Self Care for Activists

Letter to young activists, on self-care and emotional resilience

Posted Aug 17, 2016

Pixabay
Source: Pixabay

Adapted from a talk to community organizing interns about self-care and emotional resilience on August 8th.  This is a long-ish essay (about 5000 words, or 10 single spaced pages).  I hope it can help you on your journey.  Please add your feedback at the end, or send me an email through my contact page.  You might also like my article "Assault on the American Mind" from November, 2015, about campus unrest, culture clashes and the alarm over "trigger warnings" and "safe spaces".)

Thank you for inviting me to speak to you about mental health, well-being and wholeness from my perspective as a psychiatrist and someone who cares deeply about social change and cultural wellness.  I have so much respect for what you are doing as activists and organizers.  I know that facing our personal and communal wounds is very painful.  But without the wound, there’s no reason for the journey.  I hope to give you some tools for your journey.  The longest journey we’ll ever take is from the head to the heart.  This talk is primarily about healing and strengthening the heart.

By way of introduction, I’ve been a psychiatrist for over a decade, doing psychotherapy with a diverse population, from Cambodian American survivors of the Pol Pot genocide to 1st and 2nd generation immigrant tech workers dealing with family, work and relationship problems to young people struggling with trauma, depression, anxiety, bipolar disorder and schizophrenia to older men and women of many ethnicities with significant challenges to their mental health.  I like to say that I minored in protest as an undergrad at Brown University, where I first ‘found’ myself as an Asian American and person of color.  At Stanford Medical School, as president of the Medical Students Association, I was an advocate for women affected by sexual harassment, among other issues.  I was deeply and personally affected by issues of racism and sexism on campus – so I know how powerful and destabilizing these issues of identity and community can be, but how essential it is to face them. 

This is a time when deep wounds and trauma have been exposed.  We can no longer be in denial about race, gender, class, power and religious disparities and conflicts.  There is rising and alarming political polarization.  Interpersonal ties have seemingly worsened.  Yet there is also great potential:  we have to surface the problem before we can solve it.  Perhaps I’m biased as a psychiatrist, and see the world through my own lens, but I think the core problem is relationship, and ultimately, the challenges of love.  Therefore, how we hold love and compassion with us as we engage with the task of relating to our personal and interpersonal difficulties is the key to solving them. 

The trends for civic engagement are mixed.  Long-term affiliation with political, community and religious organizations has been declining for decades (as described by Robert Putnam in Bowling Alone), and Princeton’s Future of Children reported that recent trends have “led to speculation that the character of American civic life is changing toward more short-term and episodic engagement and away from enduring memberships in associations and community organizations.” (Flanagan C., Levine P.  Civic Engagement and the Transition to Adulthood.  The Future of Children 20 (1):159-179)

Matthew Brashears and colleagues found that over the last 25 years, our average number of confidants has dropped from three to two.  In other words, we have fewer intimate relationships, or have become more selective about sharing deeply in relationship.  Perhaps social media has become the third confidant, but Facebook, Snapchat and Instagram are rather unreliable friends with limited capacity.

What happens when confidants and close friendships decline, polarization increases, and we have fewer opportunities to congregate and commune in civic organizations?  I believe that apathy, disappointment, antagonism, divisiveness and self-centeredness increase.  Happiness is also threatened, because relationship is a core component of happiness.  Without the conditions for health, the wounds grow.  While there has been major progress on some aspects of the inclusive vision of community (electing our first Black president, nominating the first woman candidate of a major political party, marriage equality), the voices of dissent to that vision still wield great power and rancor.  All over the world, the dangerous but powerful delusions of tribalism and self-centeredness vie with the dream of our common humanity (see Is Donald Trump a Walking Subreddit?).

Advancing the dream of common humanity, and dealing with the challenges it imposes, requires revolution on many levels – psychological, economic and social.  Grace Lee Boggs said “conversation is revolution.”  Relationship is revolution.  Ultimately, I believe, revolution is love – expanding love and compassion throughout society.  In the process, we grapple with issues of power and control in the status quo, and can feel devalued and powerless as a result, because the values of the heart are devalued in our materialistic, status-obsessed culture.  It’s not just that our identities as women, minorities or outsiders are derogated; the very idea that love and compassion should be our priority is silenced, insulted and mocked.  “Build the wall” becomes a rallying cry, and antagonism becomes a protective defense.  This is the main tool of exclusion and the abuse of power.  Even within our own minds, love is seen as a weak and weakening sentiment, rather than a deep wisdom that calls us to our best and strongest selves.  We forget that the human capacity for love and nurturance is what drove much of our evolution as a species. 

