Facing the Catastrophe

I finished reading Jon Kabat-Zinn's book on stress reduction. Now I have to face the catastrophe of actually writing my dissertation, since I'm done with my self-selected reading list. I wonder whether to go about this by returning to the beginning and summarizing the first book I read, The Worst of Evils (a history of pain relief) or start by summarizing the treatment (Kabat-Zinn's book). It's a lot less scary writing here than opening up a Word document, so I'll start, in the spirit of things, with where I am now.

Kabat-Zinn outlines in his book an 8-week stress reduction class that he taught at Massachusets General Hospital over a period of many years. The first two weeks are devoted to a meditation he developed, called the 'body scan', during which patients notice and feel the sensations in all the parts of their bodies, literally from toe to head, while lying supine on a mat. In the next two weeks, they learn to breathe while doing yoga stretches. The next weeks include sitting meditation, sometimes with a focus on an image of a mountain, or on lovingkindness, or simply breathing. He included guidelines for walking meditation. During the final two weeks of the course, patients practice on their own, first without and then with Kabat-Zinn's meditation tapes. The book is studded with vignettes of patients' miraculous recoveries from pain, or at least regaining control over their lives or learning a new sense of dignity in the face of adversity. Following the chapters describing the different techniques are Kabat-Zinn's views on stress, meditation, mindfulness - all presented in a straightforward manner easily used with a general audience. What impressed me the most was the high rate of continuation with the practice, about 90% of people who attended the course were still practicing 6 months later, 42% 3 years later and 30% 4 years later. I heard from a professional who attended the course that Kabat-Zinn has a profoundly empathic style and a talent for relating personally to each of the students in the class. He must also be very charismatic, to have achieved such a high practice rate at followup, since meditation is hard to practice regularly on one's own. Reading the book makes me want to start a class like that, I think my patients would have a lot to learn from it.

On a more philosophical note, I am not sure about some of Kabat-Zinn's views. He says that we are not our pain, we are not our thoughts - but if so what are we? A disembodied intention, a stream of awareness, a renegade shard of some greater unity? My own view is that I am part of a larger tapestry, but at the same time 'I' am a discrete part of it with ends (birth and death) bound to my body by the reality of my pain, filled with thoughts and feelings that as much as they are shared with others within the cultural milieu are also a defining part of who I am. This doesn't matter so much except that instructions such as 'being in the pain' have to be explained a lot more clearly to someone who believes that there is somewhere else to go.

So this afternoon, instead of facing the catastrophe and beginning to write, instead of resting my knee so that it will heal faster, I went on a lovely leisurely stroll with my friend, up on the Berkeley Fire Trail. This trail was described by Dorothy Wall in her book, Encounters with the Invisible, about her struggle with Chronic Fatigue Syndrome. In fact, it was where she first met her husband, before the disease overcame her and when she was still able to jog. I felt sad that I couldn't run on the trail, where I have ran many times before. On the other hand, I enjoyed walking hand in hand with my friend, whereas when we run he always runs ahead.