first assumption I’ve experienced has been made by non-oncologist physicians. They seem to be just as likely as the rest of the population to confuse correlations with causations. One doctor had been surprised that I had gotten cancer (hey, join the club) because my lifestyle “should” have been protective.

This physician, you could argue, was justified in saying what he did, as the messages we are bombarded with suggest that we have some control over our risk for cancer. However, read the fine print and you’ll see that in a great number of cases the risk factors that a cancer patient has don’t differ from those of someone who doesn’t develop cancer. But even doctors miss the fine print…

I brought this up to my oncology team which was quick to point out that as long as we don’t definitively know what causes cancer, we can’t make assumptions about whether or not someone will get the disease. So, yeah.

The other major assumption is one that I’ve gotten from the oncological community, and that is that on some level, most patients with a given cancer have the same health profile. Ironically, this concept is often mixed in with the conflicting assertion that everyone’s cancer experience is different. Granted, when you’ve seen a gazillion cancer patients, similarities emerge, and consciously or not there’s probably a tendency to pigeonhole people. Still it’s frustrating to be treated like I fit into a slot when I really don’t.

Effective communication is a critical part of quality physician-patient interactions.

My own oncologist has realized that, thankfully, but he has done a good job of listening and I do a (*cough cough*) good job of talking. Perhaps a bit too good, since he’s mentioned that it would be best if I scheduled my appointment to be his last of the day, so that we don’t face as many time restrictions. But therein lies my point: oncologists need to ask and patients need to share, otherwise, the patient remains a two-dimensional entity and it’s more likely that assumptions will be made about them.

So if there’s a take-home message from any of this, it’s that good communication is an essential part of effective treatment. This is not an easy feat, as physicians have a limited amount of time with each patient, and patients might not think that a given aspect of their experience is relevant. Believe me, it is, and the more that we talk about this and get into the nitty gritty of it, the easier it will be for everyone involved.

How Mindfulness Helps with Exercise Motivation

Exercise has been an integral and indispensable part of my cancer recovery and my life as a whole. I’ve maintained a personal trainer certification (ACSM-CPT) for over a decade and even though I don’t train professionally, I keep abreast of new research and love a challenging workout.

Still, there are days that even I find myself dreading the session I have planned. For those times, I engage in mental calisthenics and rely on a mindful attitude. If you’re struggling to find motivation to exercise, this may help you too.

Note, motivation is something you generate yourself. It is inside you, but you have to coax it out. Be gentle. Hiring a personal trainer to beat you with a stick when you’re not up to a workout is not going to make you look forward to exercising more. But the following concepts might help:

Consider that a workout is made up of a series of movements.

Stop looking at a workout as a massive monolithic thing. Doing so can be overwhelming and make it more likely that you’ll talk yourself out of it before you even begin. Instead, consider that it’s made up of distinct parts, steps that you take one at a time.

Stay in the moment and keep each movement fresh.

Stay present and focus on the part of the movement that you’re doing at the moment, truly feeling into it. If you’re on a rowing machine, concentrate on each individual stroke making sure that you’re using proper form as you reach, push with your legs, and pull the handle. If you’re lifting weights, focus on where your body is in space, on contracting the muscle as you lift, on exhaling as you do so, keeping your body properly aligned. If your exercise is a brisk walk, be aware of how you’re stepping, pushing forward, swinging your arms. These movements become a meditation in and of themselves.

What matters is the here and now.

Release thoughts of how much longer you have until you’re done. Focus on the stroke, step or rep that you’re taking at this very moment. And then when you’ve completed it, consider the next movement with the same fresh attitude. Just as you would if you were focusing on each breath during meditation.

If you can’t finish your workout, that okay. You can try again tomorrow.

Practice self-care.

Do not force yourself to finish an entire workout if you *really* don’t have the energy to–but that means truly listening to your body’s limitations, not discouraging voices in your head. You are better off making a concerted effort at doing, say, half your distance or only one set per weight lifting exercise and doing it well, instead of making yourself so miserable that you don’t exercise again for another week and a half.

If you’re thinking, “I’m not up to doing the entire workout”, ask yourself, “Well, how much can I do?” and at least start. Consistency is key.

Let go of expectations.

Release preconceived notions of how your workout will go and how tired, miserable or sore you’ve already decided that you will feel. Look at each movement with fresh eyes. Employ a beginner’s mind. Get curious about how everything feels.

While it’s true that you’re exercising your body, your mind has a lot of influence on what will happen. The kind of exercise session you have is up to you. Decide to use your best form, draw on as much energy as you have in the moment, and exercise as much as you have planned. And if you cannot go as long you anticipated and have to stop earlier, let that be okay. No matter how much exercise you do, you are still better off than having done nothing. No one can take that accomplishment away from you.

And tomorrow, experience it anew again.