One Choice in Every Moment

A musical note: In writing songs, there are common chord progressions which are the skeleton upon which melodies and harmonies can be built. One such progression is: vi IV V I, which stands for the starting chord being the sixth of the scale, followed by the fourth, the fifth and finally to the tonic chord, the I. Enjoy this song that was an experiment of setting out to see what could come of taking the progression out for some exercise! (the song title needed to leave out the fifth to make the title a punny one!). I guess that was a choice!

I recently wrote an email to a patient of mine who has long struggled with anxiety. My patient is woman in her mid-30’s, a wonderful, insightful and motivated person. She is married, has kids, works and is in the process of getting more education in order to change careers. She is making real progress in the direction of her educational and professional goals, but wrote to me, very concerned that she was still struggling with anxiety in her day to day life.

Humans are affective creatures. We have feelings. Some of them we want more of, and others we want to get rid of. But to be fully human, we need to be able (and willing!) to experience “the full catastrophe.” 

Have you ever seen the movie, Zorba the Greek?

In the movie, when Zorba is asked whether he has ever been married, he replies, “Am I not a man? Of course I have been married! Wife, house, kids, everything. The full catastrophe!”

John Kabat-Zinn, the well-known author and one of the earliest promoters of mindfulness practices for the modern era, wrote a book entitled, “Full Catastrophe Living,” in which he explains his take on living ‘the full catastrophe’, “...[it is] the poignant enormity of our life experience. It includes crises and disaster, but also all the little things that go wrong and that add up. The phrase reminds us that life is always in flux, that everything we think is permanent is actually temporary and constantly changing. This includes our ideas, our opinions, our relationships, our jobs, our possessions, our creations, our bodies, everything.”

In my email to my patient, I had the intention of being supportive, and also to encourage her to find a new relationship to the feelings of anxiety she was concerned about:

“It’s an interesting observation to me that we are never anxious about things that have happened in the past. We usually reserve anxiety for things that have not yet happened, for the future, don’t we?

It is a helpful realization to see that the future isn’t here yet, so how much control can any of us have right now over a time that isn’t here? If the answer is, “I guess I don’t…” then it makes all kinds of sense to put our awareness on what is happening right now, in this present moment. If there is something to do about some imagined or desired event in the future, then we can get busy and do something. If not, then nothing to do.

Experimenting with becoming more process-oriented, rather than outcome-oriented allows us to take care of things in an engaged and vital way as we are living our life (during this very moment), rather than staring paralyzed with uncertainty into an imagined future where all kinds of things might fall apart, feeling anxious and then spending our present moment trying to get rid of the anxiety. 

We humans also seem to dedicate a lot of time to trying to control or get rid of aversive states, (such as anxiety, insecurity, depression, loneliness, anger, etc.,). While the intention makes sense, (who likes to feel anxious or depressed or a million other words used to describe what we don’t want to feel), the actual outcome is invariably not the one we want.

“If you are not willing to have it, you’ve got it,” is a pithy saying that allows to remember that our efforts to get rid of negative states or feelings guarantees that we will have them.

It’s like the little mind experiment, (you can try it for yourself as you read this), “For the next 20 seconds, there are a thousand things you could think of, but you must not think of a yellow apple. If there is even a flash of a yellow apple in your mind for the next 20 seconds, a trap door opens up below you and me, and we plummet 4 stories to the ground. Remember, you must not think of a yellow apple. Ready? Set? Go!….”

How did you do? If you are like most people, the very thing that you did not want to think about kept trying to muscle its way in to your mind. Sure, you could have thought about an orange polar bear, really focusing on that, bearing down on that in your mind, but what was waiting at the periphery? Even if you say that you didn’t have a single thought about a yellow apple, how would you know unless you thought of a yellow apple?

“If you are not willing to have it, you’ve got it.”

Instead of spending time and precious life energy trying to not have our present moment experience, (which could include things like anxiety), what would happen if we just made room for the anxiety? Welcome it in…it’s there anyway.

It’s a curious thing, but our willingness to make space for anxiety quite often diminishes anxiety, but not because we are trying to get rid of it, but rather we’ve given up the struggle to get rid of it.

