2016 crisis, Chronic Anxiety, Gut Feelings

How Mindfulness Helps Me Manage My Ulcerative Colitis


Noise
Is a cruel ruler
Who is always imposing
Curfews.
While
Stillness and quiet
Break open the vintage
Bottles,
Awake the real
Band.

~ Hafiz
(translated by Daniel Ladinsky)


When I returned home from a long hospitalization in 2016, I began to practice mindfulness and meditation for the first time in my life. These were practices that would stick with me—I’m writing this post two years after I got out of the hospital. They still greatly help me to live with and manage my ulcerative colitis.

My journey into mindfulness, and my struggle with chronic anxiety, are such important and rich parts of my story that I’m writing a whole book about them. But in the meantime, I’ll summarize the best of what I’ve learned here.


Discovering Presence

After a month in the hospital, I was a changed woman. My severe colitis flare and C. diff infection had caused me to lose thirty-four pounds, which I’d only begun to slowly regain in the few days before returning home.

Never had I experienced such terrifying frailty. My legs and arms were sticks, and I could barely walk to and from the bathroom. My body had entered such a state of starvation that I was rapidly losing my hair—most of it would fall out over the coming months in a delayed response to the stress on my system. Had I not had my husband at home to care for me, I wouldn’t have been discharged from the hospital anytime soon, because I was still utterly dependent on others.

It was partly the emotional trauma of the summer’s crisis that motivated me to pursue mindfulness. For years, prior to developing colitis, I’d known meditation and mindfulness would be good for me—I had always been prone to workaholism and anxiety—but I’d had no desire to slow down. I had felt these practices would just get in the way of all my projects and goals.

Now that was different. Early in my crisis, I had realized it was largely my refusal to slow down that had derailed my health. To avoid more catastrophes in the future, I now needed to make deep-down changes. It was time to finally learn to take better care of myself.

The lesson had needed to wait till after the crisis resolved, though. In the hospital, I was engulfed in physical pain, discomfort, and raw fear. At the height of an ongoing trauma, the thought of trying to be “present” only caused panic to rise up within me. It was only now, with my pain subsiding and back home in a safer space, that I could begin learning about presence.


My husband Ron and I owned several books by the Buddhist monk Thich Nhat Hanh. I had read parts of them a long time ago, in Peace Corps, but had neglected them for over a decade. I pulled two off the shelf now: Being Peace and Touching Peace. I knew immediately that the books contained wisdom that was missing from my life.

Even when we have some leisure time, Nhat Hanh writes, we don’t know how to use it to get back in touch with ourselves…We are not used to being with ourselves, and we act as if we don’t like ourselves and are trying to escape from ourselves.

That had described me perfectly for years. I was busy, busy, busy, and even in leisure hours, I kept my mind occupied with TV or other entertainment, or with plans and fantasies about getting my projects done.

But my near-death experience had awakened me to the importance of being present, and my ongoing exhaustion was forcing my world to become smaller and slower. I couldn’t be productive. My whole job right now was to rest and heal. My illness had wrangled me into submission, and I had surrendered.

So I lay on the guest bed and quietly read Thich Nhat Hanh, and I practiced breathing.


Touching Peace is filled with small meditations.

Breathing in, I know that I am breathing in.
Breathing out, I know that I am breathing out…
Breathing in, I see myself as a flower.
Breathing out, I feel fresh…
Breathing in, I see myself as a mountain.
Breathing out, I feel solid…

I would read a passage then put the book down, placing my hand on my tender belly and feeling it rise and fall as I breathed. Even this small act of pausing and following my breath was powerful for me. I had never done it before. Or perhaps I had done it in passing, at workshops or as a brief exercise, but never like this. Never with the earnest goal of learning an important new skill.

As the weeks passed, I became stronger. One by one, I hit milestones. I took the stairs without Ron’s help. I walked on a flat road without using a hiking pole or clutching Ron’s arm. I stood from the toilet without using my hands to pull myself up. I took a shower instead of a bath. I drove myself to a store. I cooked a meal for myself. I began working part time from home.

All the while, I learned more about mindfulness. The more my strength returned, the more I could explore different techniques and find the ones that worked best for me. I was determined to incorporate these practices into my new life, to rebuild it healthier than it had been before.


Mindfulness Practices

There is a broad range of practices to choose from. The general idea of mindfulness is training the mind to pay attention: to be present in the moment, and to notice what’s happening in the body, the thoughts, and the feelings. For me, the goal was also to calm my naturally anxious nervous system.

Mindfulness can be practiced anytime, but specific exercises help in developing skills. Meditation is one broad category of such exercises.

