Recently, I met a beautiful woman who presented as a new patient. She was fit, curious and intelligent. As I read through her chart, I made note of her history – cancer treated with conventional therapy a few years ago, now in remission. She also had a few risk factors for heart disease, for which she was referred to me. As we talked about her history and her life, she stated that she had chronic insomnia from worrying about her health. What follows is a snippet of this conversation.
Question (me): So, tell me about your lifestyle.
Response (her): You know what? I have always been very conscious about my lifestyle. I eat healthy, I exercise avidly, I have never smoked, I don’t drink alcohol..
Q: That is wonderful!
R: Yes, but look at the irony of it. Compared to all my friends and family, I live a very healthy life. And yet, I am the one that got the cancer.
Q: Hmmm.. So, you think you should not have gotten cancer..
R: Exactly. Cancer runs in my family. My siblings are obese, they smoke, they never took care of themselves and yet I am the one that got it.
Q: So, in your opinion, if anyone should be getting cancer, it should be one of them. Not you. Is that how you feel?
R: Yes (sheepishly). Although I know that sounds terrible and I should not think that.
Q: Well, it is irrelevant what you “should” think. You are thinking it anyway, isn’t it (smile)? So, essentially you are saying that all those people that don’t take care of themselves “should” get the disease, and those that do “should not”. Is that right?
R: Yes.. This makes me so angry. I should be the last person to get cancer.
Q: Because..?
R: Because I am conscious about my lifestyle.
Q: And yet, you got the cancer.. Even when you think you “should not” have. Clearly, life is not listening to you. Tell me something. Have you always felt like you were in control of life?
R: Oh yes! I am a Type A personality.
Q: So was I (smile). Until life showed me who’s boss. Is it the loss of control over life, and things not going your way that is keeping you up at night?
R: Absolutely. I worry about my health. What more can I do? I am already doing everything!
Q: Are you? What do you think a “healthy lifestyle” entails? How about this seething inside you are experiencing? Are anger and resentment a part of healthy lifestyle choices?
R: No.. I have been angry for a long time about how hard I have to work to keep healthy and after I got the cancer, I became more angry and resentful.
Q: Do cancer or heart disease care about how hard you have worked? Have you tried to reason with the cancer about this?
R (Laughing): No. Of course they don’t care. Still..
Q: Still.. Hmm.. So, the cancer won’t listen to you and will do what it wants. Sounds to me like your trying to convince it otherwise is the problem. Would you agree?
R (after several moments): Yes. I can see that.
Q: Would you say that the main problem in your lifestyle is your worrying about something that cannot and will not change? It is like banging your head against a brick wall. What gets hurt – the wall or your head?
R: My head.
Q: Exactly! You can wage a war with what is really happening by thinking it should not have happened. In this case, you got cancer. What you think about it makes no difference to what has transpired. The cancer happened – yes, despite your lifestyle choices. Is there anything else happening right at this moment, without reference to memory, should or should not have, who should get it or not get it, and what might happen in the future? What is reality at this moment? There are two women talking in a room. Words are spoken and heard. Even as the words are spoken, they are already in the past – nonexistent. Can you find the memory of cancer hidden away some “place”?
R: No.
Q: Can you find anything else at this moment?
R: My heart is beating. I can feel it.
Q (smile): Even as you say “heartbeat” referencing one particular heart beat, it is history. Is anything going on at this moment that isn’t already the past?
R (thinking several minutes): No. Wow! I had never looked at it this way.
Q: I’d say the most important “lifestyle change” is to question the contents of your mind – your assumptions, judgments, comparisons, the incessant commentary about everything. Perhaps the cancer was a wake-up call for you to do just that. Perhaps it was the cancer’s way of telling you that despite your “healthy” living, you are caught in a whirlpool of toxins – the toxins of your thinking, of you trying to dictate what must happen to not just you, but to the whole world. When life doesn’t listen, you go to war with it. And you find yourself losing this war. This is not a war that can be won. The only way out is to wave the white flag in surrender. Tell me, how do you feel about your siblings and friends who don’t live a “healthy lifestyle” and have no disease?
R: I resent them.
Q: I love your honesty! Yes, that is exactly it. You resent these people that you love because they don’t have the disease you have! Look at the insanity of our minds!
R (shaking head): I had never thought of it this way.
Q: Lets see if we can make this most important lifestyle change now. Would you be willing to try something?
R: Anything!
Q: Great. I’ll teach you a simple mindfulness meditation technique to practice twice a day. Don’t expect changes overnight! This is a gradual undoing process of years of toxic thinking (smile).
R: Ok. I’ll do it.
And so this is the pattern I see so very often. Lifestyle changes are great, as long as there is no “tightness” around them. “Tightness” is the fixed expectation of the outcome that an action must bring. When the outcome differs, there is great suffering. The problem then is not around the lifestyle choice, but around the expectation. Why? There are infinite possibilities in every given moment on how the next moment will turn out. When we perform an action, the only thing we have control over is that specific action (and even this is an illusion, actually). We have absolutely no control over the outcome. Sure, we seem to know this intellectually quite well. However, how we take an unexpected outcome is the sure test of how well we really know this!
There is no dispute that most chronic illnesses are related to lifestyle choices. However, it is not as simple as saying that everyone that does “a” will develop “b” or that everyone that does not do “c” will not develop “d”. Even within these lifestyle choices, there are infinite possibilities – the environment, our individual constitutions, genetic predispositions and very importantly, the role of the mind. If fear of disease is the driving force for a particular lifestyle change, that disease is foremost on our minds. This fear “eats away” the sophisticated apparatus that connects the mind and body even as we make those lifestyle changes. Fitness of the body does not guarantee a balanced mind and outlook.
On the other hand, if the relationship with the lifestyle choice is one of wisdom and acceptance (and not of war), we can make the appropriate choices but not be too hung up on the outcome. Perhaps disease is the outcome – perhaps now we can be led to that place within that is already (and always) free of suffering. From this vantage point, there is no dis-ease. There is only wholeness.
Image Source: Cancer cell, Wikipedia Commons.