Tuesday, May 29, 2012

Wasted Time?

"Is it all just wasted time? Can you look at yourself when you think of what you left behind?" - Skid Row, "Wasted Time"

Unsurprisingly, I think a lot about miscarriage. I have been pregnant seven out of the last 12 months of the year. Not the fun, rewarding, feel-good parts of pregnancy I imagine, but the nausea, exhaustion, want-to-gnaw-my-arm-off-from-hunger first trimester. Although we saw Eddie the embryo's heartbeat -- a milestone in our personal pregnancy history --  we have a long way to go. I think I'll be able to exhale a little if I make it past the first trimester, but I know families who have lost babies literally in every month of a pregnancy, and through stillbirth, so I have no illusion that you're ever really out of the woods.

I think almost every day about the possibility of miscarriage. The other day I was thinking, "What would be the worst part about miscarrying?" I was a little embarrassed to note my answer to myself: "the wasted time." The nausea, hunger, exhaustion, and lack of libido would be more tolerable if I was sure they would pass, that they would just be way-stations on the way to a healthy kid. As they are, they have been the sum total of my pregnancy experience. I don't mean to sound ungrateful, because I'm thrilled I am pregnant! But I feel like hell, and again, I've spent more than half of the past year in that state. Staying in my first trimester feels like spinning my wheels. It seems fair to add that when I feel this bad, I don't do a lot of socializing, so I feel like I'm missing some opportunities on that front by spending all this time in first-trimester land.

God forbid, if I lost this pregnancy, I would, of course, be devastated beyond feeling like I wasted time. I passed some kids drawing with sidewalk chalk this evening and my heart almost exploded from wanting. But I know I could get through the loss, and I know I could get pregnant again, since that doesn't seem to be a problem. I am just sick of feeling stuck, of feeling like I'm wasting time. I want to move forward. Intellectually, I know that whatever happens will be a kind of moving forward, but that is a solution for the mind, and again, this is a matter for the heart.

Monday, May 21, 2012

Shared Sorrow, Shared Joy

"You have the pain, the sorrow, the fear within yourself; don't keep it for you alone. Allow the sangha, allow the community to embrace it for you. Allow the collective energy to help you to embrace it, because alone, you are not strong enough to embrace your pain, your sorrow ... If we allow the community to embrace us, then we will not sink into the ocean of suffering." -- Thich Nhat Hanh

May 17 was one of the most nerve-wracking days of my life. I was heading in for my third prenatal sonogram ever; the first two revealed that our embryos didn't take off, the cells never differentiating enough to create organs. I was expecting the worst at this one. My anxiety was palpable; I even sobbed in a public restroom the night before. I just needed an outlet for that anxiety to leave my body, and that night, it was in tears. I was looking for a way to process this anxiety, and one of my mindfulness teachers gave me a good suggestion: to tap into collective suffering as a way of making the container for my own suffering bigger. I think this is akin to Tara Brach's oft-quoted metaphor that if you are in touch with the whole ocean, you are less afraid of the waves.

So, I stopped looking at Wednesday's appointment as "my" ultrasound, and started thinking of all the women who have been on that same table I was going to be lying on. I broadened the thought to all the women having fertility issues everywhere, and more broadly, every expectant mom praying that everything would be ok with her sonogram. The exercise didn't stop there: I was able to relate my worry about the sonogram to all the suffering of the world, and I thought in particular about a dear friend of mine right now who is very sick. I can't explain why this helped ease my anxiety, but it did. It took me out of myself, and made me a part of something bigger, which, of course, I am.

Before David and I got out of the car to head up to the clinic, we prayed together, asking God for a favorable outcome to the sonogram, or the strength to get through this together if it was not a favorable outcome. I don't think anyone was more surprised than I was to hear our doctor say, "So, there's the baby, and you can see it's heart beating." Hearing that heart beat* was magical, though I could barely hear it through my tears of joy (and shock!)

The concept of sharing sorrow doesn't just exist in the narrow way I describe it above. It has helped me more than once to share my sorrows with all of the communities I'm blessed to be a part of. One of the starkest contrasts David and I noticed was the aftermath of my father's death vs. our first miscarriage a few weeks later. After my dad's death, there were about 70 people here a day to sit shiva with me. I found their presence comforting. We largely faced the miscarriage silent and alone, except for the few friends we notified. Several of them came to hang out and talk. Suffering of this magnitude is too big to be handled alone, and I am often saddened by the many women who tell me they have had serious fertility problems, miscarriages, and ectopic pregnancies and told no one other than their doctors. I am including women whom I know who are extremely close to their mothers, yet never tell their moms about these events. This kind of extreme secrecy only harms, in my opinion, never heals.

