Advance Healthcare Planning Part 2:
Why Filling Out Your Forms is Not Enough
In Part One of this article, I discussed why every mentally-competent individual over the age of 18 needs to have advance healthcare plans in place. Here we will look at the in’s and out’s of how to make sure your plans will be able to be put into effect when the time comes. To put the importance of Advance Healthcare Planning (AHP) into perspective, consider the following facts:
• Doctors are trained to preserve and save lives and for many it is difficult and sometimes considered a professional failure to broach the subject of death and referral to palliative care or Hospice services rather than to suggest yet another treatment with slim possibilities of helping the patient to recover.
• According to the Center for Disease Control the vast majority of Americans say they want to die at home, but 75% die in a hospital or nursing home.
• Almost 1/3 of Americans see 10 or more doctors in the last 6 months of their life, most dying in the ICU. (Source: Dartmouth Atlas of Healthcare, 2005)
• In 2009, Medicare paid $55 billion just for doctor and hospital bills for the last two months of patients’ lives. That’s more than the budget for the Department of Homeland Security or the Department of Education. It’s been estimated that 20-30% of these medical expenses may have had no meaningful impact. Most of these bills were paid by the Federal government with few or no questions asked. (Source: The Cost of Dying, 60 Minutes, 8/8/10)
As mentioned, most of us who have even filled out our Advance Healthcare Directives, are woefully in the dark about some very important aspects of how this all works. Basically, filling out the forms simply isn’t enough. That’s only one of five critically important things you have to do to ensure that whoever you appoint as your Healthcare Proxy will be able to speak competently on your behalf if, and when, you cannot speak for yourself. The five key things you need to do are:
1. Educate Yourself and Others: Before you fill out any forms, educate yourself about all the terms and nuances involved. Understand the purpose of each form as well as what it can and cannot do. Here are some fundamental points you should be aware of:
• A Healthcare Proxy is a legal document. It can be overridden by either a revised form or by your spoken word (when conscious and mentally competent). Your proxy is only called upon if and when important healthcare decisions need to be made and you are unable to do so for yourself. This means, anytime you are having surgery and being anesthetized, are unconscious briefly or for an extended period of time, or are declared mentally incompetent to speak for yourself. If you don’t have this form filled out in advance of need, then you forfeit the opportunity to exercise your right to choose a spokesperson.
• Remember, according to the U.S. Census Bureau, 28% of us die before reaching the age of 65 – so do yourself and your family a great service by educating yourself and them about Advance Healthcare Planning.
• When selecting your healthcare proxy and alternate proxy, your obvious choice is often not the right one. Don’t worry about offending anyone for not choosing them, but be sure to explain to them why you made another choice. For example, my brother was my obvious choice, but when I reflected on how hard it was for him to be around our mother when she was dying, I realized how hard it would be for him to serve me in that way and chose someone else, but have made sure he will be well-informed and able to just focus on being my loving brother. Other than the legal criteria spelled out by your state laws, consider the following in choosing your proxy. Pick someone who:
• Knows you well and will respect your wishes and needs even if they would make different personal choices.
• Can provide a safe emotional space to share your thoughts and feelings without imposing theirs on you.
• Will be able to take care of him or herself while serving in this capacity for you.
• Will support your needs even when the going gets tough.
• Will be able to speak up to doctors and caregivers to be sure your wishes are honored.
• Will stay informed of your condition and be available to make important decisions.
• Is likely to be available in the future. For example, does he/she live close by? If not, will they come if needed?
• Will be able to be assertive in handling potential conflicts between your family, friends, doctors, and/or caregivers?
• A Living Will is not always considered a legal document, but is intended to provide clear and convincing evidence of your wishes regarding care and treatment in the event that you are deemed to have no reasonable expectation of recovery. The purpose of a living will is to exercise your right to instruct your doctors and caregivers to withhold or withdraw treatments that would simply prolong your life under such conditions and to focus instead of keeping you comfortable and pain-free. Specific treatments that are often withheld or withdrawn are:
• Cardiac Resuscitation (CPR) is a group of treatments used when someone’s heart and/or breathing ceases. CPR attempts to restart the heart and breathing through mouth-to-mouth breathing, pressing on the chest to circulate the blood, electric shock, and/or drugs to stimulate the heart. When used quickly in response to a sudden event like a heart attack or drowning, it can be life saving. However, if someone has stopped breathing for more that 4-6 minutes lack of oxygen to the brain may lead to brain damage. It is important to realize that the success rate for CPR is extremely low for people at the end of a terminal disease process – especially for the elderly where successful CPR, if achieved at all, is seldom sustainable and often results in broken ribs.
• Mechanical Respiration involves inserting a tube through the nose or mouth and into the windpipe, forcing air into the lungs. For the dying patient, mechanical ventilation often merely prolongs the dying process until some other body system fails. It can supply oxygen, but it cannot improve the underlying condition.
• Artificial Nutrition and Hydration can save one’s life by supplementing or replacing ordinary eating and drinking when used while the body is healing. It can also be used long-term for those with serious intestinal disorders or an irreversible and end-stage condition. Withdrawing artificial nutrition and hydration does not cause starvation or pain to the patient and no legal or ethical issues exist when this is done in accordance with the patient’s wishes. It is the underlying disease and NOT the withdrawal of treatment that causes death.