There are many ways to meditate. At first, I wasn’t strong enough to sit upright on a cushion, and the concentration of clearing my mind took too much effort to do for long. But when I became stronger, I began sitting for ten, fifteen, or twenty minute intervals and practicing various techniques I learned in books. Sometimes I followed my breath, counting breaths from one to ten and then starting over. Sometimes I tried the flower and mountain meditations that Thich Nhat Hanh described. I discovered the pleasure of lovingkindness meditation, in which you send loving thoughts to yourself, your loved ones, strangers, and even enemies.

And although there are countless ways to meditate, I came to realize that the point was not to master them all or to develop a catalogue of them in my mind. The point was much simpler: to stop, and to observe.

Zooming through too many books and techniques was a potential trap, a way even a meditator might distract herself from herself. The important thing was not the books or techniques, but the unstructured time: the moments spent actually pausing and looking inward.


Along with meditation, I’ve found many other practices that either cultivate mindfulness, calm my anxious nervous system, or (often) both. For simplicity, here’s a list of my favorites, in no particular order:

  1. Mindfulness chimes. These are bell-like sounds programmed on phones or computers to sound at regular or irregular intervals throughout the day. On my Android, I often turn on an app called MindBell and program it to chime once every half hour. When it does, I stand, stretch, and take three deep belly breaths. This provides a wonderful check-in and helps ensure that I never get so wrapped up in my work that I forget to tend to my body.
  2. Guided visualizations. My favorites are by Belleruth Naparstek, who has recorded many luxuriant sessions in which you lie peacefully and listen to her voice. One series even deals directly with healing IBD and IBS; another is for anxiety and panic.
  3. Forest bathing and walking meditation. Moving slowly through a forest or even through my own neighborhood, I pay attention to trees and plants, and often pause to take in or touch their textures and smell their scents. Connecting with nature in this way makes me feel alive and at peace.
  4. Mindful eating. I like to remind myself, during meals or even just when beginning to eat, to contemplate where my food came from. Taking slow, intentional bites while thinking about the food’s ingredients and origins, I remind myself of the interconnectedness of all life. And eating mindfully is good for digestion.
  5. Tai chi. This is a form of gentle movement that’s especially useful for those who are averse to sitting still. It cultivates balance, inner strength, and healthy energy as well as mindfulness. My tai chi classes are full of people decades older than me; I’m honored to learn with them and feel like I’m getting a head start on healthy aging.
  6. Abhyanga. This wonderful ayurvedic self-massage with warm oil calms the nervous system and fosters lovingkindness towards oneself. I do it once a week or so, and it always makes me feel blissful afterwards.
  7. Tibetan singing bowls. Their ethereal sound is said to open the chakras, and whether or not that’s true, I find it deeply relaxing. Many free videos are available online, and if you are willing to invest in your own bowl, playing it can help cultivate mindful awareness. Often, when I feel unfocused, playing my bowl helps my mind to clear.
  8. Reading for nourishment. Before my crisis, most of my reading was goal-oriented: I read mainly nonfiction, such as history and health books. Now I read mainly either contemplative works, such as books by Thich Nhat Hanh, or fun fiction, like cozy mysteries by Louise Penny and Martin Walker. My mind is much more relaxed!
  9. Sabbath. Each week, I take a day off from screens, productivity, and stress. This practice warrants more explanation; I’ll describe it in its own section of this post.

As I explored all these practices, I discovered a rich world inside myself. Stillness had always made me nervous in my previous life—I had habitually structured my time and even my thoughts. Now I discovered the joy of just being: just noticing my surroundings, my body, and my feelings. Often, I found myself feeling truly calm and grounded for the first time in my life. My chronic anxiety was finally beginning to ease.


The Power of Letting Go

Reemerging back into life in the years following my health crisis, I sometimes struggled to balance my newfound love of mindfulness with the demands and opportunities of the modern world. The key, I’ve found, is to let go of doing everything.

If moving at a slower pace and taking time to check in with myself is truly a priority, then my other habits have to be adjusted to make space for the new ones. I’ve let go of many things. I’ve pared down the number of hours I work (and thus the money I earn), the number of friends I see on a regular basis, and the number of hobbies I pursue at one time. I find myself saying “no” a lot, gently.

My schedule used to be much fuller, but now, my life is fuller. Letting go of things sometimes brings sadness or frustration at first, but I’ve learned that those feelings are usually followed by relief.

It’s a relief to remember, again and again, that the modern world asks too much of us, and that what is a normal pace for many of the people around me is not healthy, at least for me. I’ve discovered that when I simplify and do less, my happiness generally increases.