As we notice the experience of anxiety, and make room for it, (acceptance), we can at the very same moment get in touch with what really matters to us. If there is some action we can take in support of what really matters, we do it, bringing the anxiety along with us as we take action.

Following this fork in the road leads to increasingly experiencing more vitality, engagement and being alive, mostly because we are doing that: being vital, engaged and alive.

As far as I can tell, the point of life is to live it, to make choices about the life we do want to live, and then taking action that is consonant with the life we want to live.

Because there are some things that matter to us in our life, and there is always uncertainty about the future, (including how things might go this afternoon, later tonight, tomorrow morning, and on and on), anxiety may arise. But at all times, we are at a decision point: do I want to invest energy in trying to get rid of the anxiety (and thus make it more pronounced), or do I want to be in my life as it is happening, doing those things that matter most and make room for any anxiety that may arise?

Every hour (and I would suggest, every minute) we are at a decision point. We can ask ourselves a very helpful question, “In this moment, what is the function of this behavior I am doing? Is it in support of living as fully as I have chosen to do, or is it an effort to not have my experience of anxiety, (or any other aversive state)?

Two pathways ever before us…which path am I choosing right now?”

Dear Reader, how does it seem to you? Is anxiety something to get rid of? How about boredom, anger, irritation? Have you found a way to relate to difficult thoughts and feelings that allows you to keep moving towards living the life you want? What happens when you welcome all your feelings, (anxiety, joy, depression, peace)?

Nothing To Do…

I composed a song today that I’d like to share with you. It’s called Shifting States, and it is my musical representation of something that happens in all of us all day long. Hope you enjoy it!

Shifting States by Ian M Crooks, MD
To return of clarity, leave it alone…it will clear by itself!

Every year, I have about 2000+ visits in my private practice office with the people who are my patients. I meet with some people more often than with others, but in general, I have the honor and privilege of working with many people from all walks of life. In meeting these people, and getting to know them, I also learn a great deal from them.

Many people in society think that psychiatrists only manage medications. The people with whom I meet seem genuinely surprised when I tell them that I provide psychotherapy as an integral part of my practice. 

The longer I practice, the clearer it is to me that the majority of suffering comes from people being unaware that ‘who’ they are is just fine. At the core of everyone, there is health and well-being. There is a big difference between ‘who’ a person is, and what they are experiencing.

I’m certain that you, like me, have had times when you have felt stressed and upset, (help me out here…it’s not just me, is it?). Likewise, I’m certain that you have had times in your life when, on the whole, life seemed pretty good and a feeling of peace and calmness would describe your state of mind. Isn’t that true?

What we sometimes miss is the realization that our state of mind is changing all the time, even in the course of one day, (I would argue even in the course of one hour).

We are never one mood for hours or days at a time. Take a moment to reflect and see if this is true for you. Consider how you were feeling yesterday afternoon. Now, how were you feeling two nights ago? How about this morning? How about right now?

Even the most depressed person I have met with in my office will have some variation in the intensity of their mood symptoms throughout the day. The person with intense anxiety will admit to some periods of time during the day or week when they are less tight. People with psychosis, who are hearing at times threatening and critical auditory hallucinations, will report that sometimes it is easier to deal with the voices, and they don’t feel as frightened of them during those times.

I do not recall a single morning where I have gotten up, grabbed a piece of paper and started making my to-list: I need to get frustrated at least twice today. Remember to feel insecure for at least 15 minutes. Don’t forget to feel proud and confident once in the morning and then from 3-4pm. Oh, and make sure that some time is devoted to ruminating about a wrong someone did, and make sure I stew about it, maybe even give the other person the silent treatment, that will show them!

No one makes these kinds of lists, but that’s what shows up as we go through the day, isn’t it? All day long, our mood is shifting up and down. When our mood is up, there really is nothing to do, is there? Simply enjoy it. But then what happens? We like the feeling of the good mood, and we want to keep it.