The concept of shared joy is as powerful as shared sorrow. In my immediate circumstance, experiencing my wider social circle's joy at our pregnancy is infectious and exciting. In a broader context, this is a skill I have had to work to cultivate over the past few years. My disability from Lyme Disease has meant the end to many professional and social opportunities that I used to enjoy. When you encounter that, your choice is to withdraw and become closed off and contracted, or to learn to cultivate joy from others' happiness. At times, it was very hard to hold this joy as most of my friends expanded their families as I was struggling with first having to delay childbearing because of my infections, and later, my inability to stay pregnant. Nevertheless, I have always found this goal worth pursuing to the best of my ability.

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* Seeing the six week-old on this sonogram was powerful for me in another context: seeing and hearing that little heart beating brought me back to when I used to volunteer for Planned Parenthood in what seems like another lifetime. They drilled into us in the clinic where I volunteered that what was being aborted was "just tissue." Seeing the heartbeat in my sonogram reinforced my unease with abortion, and also made me understand why pro-choice advocates are so upset by Christian pregnancy counseling centers using early ultrasound to influence women's decisions about their pregnancies. It also occurred to me, seeing that beating heart, that it was "just tissue" -- the same way my heart, my hands, and my brain are also "just tissue."




Monday, May 14, 2012

Everything Zen? I Don't Think So!

Horatio: "Oh, day and night! But this is wondrous strange!"
Hamlet: "And therefore as a stranger give it welcome. There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy." - Hamlet, Act I, Scene V, 159-167

"And therefore, as a stranger give it welcome." This quote from Hamlet came to me when I was doing my sitting meditation in my mother's garden this morning. I have had mounting anxiety because David and I are approaching our first ultrasound this week. It will be the six week ultrasound, the one where Preston, our reproductive endocrinologist, is looking for what he calls "early cardiac activity" of our embryo. Basically, this is the sonogram where we find out if our pregnancy has a chance. Neither of our others got to the point of having a heartbeat. This is really freaky, because we didn't know until weeks 9 and 11, respectively, that either embryo had died, even though both died around 5-6 weeks. The placenta, not the baby, is what makes most of those lovely pregnancy symptoms, and the placenta continues to grow even sans kid. So, I felt pregnant even though the baby had died. In any case, this is a BFD ultrasound.

I wish I could tell you that I'm all chill about it. That I feel like, "God's will be done," or "It's totally out of my control, so I won't worry." I have moments of grace, but much of the time I feel a knot in my stomach. I recognize that most of it is anticipatory dread: I have had two ultrasounds with disastrous results. As my friend said, "This is operative conditioning: of course you're scared! You've had two terrible experiences." I am definitely remembering "real but not true," though it doesn't always tame the anxiety.

This morning, I tried some of the other techniques I've written about, but none of them were hitting the spot. Then I remembered Tara Brach's "Power of Yes" meditation that she writes about in her book "Radical Acceptance." Basically, instead of doing what I (and most others) usually do -- direct a steady stream of "No, go away!" to anything I have aversion to -- I decided to say "yes" to it. I literally put my right hand on my pounding heart to soothe it, and my left hand on my solar plexus, which is where I seem to most keenly feel anxiety in my body. I said to my anxiety, "Yes, I see you. I understand why you are here." I directed a steady stream of "yes" to it: "Yes, it's ok that you are here. Stay a while, if you need to. I can handle you. Yep, I see you and I feel you." It really took the edge off of the anxiety: I'd say it lowered it from a 7 to a 3, which is a big improvement. Even thinking about this experience now is comforting to me. I instinctively want to run from the sensations of my worry and anxiety; it feels so uncomfortable to me. Spending just 15 minutes dwelling with it today -- welcoming the stranger, to paraphrase Shakespeare (or Rumi!) -- reminded me that I can handle it. I may not like the feeling, but I can be with it, and be ok.  

I will also give a nod to the power of positive distraction when you are worried about something you cannot change. I am losing myself in my knitting and Downton Abbey, and those activities soothe me and distract me in healthy ways. However, these types of distractions feel much more wholesome to me when held in the larger context of awareness; it feels good to pay my seemingly unwelcome  "strangers" a little mindful attention, too.