Cultivating our own capacity to love, accept and care for ourselves and each other is part of the revolution.  We are all students of love, beginners in the art of love.  Love’s synonyms are listening and understanding – and must listen to and understand ourselves.  If we are to become powerful, we must be able to respect the image of power that we embody.  Our ends determine the means to those ends.  Our goal of a society of compassion and wisdom requires that we cultivate compassion and wisdom in ourselves.

Understanding Ourselves:  we are all vulnerable

As human beings, we are all vulnerable.  We are all subject to changing life conditions, sickness and mortality.  With our self-awareness comes self-consciousness, insecurity, uncertainty, and self-doubt.  Despite appearances, I don’t think we ever truly lose that part of our identity, nor should we want to.  We may gloss over our vulnerability in confidence about our capabilities, achievements, etc., but if we lose touch with our essential nature, we are at risk of losing compassion, humility and groundedness.  By developing insight into our essentially frail, vulnerable selves, we can develop a wisdom of insecurity that brings us to depth, connection and greater peace.  Our reactions to our insecurity and vulnerability can cause suffering, or pave the way to our enlightenment.

We are shaped by our family experiences, and may have vulnerability at that level.  Many of us have experienced family conflict, abandonment, neglect or abuse.  Our parents are not perfect, of course, and they may not always understand our needs, interests and desires.  Some of us may be caring for our parents in some way, assuming responsibilities beyond our years.  This often happens in first generation immigrant families.

We all face the injustice, inequality and ignorant ways of the world. 

All these factors can produce powerful dissatisfactions and frustrations that we must manage.  We think we cannot be happy unless the world changes in important ways.  And perhaps ultimate happiness eludes us when we are aware of the magnitude of suffering.  At least working on our piece of the suffering pie provides some relief.  But I think we become more effective agents of change when we are nurturing our own happiness and personal growth. 

The suffering the Buddha talked about was “not having what one wants and having what one doesn’t want,” a state of dissatisfaction.  His philosophy looked at changing the delusion that we are separate and independently existing.  In other words, we are interdependent.   The idea of separateness causes suffering, primarily through causing turbulent emotions like greed and hatred, as we strive to fuel and protect our mistaken notion of self. 

If we were to examine our individual and collective suffering, we would see that much of it comes from crises in connection, and multiple empathic failures.  We hurt when others don’t recognize interdependence.  Resolving suffering requires connecting more deeply to ourselves and others, and becoming more empathic. 

Empathy means understanding and sharing the feelings of another, seeing things from their perspective.  There’s a spectrum from pity (feeling sorry for someone, but feeling they’re in an inferior position) to sympathy (expressing one’s sorrow for another, on a more equal basis) to empathy (sharing and understanding feelings) to compassion (recognizing someone is suffering and wanting to help them).  In addition to cultivating empathy and compassion, I think it’s also important to cultivate ‘equanimity’, also known as ‘even-mindedness’ or acceptance.  Acceptance protects compassion, and recognizes that sometimes we have to accept things, that we can’t change them.  In the words of the Serenity Prayer,

“God grant me the courage to change the things I can
The serenity to accept the things I can’t
And the wisdom to know the difference.”

The opposite of suffering is belonging.  But belonging is not always present.  

Being devalued is the main way we feel a lack of belonging.  Being devalued can take many forms, from outright violence to voter suppression to microaggressions that land on our vulnerabilities and insecurities to the devaluing that happens when we’re around very self-centered people.  I’m sure much of your activist work revolves around having the issues of our communities seen and heard, resisting and overturning the devaluing we encounter.

How do we deal with the difficult emotions and narratives that arise from being devalued and striving to make a more equitable, just society?  How do we support ourselves as we face difficult people and situations?  I think the answer lies in cultivating compassion, wisdom, and better relationships with ourselves and others.  I’ll next lay down some strategies and perspectives to do this.

Neuropsychological perspectives – our inner child needs our inner caregiver

Our relationships with our caregivers and earliest life experiences lay down imprints in our developing brain.  I like to call these imprints our “inner child”.  The inner child is sensitized to the kinds of threats it faced in those early years, and comes with its own tendencies of perception, cognition, emotion and behavior.  Perceptions of abandonment, punishment, loss, discrimination, shame over one’s identity, etc. become linked to the amygdala (one of the evolutionarily oldest parts of our brain) and parts of the cortex that form the fight-flight-or-freeze survival mechanism. 