During a good mood, (it might be peace, joy, happiness, gratefulness), have you ever had the thought, “Hey, I finally got it figured out. I’ve arrived! No need to ever feel down again.” (Honestly, it is the same thing when I hit a good golf shot…“There we go! I knew I could hit good golf shots! I’ve got my style down now. It’s going to be all fun and enjoyment from now on.” Until it isn’t, and then I’m tromping around in the woods, fighting with frustration, finding it difficult to understand what happened, and difficult finding my golf ball!).

Well, if there is nothing to do when our mood state is good, what’s the key to dealing with low moods? Would you be surprised if I said, “Nothing to do,”? I know it surprised me when I first started to understand the nature of moods.

The world around us has about a zillion approaches to getting away from low moods and into better mood states, doesn’t it? We can buy stuff. We can recite positive statements to ourselves. We can visualize. We can get the right relationship. We can work out and eat the right diet. We can mediate and pray. We can work towards goals and get awards and create a reputation. We can surreptitiously elicit approval from others, (sometimes we just demand it). We can also drink booze, smoke cannabis or throw back a few pills as we drink and smoke! The list is really too long to include here. Perhaps you have your own approaches to change the way you feel? 

There is nothing wrong with any of the approaches listed above. Our old friend Shakespeare would say, “there is nothing either good or bad, but thinking makes it so.” 

However, here is something worth considering: when experiencing a negative state, a low mood, there really is nothing to do.

Have you ever held a snow globe and given it a pretty vigorous shake? What happens? The snow inside flies around every which way, doesn’t it? 

The snow is like our difficult thoughts and feelings. When challenging thoughts and feelings are flying around in our head, we get pretty busy shaking the snow globe harder trying to get the snow to settle down, don’t we? “If I could just get rid of these thoughts/feelings! Then I could feel better and get on with my life!”

How do you get the snow to settle down in a snow globe? The answer is simple, isn’t it? You need to put the globe down, and then the snow settles by itself. In fact, if you do anything with the globe, the snow will start to fly again. It’s the same way with the difficult thoughts and feelings we can experience. Simply leave them alone, and at some point, they will move on. The entire body, including that mysterious thing called our mind,  is designed for homeostasis, a term that means ‘getting back to the norm.’

There is an oft cited study from 2005, the National Science Foundation that stated that we have about 70,000 thoughts a day. That is a lot of thought, isn’t it?

It is the nature of thoughts that they come and go. If we leave them alone, they arise and then they move on. Don’t take my word for it, see for yourself. Notice in this moment what you mind is doing. What thoughts are arising? Are they the same thoughts that you were having earlier today? 

When we begin to see that ‘who’ we are and what we are experiencing are two different things, it becomes easier notice thoughts and feelings and not be as frightened of our own experience, because we understand that a new thought or feeling is already on its way. 

Some psychotherapy approaches encourage people to get good at spotting dysfunctional thoughts. People are encouraged to look for evidence that their cognitive appraisals are either true or false. Homework is assigned where people are instructed to identify difficult thoughts and then pull them out like you would a weed in a garden and then actively plant more realistic thoughts. Time is spent learning how to reframe the cognitive distortions that arise and try to arrive at a more empowering way to deal with the thoughts and feelings that arise.

Is there anything wrong with this, or the nearly 400 different modalities of therapy currently used in psychotherapy today? Nope. But it does sound like creating a dam in a river that would otherwise be flowing, doesn’t it? Keep holding on to thoughts, and treat them like Play-Do…eventually they’ll improve and you’ll feel better.

Don’t take my word for it. Consult your own experience. What happens if you are simply grateful for the ‘good’ moods that arise, and do your best to be graceful when the ‘bad’ moods show up?

There is nothing to do. You are the experiencer. You are not the thoughts or the feelings that arise and then depart, to be replaced by other thoughts and feelings. When this simple relationship is seen, how much easier it becomes to see that trying to change negative thoughts and feelings is like trying to prevent storm clouds from moving into the sky. Good luck!

The sky has room for everything: clouds, storms, birds, planes, fumes, buildings. None of these things change the sky at all. 

You are the sky, and whether presently your mood is up or down, there really is nothing to do in order for your mood to change. See if this isn’t true for you as you go through your day.

When we give up spending time and effort trying to get rid of difficult thoughts or feelings so that we can get on with our life, we more easily see that we can use our time and effort in this moment in the pursuit of doing things that really matter to us.