Thursday, May 10, 2012

Anxiety and Meditation

"Anything can happen
From the point of conception, to the moment of truth
At the point of surrender, to the burden of proof
From the point of ignition, to the final drive
the point of the journey, is not to arrive." -- Rush "Prime Mover"

My anxiety about losing this pregnancy was extremely high yesterday morning. I was catastrophizing things, envisioning our first sonogram ending up just like the previous ones: no baby, two broken-hearted parents. I was really lost in my stories about this, and boy was I suffering! I tried a few tactics to manage this. One, intellectualizing it: "Worrying isn't going to help, so stop. You can't control it." Two, praying for God to remove my anxiety. This technique rarely helps me and it didn't help now. Three, applying "real but not true." That took the edge off, but I remained restless and discontent.

I sat down for my morning seated meditation, and Tara Brach's voice came into my head, with one of her catch-phrases: "What is asking for attention?" I got in touch with what was behind my anxiety, which was the intense longing to be a parent, and for this baby to thrive. Instead of getting lost in what that "meant," which would be more stories, I focused on the sensations of that in my body. The longing manifested clearly in my heart area, and had a distinct color, sensation, texture. I just paid attention to those sensations for about ten minutes, noting them, and not either grasping for them or pushing them away. Just holding them lightly with a tender quality. Evidently, that is what was asking for attention, because my anxiety evaporated, and I was able to stay in the present moment and out of anxious obsession for the rest of the day. What sweet relief!

I have a belief that we all need tool kits for different situations. I don't have one pain management strategy to manage my chronic pain; if I did, I'd be up a creek. This is why people who rely only on pain medications for pain relief rarely find any relief. My pain tool kit includes: warm baths, meditation, exercise, sleep, massage, Feldenkrais, and other techniques, in addition to medication, which I use too. I am coming to understand the same principle applies to my anxiety: I can't have only one tool for it (i.e. Xanax) either, nor can I apply just one meditation technique to it. The technique described above worked yesterday. Sometimes, I need to focus on my anchors (breath, sounds, or bodily sensation) to ease my anxiety -- I literally need to distance myself from it in this way. Sometimes I use a "titrating" technique taught to me by some of my teachers: I pay attention to the bodily manifestation for anxiety, usually in my chest and throat, for a few moments. Then I titrate my attention and apply it to a neutral place in my body, like my thigh, where my anxiety doesn't manifest. Sometimes, my anxiety is too severe for seated meditation at all, and I need to do more walking meditation or mindful movement.  I'm grateful to be developing my tool kit, but it felt like a huge victory yesterday to get such dramatic relief from just opening to what was legitimately asking for my attention.

Monday, May 7, 2012

Real But Not True

"They say it's never too late
To stop being afraid
And there is no one else here
So why should I wait?
And in the blink of an eye the past begins to fade

So have you ever been caught in a sea of despair?
And your moment of truth
Is the day that you say 'I'm not scared'

Put your hands in the air
If you hear me out there
I've been looking for you day and night
Shine a light in the dark
Let me see where you are
'Cause I'm not gonna leave you behind

If I told you that you're not alone
And I show you this is where you belong
Put your hands in the air
One more time..." --
"Unity" by Shinedown


I feel like I've been selling our baby short. Every time someone congratulates me on our pregnancy, I have to somehow negate it with, "Yeah, but, this is my third pregnancy in a year, so we'll see..." I realize I'm saying this for me, not them, but it has been bothering me: I feel like I've been selling our baby short. Again, we encounter the brain's weak attempt to protect me from something that isn't happening. Thank you, brain.

I heard Tsoknyi Rinpoche speak recently (you can listen to his inspiring, funny talk here), and am currently reading his book "Open Heart, Open Mind." One of the most powerful concepts he presents is "real but not true." That is, something can be very real for you, but not actually factually correct. In my case, my fear of losing this pregnancy is very real, and not to be minimized. At the same time, for today, it is not true that I am losing the baby I am carrying. I am very tempted to write "real but not true" on an index card and keep it in my purse. My very real feelings and stories about pregnancy loss are based on my history, my brain's attempt to make sense of it, and my physical body's -- and subtle body's, i.e. energetic field, emotions, etc. -- interpretations of these experiences. For today, which is all any of us has, it is not true that I'm losing this pregnancy. Therefore, it's not fair for me to sell our little one short by qualifying news of our pregnancy with reports of my miscarriages.