If you close your fist around your thumb, you have a model of your brain.  The amygdala is roughly where your thumb is, and the prefrontal cortex is where your knuckles are.

These neural networks were evolved to protect us from actual death threats, such as lions on the savannah of our origin in Africa.  Now, threats to ourselves, our loved ones, our principles or our self-concept trigger activation of the survival mechanism, and quick defensive reaction.  These predominantly social threats are subconsciously viewed as “death threats” to our primitive brain.

This is a very fast acting system, with neurons that fire at least twice as fast as the neural networks that govern long-term planning, love and compassion.  Our fast-reacting survival network can hijack the rest of our brains, and usually this causes problems in relationship as well.

The challenge of maturing is developing those other slower acting neural networks, predominantly in the prefrontal cortex, which I call the “inner caregiver.”  Cultivating the capacity of our inner caregiver to soothe and care for our inner child, to help our inner child grow, and help it meet the challenges of a difficult world is the task of a lifetime.  (Or if you’re Buddhist like me, many lifetimes!)

In addition to the inner caregiver and inner child, we have other personalities in our ensemble, an inner committee if you will, each performing some role for our psyche.  As we mature, this inner committee works with greater synchrony.  We learn to work, love and play, fulfilling the components of a healthy and balanced life.

Our inner child is not only the most sensitive and vulnerable part of our self, it is also the part of our self that is most open and curious about the world, much like the child we once were.  Having met threat, though, the inner child often develops defenses that close it down.  Holding and healing those difficult emotions allows us to stay open and connected.

Holding difficult emotions and developing the inner caregiver

Developing skills to cope with, process, and soothe difficult emotions is vital.  It’s not simply about being an emotion (being angry, being sad, being anxious) – but being with our emotions.  Developing an observer awareness of thoughts, emotions, and narratives allows us to have a dialogue with them.  We can have compassion for ourselves as we struggle with difficult emotions.  And we can relate better and more productively with others.  Through all these mechanisms (Mindfulness, Compassion and Relationship), we can develop deeper wisdom, insight and peace.  (I wrote about Mindfulness, Compassion and Relationship in this one-page Hyphen Magazine article.)

Sometimes, of course, we get caught up in our emotions, thoughts and narratives.  It’s often important to express an emotion rather than bottling it.  I’ve written and thought a lot about anger, in particular.  (See my free e-book on Asian American anger on my website http://bit.ly/RCbooks.)  I deal a lot with anger, and I know it as a two-edged sword.  Anger can be protective, and a signal to be heard and seen.  It is also a marker of boundary.  But it can morph into general hostility, hatred, resentment and blame, which are counterproductive and causes of deep suffering.  Some people get behind “righteous anger”, and that’s all well and good, but in my experience righteous anger can become a habit of anger.  Anger also causes you to focus on a small part of reality.  It may be the most important part of your reality at that moment, but it is never the whole story.  Anger doesn’t help you hear other perspectives, be empathic to the targets of your anger, or resolve the feelings that lie beneath and fuel anger:  fear, uncertainty, shame, insecurity, abandonment, isolation and so on.  These are the feelings we really need to hold with kindness if we are to heal our wounds.  “What is underneath your anger?” is a question I often ask. 

Anger is a survival mechanism and assertion of power.  But I don’t think we should enshrine anger.

I was told you’ve spoken about organizing from a place of love.  The failure of love can spark anger, our love for our communities can spark anger, but anger is hard to square with being a loving person.  Anger can only be resolved with empathy, but we also have to be empathic to ourselves too, even as we experience anger.

I think the first step is recognizing we are having a difficult emotion, and that we are suffering.  Then we can turn towards this suffering, rather than trying to flee or fight it.  We can open our hearts to our suffering, and learn to connect with and hold our vulnerability with compassion. 

Exercise 1

Take a breath, noticing the passage of air through your nose and mouth, into your chest and filling your abdomen.  Say to yourself, “this is a moment of suffering.  I care for this suffering.  Let me help this suffering.”