Right now is the only moment there is. Our life is happening right now, not in a week from now, and not a year from now. Similarly, our life is not happening yesterday or even earlier this morning when we were eating breakfast.

When we devote each day to taking action in service of our freely chosen values, we experience more engagement, more vitality and fulfillment, not because we got rid of bad thoughts or moods, but because we are living the life we have chosen for ourself. Meanwhile, clouds float by, storms advance and then pass along, planes and birds fly by, noxious fumes float up and then away, and Sky says, “You are all welcome. Stay as long as you’d like. I have room for you all!”

Please feel free to forward this to someone you think might find it helpful.

I’d be interested in hearing your comments, (so, I guess there might be at least one thing to do!).

Riding the mood elevator up and down

Creativity is good for you…

( I was a musician prior to becoming  a physician. I have no formal training in music composition. However, every time I boot-up my MacBook Air, plug my keyboard into my laptop and click on the GarageBand application, I sit for a few minutes and get ready to be surprised. Several hours later, I am listening to the freshly finished piece wondering, “where did this song come from?”  I hope you enjoy the little musical sketch, entitled, “Walk in the Park.” Best listened to with earbuds, but using just your ears works, too!).

Whether you believe it or not, within you lies an ever-present source of creativity. Every human being has creativity factory-installed within them, a direct connection to something fresh and new.

Some people say that they are not very creative. Some people think that other people who demonstrate the output of creativity were lucky, or born with it. “They have natural ability,” can be heard, sometimes with a tone of admiration and at other times with a tinge of resentment. 

Is it true that some people don’t have access to their inborn source of creativity? More and more, it seems to me that the only way you cannot access your creativity is if deny you have it.

As we go through our day-to-day life, we actually have many opportunities to consult our creativity. Some people may face a routine task and find a way to get things done in a novel, more pleasing and enjoyable way.

Any activity becomes creative when the doer cares about doing it right or better. -John Updike

People who play sports are often delighted when they come up with a different move or strategy that adds to the richness of the game. Artists, painters, musicians, and writers all look to the inner creative source for ideas, inspiration and vision.

Creativity is different than knowledge or skills, isn’t it? Having knowledge and skills is certainly helpful, and can often be put in service of creativity. But if knowledge and skills were the same as creativity, I’m pretty sure everything would have been already invented or done and we would live in a world of drab, rule-oriented drudgery, (well, maybe not all that bad, but you get my point).

Creativity is frequently accompanied by a sense of freshness and newness. It’s like being given a gift!

The creation of something new is not accomplished by the intellect but by the play instinct. The creative mind plays with the objects it loves. -Carl Jung

For me, creativity begins with a willingness to admit I don’t know very much. You would think that admitting that would be dispiriting and halt any effort, but for me, I feel as if I press ‘pause’ on my rather limited know-it-all mind and then I simply wait for something new. There is an experience of curiosity and playfulness.

Maybe if you reflect for a moment on your experience, you will remember when a helpful idea or solution to a problem showed up when you least expected it. Do you remember what happened? Start to notice the antecedents to your own accessing of creativity and then start putting yourself in its pathway!

Get comfortable with being misunderstood, disparaged, or ignored — the trick is to be too busy doing your work to care. -Austin Kleon

The accessing of creativity can be a solitary process. It involves slowing down, especially slowing down the critical, rational mind. This usually means that you have to step out of the frantic pace of life from time to time. Sometimes people worry that they will be seen as selfish if they devote themselves to pursuing creativity in their daily life. 

Making yourself available for creativity is like making yourself available for food and water. It will nourish you, replenish you and invigorate you. -Ian M Crooks

You will be more able to make a difference for the people in your life when you are well-fed. You don’t need to beg, borrow or steal to get creativity. It is already present within you. You need only turn in its direction, and it is ready to deliver. Be available and as a result, you will be available for others.

Every man must decide whether he will walk in the light of creative altruism or in the darkness of destructive selfishness. -Martin Luther King Jr

There is an ever-present source of creativity waiting to well up within you.

Will today be the day you empty your bucket of stress and cares, and make space for the inflow of creativity?