I was driving home yesterday from a half-day mindfulness retreat for my Mindfulness-Based Stress Reduction class I'm enrolled in. I normally don't listen to the radio when re-entering the real world after a retreat, but I was so exhausted, I feared falling asleep if I drove home in silence. So, I put on Shinedown's amazing new album, "Amaryllis." Their song "Unity," quoted above, is powerful even if you are not moody and pregnant, and I highly recommend a listen.  However, since I am especially sensitive and emotional right now, it really hit me. Tears started streaming down my face, to the point I considered pulling over. Particularly, the idea that "I'm not gonna leave you behind," and the idea that this baby is NOT alone, and that if God wills it, she or he belongs with David and me -- all concepts related clearly in "Unity." I want to set the intention of encouraging him or her, not prematurely giving up became of my fears based on the past. Grow little one, grow and thrive!

Friday, May 4, 2012

A Heart That's Ready for Anything

"We do this practice to have a heart that's ready for anything." -- Eric Kolvig, to me, about why we cultivate a mindfulness practice

"Darkness has a hunger that's insatiable, and lightness has a call that's hard to hear." -- The Indigo Girls, in "Closer To Fine"

This is my third pregnancy in a year. To our great joy, David and I found out that eight weeks after my D&C for a miscarriage, I am pregnant again. In the past, we only told people whom we'd lean on "if something happened." Both times, something happened. This time, we're trying a different approach: We are embracing that we are just very public people. We don't care if you know we're pregnant, even if things go wrong. In fact, especially if things, God forbid, go wrong. The feedback David and I have  gotten on our blog posts about our miscarriage posts have been overwhelmingly positive; many people said they helped them or helped their friends. We hope that by sharing our experience with this pregnancy, however it turns out, it's helpful. Emboldened by posts such as this one, I want to be upfront this time. I want you to know why I'm overly sensitive, why I'm flaking on commitments (nausea and extreme exhaustion) and that I don't think Sea Bands are fashionable.

I went to a powerful meditation retreat last week, and really connected with teacher Eric Kolvig. I talked with him openly about my grief, and how to apply a mindful and compassionate presence to it. Have you ever had someone say something to you that seemingly went straight through your chest and tattooed itself on your heart? I've had it happen three times; one is too personal to recount here. The second was when my first OA sponsor suggested, "Nothing else you've done to control your food addiction has helped. Why don't you try something different and just trust?" The third was Eric's statement to me that we do our mindfulness practice to have "a heart that's ready for anything." It was clear to me that after a lifetime of feeling blown about by my outside life circumstances, that is my deepest longing: to have a heart that's ready for anything.

If you know me you know that I am anxious by nature, and in fact have a severe anxiety disorder. So, I don't have unrealistic expectations that I'm going to be all Zen about this pregnancy. Every pregnant woman I've asked worries through her pregnancy.  After all, the stakes could not be higher, and we all desperately want to control the uncontrollable. What I am aiming for is to bring a mindful and compassionate awareness to my experiences, and not over-identify with them or become lost in my stories. For example, the other night I was brushing my teeth and thought, "I wonder if I'll have an ectopic pregnancy." I have no signs of an ectopic and no reason to think I'd have one. Instead of beating myself up for the "stupid" thought, I said to myself, "Sarah, brush your teeth. You're pregnant right now." I kindly acknowledged to myself that my brain is looking for ways to predict danger so it can protect itself. It's what brains do, the same way that hearts beat. That doesn't mean I have to buy into every thought my brain comes up with.

Another example of what I'm trying to achieve with this pregnancy is this: yesterday I became gripped with fears that we will lose this baby. Instead of my usual coping mechanisms, like telling myself that the doctors said we have a 70 percent chance of having a live birth eventually, or saying to myself, "don't worry," I took the advice of my teacher Tara Brach. She told me to greet the fear with compassion. So I put my hand on my heart and said, "Of course you're scared. It's ok." I then reconnected with my body and breath. This felt much better than pushing away what is desperately seeking my attention. This process about applying mindfulness to a pregnancy that has some anxiety coming up is what I hope to share on my blog.

So here I sit, full of anticipation about our pregnancy. Hope and optimism that things will go well, but the life experience to know that things might not. Yet, I truly feel like my heart is ready for anything. Bring it.