Relating to difficulty with Mindfulness, Compassion and Relationship

Mindfulness is “awareness of present experience with acceptance.”  We’re usually caught up in our thoughts.  The mind creates thoughts, thinks about problems, and creates a self-concept.  These are obviously important, but we often need relief from these processes as well. 

There are two more selves in the brain I’d like to discuss.  There is the “narrative self”, which is the self composed of stories and ideas about one’s life and world.  There is also the “experiential self”, which involves different parts of the cerebral cortex.  The experiential self is grounded in present experience and moment-to-moment awareness.  This observer awareness is more centered and calm, and as described earlier, can help us have a dialogue with the narrative self, and not simply react to the storyline our brain wants to spin.  Psychiatrist Viktor Frankl wrote “between the stimulus and the response is a space.  In that space is our power to choose our response.  In our response lies our growth and our freedom.”  Mindfulness helps us find and expand that space, and thus increase our freedom.

Mindfulness is as simple as paying attention to what you’re doing:  walking, doing the dishes, or breathing, for example.  We can gently let go of our thoughts, and come home to our bodies.  I like to use the breath as an anchor, because it is always available to us.

Exercise 2

Focus your attention on your breathing, watching the in-breath, all the way into your chest and abdomen, and then watch the out-breath, as it leaves your body.  Count up to ten breaths, and then back to one.  If you notice yourself thinking, gently bring your awareness back to your breath, as you might gently return an energetic puppy to your lap.  Every time you come home to your breath, you increase the space of stillness and calm in your mind.

You can take a mindfulness break anytime, with just a few breaths or a few minutes.

Exercise 3

Three-minute breathing pause (From Mindfulness Based Cognitive Therapy for Depression by Segal, Williams and Teasdale, 2002)

Awareness
Bring yourself into the present moment by adopting an erect and dignified posture.  If possible, close your eyes.  Ask yourself, “what is my experience right now…in thought, in feeling, in bodily sensation?

Gathering
Gently redirect your attention to breathing, with each in-breath and out-breath as they follow, one after the other.  Your breath can serve as an anchor to bring you into the present and tune into a state of awareness and stillness.

Expanding
Expand the field of awareness around your breath, so that it includes a sense of your body as a whole, your posture, and facial expression.

Exercise 4:  STOP

This is an acronym for “Stop, Take a breath, Observe, Proceed.”  Sometimes we just need to slow down for a moment, gather ourselves, and move forward with calm and intention.

Exercise 5:  Mindful Intention Breath

Fold your hands together or rest them gently in your lap.  Take three deep breaths, with your eyes closed if that is comfortable for you.  After the third breath, ask yourself “what is my intention for this next moment?”

Mindfulness can be used regardless of religious or spiritual orientation.  I personally meditate for 45 minutes a day, and it has helped build up my reservoir of attention and calm to be more helpful and engaged with my patients.  You can also go on daylong or longer retreats.  Spirit Rock Meditation Center in Marin and other meditation centers often offer partial or full scholarships and sliding scales based on need.  If you have an aversion to meditation based on your religion, you can try “centering prayer” instead, which is basically using a prayer to focus your attention.

Compassion and self-compassion

The Dalai Lama said “if you want to be happy, practice compassion.  If you want others to be happy, practice compassion.”  Self-compassion has been extensively researched, and as Dr. Emma Seppala of Stanford states, self-compassion is “the source for empowerment, learning and inner strength.” 

Sometimes we think we have to be hard on ourselves in order to improve.  But the research shows the opposite.  Our self-criticality makes it harder to change.  As psychologist Carl Rogers put it, “the curious paradox is that when I accept myself as I am, I can change.”  Self-compassion allows us to accept ourselves as we are, and heals the feelings of shame, unworthiness and dissatisfaction so many of us carry.  In order to help others, we have to learn how to relate to our own suffering with kindness, gentleness.  Self-compassion helps us befriend our suffering, that vulnerable, isolated part of ourselves, and bring it love and acceptance.

Self-compassion consists of three factors (from Drs. Kristin Neff and Christopher Germer’s work):

  • Self-kindness vs. self-judgment  (being gentle with yourself)
  • Common humanity vs. isolation  (recognizing that all people suffer)
  • Mindfulness vs. over-identification with thoughts and emotions  (as described above)

Dr. Neff has developed a 26-question self-compassion scale you can take online that can give you a reading on these factors, and tell you which factors need the most work.  (Very often, it’s “all of the above”!)

