Dancing in the Rain: Learning How to Live With Treatment-Resistant Depression and Chronic Pain

“Life isn’t about waiting for the storm to pass … it’s about learning to dance in the rain,” wrote Vivian Greene. Dancing in the rain is the modus operandi of folks living with chronic pain. They spend a lifetime figuring out how to dance gracefully–with little effort visible to the observer—and to resist the urge to sit down and close their eyes until the sun comes back out.

Living with treatment-resistant depression, the kind of melancholy that hangs around for years or decades or sometimes a lifetime, requires the same skills. We don’t often categorize it as such, but treatment-resistant depression is a type of chronic illness, sometimes involving disabling pain on a daily basis. Like most people with compromised health, I have concentrated my energy for the last 40 years on how to get rid of the pain, how to get to a better spot where I will be able to live more freely and won’t have to spend so many hours with my nose to a self-help book or scribbling symptoms in my mood journal, recording the day’s number, between a serene 0 and a suicidal 5.

I have always regarded peace as the absence of pain, and happiness a place with no discomfort.

One of the lessons taught in the mindfulness-based stress reduction (MBSR) program in which I am participating is to approach pain in a new way: as a friend from whom we can learn a thing or two, and as something we can work with, rather than an enemy from whom we have to run. The course, designed to help people manage chronic illnesses with calmness and experience more peace in their lives, uses mindfulness meditation as a way of working through pain. In his book “Full Catastrophe Living,” Jon Kabat-Zinn, the founder of the program, writes, “Mindfulness involves a determined effort to observe and accept your physical discomfort and your agitated emotions, moment by moment.”

Whenever possible, Kabat-Zinn suggests that, instead of escaping from pain, that we go into the very core of it.

If you have ever experienced the pain of childbirth, had your appendix burst unexpectedly, or passed a kidney stone, you might question his advice. I certainly did. I am not one for singing “Come By Ya” as I lay on the gurney on my way to surgery. However, this new perspective affords me a sense of control over my health, a new relationship with pain and suffering in which I am the driver, not the panicked passenger in the back seat on the way to the psych ward.

Kabat-Zinn offers a few insights that can help us work with pain.

Pain isn’t static.

The first is a lesson explained in Lamaze classes: pain isn’t solid or constant. Much as we like to think otherwise, it is not a static experience. It waves. There are seconds of excruciation, followed by seconds of calmness. If we can focus on the impermanent nature of pain, the distinct changes in its intensity, we can transcend some of the suffering.

We are not our pain.

Kabat-Zinn explains that it’s easier to enter into pain for even one breath or a half of breath if, instead of categorizing the overall feeling as “pain,” we tease apart its many sensations, emotions, and thoughts. We might hear all kinds of fear-based thoughts like “I’m never going to feel better,” or “How long until I die?” or “I can’t take it anymore.” Kabat-Zinn reassures us that none of them is the pain itself. Even better, none of them is us. “Your awareness of sensations, thoughts, and emotions,” he writes, “is different from the sensations, the thoughts, and the emotions themselves—that aspect of your being that is aware is not itself in pain or ruled by these thoughts and feelings at all. It knows them, but it itself is free of them.”

Pain is universal.

Kabat-Zinn includes in his book a letter from Albert Einstein to a grieving father of a 16-year-old girl. The father basically asked this scientific genius, who was also known for his compassion and wisdom, why these things happen. In response, Einstein explained the delusion with which we often experience ourselves, as separated from the rest of humanity. “This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us,” Einstein wrote. “Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all living creatures and the whole nature in its beauty.” He did not write this to make less of the man’s pain in any way, or to say that he was wrong to grieve. He merely reminds us to never lose sight of our place in a larger wholeness that is beyond our comprehensibility. The late theologian Henry Nouwen said it this way: “Every time you can shift your attention away from the external situation that caused your pain and focus on the pain of humanity in which you participate, your suffering becomes easier.”

You need to be well enough to go into your pain, of course. When I’m severely depressed this exercise is futile. Kabat-Zinn says as much, with his coauthors, in his introduction to the book “The Mindful Way through Depression.” However, when I’m grounded enough to experiment with this perspective, I have found that by staying with the pain, and accepting it as merely part of the chronic illness I’ve had since the fourth grade is immensely freeing. I’m less afraid of my depressive episodes and the damage that they might leave. I can sometimes find the quiet within the storm, which leads me to peace.

Originally posted on “World of Psychology.”

Image: danceyourheartaway.com