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I was a successful accounting manager, climbing the corporate ladder, before I was "thrown off" by the concurrent diagnoses of cancer and severe brain injury. I now have untreatable chronic pain, fatigue, memory problems (both loss of memories and difficulty in making new memories) chronic hunger, thirst etc. I am now unable to work and have moved back with my parents. Psychologists have told me I've coped very well - I've not ignored it or anything. But I still get reminders of things that I've lost popping up several times a day and depending on my mood they sometimes make me feel sad. Unfortunately because of my poor memory I can't remember to try to change the thinking at the time I'm processing the sad thought. Is there anything easy that I can do for myself?

Thanks Doctor Robert


Dear Iolanda--

So that other readers will understand, I should mention that you wrote me a long "ask the psychologist" letter earlier, explaining that you had been severely disabled by your illnesses, and asking me how to cope with your new situation. In reply to that letter, I wrote the following:

"I thought of answering your question on my website, but a colleague of mine already has written something very helpful on this subject, and, since I doubt that I could do better, I will refer you to her article. You will find it here.

If I can be of further help, please do not hesitate to write to me."

Now you have written again asking a second question which is a bit different from the first, and this time I would like to reply personally. First off, I know that you have taken some very hard hits. You have had to cope with severe illnesses, and now, as a result of your illnesses, you have lost some your previous abilities and potential. Further, you have gone from a situation of relative independence to a situation of dependence on your parents, which must be painful to you no matter how willing they may be to help. I want to say before continuing that I feel for you, that I understand that you have lost a great deal, and that I know you have much to mourn. I cannot think of a single person in my acquaintance who would be able to cope with your kind of situation without a great deal of struggle. In other words, remembering all you have lost and feeling sad about that loss, to me seems perfectly normal and expected.

This is to say, please do not feel guilty about your sadness. Instead of trying to cheer up as your letter implies you imagine you should, Iolanda, I suggest that you allow yourself to feel sad when you do, and that you simply watch the sadness as it changes into other feelings and other thoughts, and then, perhaps, back again into a sense of sadness, or perhaps into a feeling of the unfairness of life and of your losses. If you observe this flow of feeling without trying to change anything, I think you will come to see that sadness is only a part of your daily experience, and that other feelings also arise, some of them even enjoyable to you.

Now, as to a recommendation about how to better manage your psychological situation--it is this:

I suggest that you learn to live life in the present. I have written a bit about this elsewhere, but will say more about it here.

Of course, most people imagine that they already do live in the present. After all, where else can one live? Well, this is true, undoubtedly, on the physical level. In each moment, the body must breathe, the heart must beat, etc. This is obvious: last week's respiration or yesterday's heartbeat will do nothing for remaining alive in this moment. But the same is not true of the process we call thought. Thought may travel far into the remembered past or far into an imagined future. Thought may even create worlds that never were and never will be. And these thoughts constantly arise. Constantly. If you will take a few moments simply to watch your thoughts without trying to change them or judge them, you will see easily that this is true. Thoughts flow like water in a stream, constantly changing and constantly moving on. Perhaps there are small spaces between the decay of one thought and the birth of another, but the flow of thoughts--the stream of consciousness, that is--never ceases, except in the deepest, dreamless sleep.

If you will sit quietly, close your eyes, and put your attention on your breathing, you will begin to relax. Simply observe your own breath, without trying to change anything. Probably your breath will deepen naturally as you do this, but do not try to make it deeper. Do not try to do anything. Simply put your attention on your own breath, and allow the body to breathe as it wishes. Once you begin to do this, you can assist the process of relaxation and observation of your breath by counting your breaths. Just count each time you exhale. Begin counting at 1, continue until breath number 10, then begin again at 1. If you lose count, don't worry, just start again at 1.

When you follow this procedure, I think you will find that your attention will wander away from observation and counting of your breaths to thoughts about other matters. When it does, don't worry, just return to counting your own breaths. In other words, when you find yourself lost again in thought, just gently shift your attention from whatever thought has captured it back to counting breaths. Just let whatever thoughts arise simply to pass by on their own like water in a stream. Your attention is not on them, but only on counting your breaths.

I suggest that you practice this exercise two or three times a day at first, perhaps for ten or fifteen minutes at a time. If you will do this, I think you will find after a while that you will have developed the ability to get out of your thoughts when they are troubling you, and back into the actual present time--out of your head, that is, and back into your body and its real, present existence.

This is totally different from telling yourself not to feel sad. Sadness is real enough (the emotions are a psycho-physical experience which involves not just thoughts, but also all the organs of the body), and should be honored. But dwelling on sad thoughts is not helpful, and as you work with this technique, I think you will gain the ability not to be dominated by sad thoughts, not to be dominated by any thoughts whatsoever, but rather to allow thoughts to arise and pass away naturally, as clouds in the sky constantly move, rearrange themselves, and pass into nothingness. When you do that, you are in the present--the only place where life--and happiness--really is.

I hope this will help.

Be well.

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