There are many practices to help boost our self-compassion.  I have several resources on my psychiatry website to help you along this path, including books, links, and a 4-session video course by Drs. Kristin Neff and Brené Brown.  I like the instructions by Buddhist teacher Jack Kornfield:

Exercise 6:  Lovingkindness meditation

This exercise connects your mind and heart, and is a way to replace the well-worn tracks of self-criticism and even self-hatred with compassion.  You can repeat these phrases to yourself, or even imagine that a benevolent figure is saying them to you.

May I be filled with lovingkindness,
May I be well.
May I be peaceful and at ease.
May I be happy.

The mind often rebels, saying it’s selfish or foolish to wish these things for yourself.  It can take months of practice to overcome this habitual resistance.  We might think we need “an edge” or “toughness” to accomplish our goals or cope with the world.  Lovingkindness and self-compassion don’t turn us into blissful idiots.  Rather they bring us to greater peace that can help us become more effective as we deal with difficult people and situations.  If we feel more comfortable and at ease with ourselves, we can face the world with resolve and resilience.  Over time, you can extend this practice to others: benefactors, friends, people you feel neutral towards, the difficult people in your life, and finally to all beings.  Transforming our ordinary feelings and attitudes towards others can relieve our suffering, and open the way to new possibilities in relationship.

One important question that came up in our discussion was essentially “isn’t asking us to love our enemies or have compassion for them a form of emotional labor?”  True, it is a challenge – but as the Buddha said, “hatred never ceases by hatred.  By love alone does hatred cease.  That is the Eternal Law.”  It is a spiritual and moral challenge to work on difficult emotions.  Hatred itself is a cause of our own suffering.  Hatred is emotional labor too.  Hatred is like “drinking poison and hoping the other person dies.”  I’ve found that lovingkindness practice for the difficult people in my life has allowed me more space and freedom to creatively meet the challenges of relationship.  Difficult people live rent-free in our minds.  It’s all a question of how we deal with our tenants, so to speak.  Lovingkindness is the basis for good mental health as well as a good society, in my view.

As far as emotional labor goes – well, I’m a psychiatrist.  I’m pretty much an emotional industry worker J.  And all of life really is some form of emotional work.  Learning how to manage difficult emotions actually makes the work easier.  They don’t call it doing difficult things a “labor of love” for nothing. 

Exercise 7:  Simplified Tonglen practice

Tonglen is “giving and receiving” meditation from the Tibetan Buddhist tradition.

On the in-breath, imagine yourself breathing in all your suffering.  On the out-breath, breathe out peace and health.  Imagine that your lungs and body are transforming suffering with each breath.  You can also picture someone you care about who is suffering.  Breathe in their suffering, and transform it within your body as you breathe out peace.

From inner peace comes family and community peace, and ultimately world peace.  If you’re unable to be an agent of peace for yourself, you’re unlikely to be an effective agent of peace and change in the world.

Exercise 8:  RAIN

When we are having a difficult emotion, RAIN helps us observe it and not-identify with it.  Just like a Chinese finger trap, when we struggle with our thoughts and emotions, it’s impossible to get free.  Non-identification is the path of not struggling, of allowing and emotion or thought to just be, and letting go of it.  I describe RAIN in this blogpost.

R – Recognize what is happening
A – Accept and allow life to be as it is.  Accept and allow the present moment, thought or emotion to be.
I – Investigate inner experience with kindness and compassion
N – Non-Identification.  Observe experiences, thoughts and emotions without identifying with them.

Relationship

There’s a saying in Buddhist circles:  “Relationships are the highest level of spiritual practice.”  Also:  “you can be enlightened to everyone but your family.”  Often, we’re most vulnerable to the people we care about the most.  Obviously, we like to associate with people who we love, and bring us joy, support, knowledge and wisdom.  But “every rose has thorns,” as they say.  A difficult person, or even a friend being difficult, can teach us a lot.  We can use these encounters to grow, even though they are painful.  But there’s only so much any of us can take, especially on our own.

The people I’ve had most problems with are those who have power and thus left me feeling powerless, and also self-centered people who devalue me and others in a quest to boost their own feelings of worth.  It can actually help to label and name the problem, just as labeling and naming our wounds and emotions can give us some control of them.  We can develop immunity to difficult people by recognizing and getting distance from the emotions that they evoke in us.  That being said, it’s hard work, and an ongoing challenge!