The modern world is fueled by consumerism and capitalism, in which corporations convince people that they need more than they already have. There always seems to be a better device, a better house, a better body, a better vacation spot, a better life than the one we have here and now. But paring down my life and expectations has opened up the simple joy of gratitude for what I already have. And some of Ron’s and my best vacations are those where we just stay home.

Most people now are looking for “a better place,” Wendell Berry writes, which means that a lot of them will end up in a worse one… There is no “better place” than this, not in this world. And it is by the place we’ve got, and our love for it and our keeping of it, that this world is joined to Heaven.


My Sabbath Practice

Once a week, I honor a secular Sabbath of my own invention. Along with reading for nourishment, this is probably the practice I’ve followed most consistently since my hospitalization.

On a Saturday or Sunday, I almost always abstain from screens, productivity, and stressful pursuits. If we have a newspaper lying around, I flip it over on Sabbath so I don’t see its headlines. I tell my family I won’t be available via text or email (actually, by now they know to expect this). I may check my phone briefly to meet up with someone, but otherwise my phone is off. If I need to look something up, I use the dictionary or our old atlas, or I write it down to remember to look it up the next day on the internet.

I usually spend most of Sabbath journaling, reading, hiking or walking in nature, and visiting with friends. If possible, I try not to drive, which is stimulating and can be stressful. I try to spend at least a few hours alone, checking in with myself, sometimes meditating and/or playing my Tibetan singing bowl. Often, this is the day I do abhyanga (the self-massage with warm oil, mentioned above), followed by a nice bath.

If there’s too much to get done in a weekend and I can’t avoid productivity on my Sabbath, I save the most enjoyable, nurturing tasks for that day. Cooking. A trip to the Farmer’s Market, hopefully walking there instead of driving. An easy organizing project at home that doesn’t require too much thinking.

But better yet, I just don’t get everything done that I was hoping to do. I let the house be messy, let projects go uncompleted. Rest is just as important as productivity.


In busy, focused weeks, I occasionally find myself reluctant to take my Sabbath. If I only had both weekend days to get things done, I would get so much more done!

But then Sabbath will roll around and I will often feel myself unexpectedly exhausted. My body knows it can fully relax that day. I realize I didn’t actually have as much energy as I had thought. Often, by afternoon I am drowsy and take a long nap.

This fatigue tells me that Sabbath is necessary for me. If I allowed myself to stay caught up in the busy world, it would be harder to notice my need for rest.

Sabbath is my anchor. Returning to simplicity, rest, and mindfulness once a week keeps me from straying too far into my natural anxiety and workaholism. I can see why this practice is so important in traditional Judaism and Christianity. And while I am not using Sabbath to attend synagogue or church, I do think of this as a spiritual day, a day to check in with myself, my center, and my connectedness to the universe.


How Mindfulness Helps My Colitis

Discovering mindfulness has had a profound and lasting impact on my life. The discovery was midwifed by colitis, and I see mindfulness as important for my disease management. But it’s important to discern what these practices do for my colitis and what they do not do.

Meditation and mindfulness reduce inflammation, which is one of the two key problems of ulcerative colitis. The other key problem, I believe, is an imbalanced gut microbiome, and meditation and mindfulness do little for this.

I’ve met IBD sufferers who hope to get their disease under control through meditation retreats, and I tend to feel that such retreats will only get us partway there. Without probiotics and prebiotics to rebalance the microbiome, a major trigger of inflammation will probably still remain and prevent healing.

In addition, there are IBD sufferers who get their diseases under control without mindfulness. One is Kenny Honnas, a bodybuilder whose entire strategy involves rebalancing the gut microbiome. I myself was another example: my first remission was achieved through a combination of probiotic foods, healthy diet, and a mild med, and there was no significant psychological element involved in my healing.

Between healing the microbiome and practicing mindfulness, healing the microbiome is probably the most important.


But my year-long remission didn’t last. And that speaks to the other benefit of mindfulness in disease management, at least for me.

In cases of chronic anxiety like mine, mindfulness has the psychological benefit of helping patients to make healthy choices. If you check in with yourself often and cultivate an awareness of your body’s sensations, you will care for it better. For this reason, for IBD sufferers who tend toward anxiety or feel disconnected from their bodies, learning about mindfulness is one of my main recommendations.

If I’d been practicing mindfulness in 2016 as I do now, I know that I would have stepped back, recognized the danger of the stress and unhealthy food I was putting into my body, and changed my habits before my crisis began. Mindfulness isn’t all I need to be healthy, but it helps me maintain healthy habits. That makes it an essential element of managing my disease.

Leave a Reply

Your email address will not be published. Required fields are marked *