These difficult people and situations can lead us to develop coping skills.  I have some resources on my Psychology Today blog that might be helpful.  Most importantly, we need to identify abuse and get support or get out of or avoid those situations as much as possible.  Sometimes it’s not possible.  Then it’s important to develop understandings of the situation, label bad behavior, and develop strategies to counteract it.  Again, maybe I’m biased, but I think getting good therapeutic support is critical. 

Just as you don’t have to believe your own thoughts, you don’t have to believe the opinions of others, or even react to them as if they were a reality.  There’s a saying, “you can’t cover the Earth in leather, but you can wear shoes.”  We can’t avoid hearing things we don’t like.  But we can develop skills to manage our own reactions to painful words, and thus find better ways to respond to provocation.

In terms of relationship, I think these three principles are important:

  • You can be right or related.
  • You can be right or happy.
  • The world is divided into people who are right.

In other words, when we get too attached to our opinions, we can create suffering and disconnection.  I think the key is not in being completely detached from opinion, but to hold opinion in a way that is more flexible.  Other people’s opinions may not make sense to us, or seem really wrong-headed.  But how do we interact with them?  And how can we use conflict as a way of deepening ourselves spiritually, and expanding ourselves cognitively and emotionally?

In another unpublished essay, I write that “opinions are the thought-body of power.”  So opinions can be empowering, but sometimes it’s not constructive to fight power with power. 

As human beings, we are social animals.  Neurobiologically, we have an “open limbic emotional loop” that makes us very sensitive to and interdependent with other humans.  Trauma and powerlessness leave us with many difficult emotions.  But there’s a limit to how much anyone else can be responsible for our emotions.  In other words, there’s a limit to how much we can demand of others to satisfy our needs.  People have varying emotional capacities to handle other people’s emotions.  We can expand our own reservoir and increase our capacity to handle our emotions and the emotions of those we care for.  Our goal of a more compassionate, inclusive society depends on expanding our emotional capacities and other skills to care for ourselves and others.  Hopefully, we can aim to take primary responsibility for our own difficult emotions, while recognizing that we are all partially responsible for each other’s emotions. 

Spiritual perspectives

  • The journey from head to heart is the longest journey you’ll ever take.
  • Connecting mind and heart is essential to our health, well-being and wholeness.
  • Forgiveness practice.  Forgiveness is letting go of anger, grudges, resentment and blame.  It isn’t letting anyone off the hook for wrongdoing, but recognizing how we create our own suffering. 
  • It’s important to turn blame systems into responsibility systems.
  • As human beings, we can harm others.  We can take responsibility, and also be gentle with ourselves for being human.
  • How might you befriend your suffering, as opposed to denying it, or pushing it away?
  • Your suffering is actually the raw material for your enlightenment.
  • We all need help sometimes.  Actually all of the time. 
  • We are interdependent with each other, connected in ways we can’t see or even be aware of.  We are all part of a bigger picture.
  • We do have to name our wounds.  Healing the wound in us is part of healing the wound in the world.
  • Another Buddhist saying (I think from Jon Kabatt-Zinn):  “In life, pain is inevitable; suffering is optional.”  We can learn to hold our suffering with mindfulness, compassion and relationship, and thus suffer less even as we deal with difficult people and situations.  This also helps give us insight into the causes of suffering as well, and thus we can become more helpful to others as they face suffering.

Conclusions

The I Ching says “when the externals are lacking, we must cultivate the internals.”  I hope my talk has given you some ideas about how to cultivate the internals, and also connect with the externals we are all working towards in our own way as activists and cultural workers:  namely a society deep in compassion, wisdom and skillful means to address suffering. 

I haven’t talked about mental health diagnoses per se – that would be a much different and longer talk.  But dealing with our own mental health issues (with therapy, medications, etc.) and being understanding and supportive of others as they deal with their mental health issues are both essential.

I also don’t want to sound like I have all the answers.  Rather, I’ve tried to develop skills and perspectives along the way to address my own suffering and the suffering of people I care about.  I’ll close with a quote by Rainer Maria Rilke:

“Be patient toward all that is unsolved in your heart and try to love the questions themselves, like locked rooms and like books that are now written in a very foreign tongue. Do not now seek the answers, which cannot be given you because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer.”

Thank you for your giving me the opportunity to bring together some ideas that inform my work.

Note:  Title of this post was updated on 1/25/17

(c) 2016, Ravi Chandra, M.D. F.A.P.A.

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