• Antibiotics are often used in hospitals and other healthcare facilities where elderly and terminally ill patients are often vulnerable to contagious and opportunistic infections. Antibiotics tend to weaken the immune system and make the patient susceptible to other infections and a downward spiral of one infection and antibiotic after another.
• Maximum Pain Relief, including the use of narcotic medications for the terminally ill patient is considered by many to be truly compassionate and humane. It is indeed for this purpose that these medications exist because they enable doctors to effectively treat most pain and keep the patient comfortable.
2. Fill Out Your Forms: As mentioned in Part 1 of this article, there are lots of wonderful websites to consult about the in’s and out’s of Advance Healthcare Planning. For the state of New York, for example, I recommend going to Excellus BlueCross BlueShield to view their Advance Care Planning booklet which can be downloaded from their site. Similar sites exist for all states and provide detailed explanations of the in’s and out’s of Advance Healthcare Planning and provide the state’s forms.
3. Communicate Effectively
Talk to your healthcare proxy, family, loved ones, and doctors about the specifics of your wishes regarding end-of-life care. Don’t be surprised if they resist and/or insist they don’t want to talk about things like that. Ask them to listen for you because it is important to you and because you do not want any squabbling or misunderstanding over your wishes regarding care and your choice of a Healthcare Proxy.
4. Distribute and Enforce: Plain and simple – what good are your forms if no one knows where they are or what they say? You need to know where your forms are and you need to make copies and distribute them to your doctor(s), proxy and alternate proxy, and bring a copy when being admitted to the hospital or having a same day surgery – in other words, any time you might be put under anesthesia. Get a business card-size proxy form for your wallet. There is one, for example, that can be used for anyone from any state at the end of the Excellus BlueCross Blue Shield Advance Care Planning booklet mentioned in #2 above. Also, keep a copy of your proxy and Living Will in the glove compartment of your car and bring them with you whenever traveling – especially overseas.
5. Review Your Decisions at Least Each Year: When looking over your forms each year, be sure to check online to find out if there have been any changes in your state’s laws regarding AHP. If so, review those to be sure your forms and understanding of the laws are up to date. If needed, redo your forms and redistribute them as discussed in #4 above. Each year and whenever there is a major change such as a change in the law or a new medical treatment option that might affect your choices or you receive a terminal diagnosis, have a change of marital status, relationship, or a change of heart review your Healthcare Proxy and Living Will to be sure they remain an accurate reflection of your wishes.
Advance Healthcare Planning is your right, but it is your responsibility to get in the driver’s seat and exercise that right. That is not a one-time thing. Circumstances change and so do our minds. Pay attention and take care of your precious self so others can take care of you according to your wishes if such a time comes.
Please circulate this article among your social network – it might save someone’s life or at least save them from a lot of heartbreak.
Advance Healthcare Planning Part 2: Why Filling Out Your Forms is Not Enough
Advance Healthcare Planning Part 2:
Why Filling Out Your Forms is Not Enough
In Part One of this article, I discussed why every mentally-competent individual over the age of 18 needs to have advance healthcare plans in place. Here we will look at the in’s and out’s of how to make sure your plans will be able to be put into effect when the time comes. To put the importance of Advance Healthcare Planning (AHP) into perspective, consider the following facts:
• Doctors are trained to preserve and save lives and for many it is difficult and sometimes considered a professional failure to broach the subject of death and referral to palliative care or Hospice services rather than to suggest yet another treatment with slim possibilities of helping the patient to recover.
• According to the Center for Disease Control the vast majority of Americans say they want to die at home, but 75% die in a hospital or nursing home.
• Almost 1/3 of Americans see 10 or more doctors in the last 6 months of their life, most dying in the ICU. (Source: Dartmouth Atlas of Healthcare, 2005)
• In 2009, Medicare paid $55 billion just for doctor and hospital bills for the last two months of patients’ lives. That’s more than the budget for the Department of Homeland Security or the Department of Education. It’s been estimated that 20-30% of these medical expenses may have had no meaningful impact. Most of these bills were paid by the Federal government with few or no questions asked. (Source: The Cost of Dying, 60 Minutes, 8/8/10)
As mentioned, most of us who have even filled out our Advance Healthcare Directives, are woefully in the dark about some very important aspects of how this all works. Basically, filling out the forms simply isn’t enough. That’s only one of five critically important things you have to do to ensure that whoever you appoint as your Healthcare Proxy will be able to speak competently on your behalf if, and when, you cannot speak for yourself. The five key things you need to do are:
1. Educate Yourself and Others: Before you fill out any forms, educate yourself about all the terms and nuances involved. Understand the purpose of each form as well as what it can and cannot do. Here are some fundamental points you should be aware of:
• A Healthcare Proxy is a legal document. It can be overridden by either a revised form or by your spoken word (when conscious and mentally competent). Your proxy is only called upon if and when important healthcare decisions need to be made and you are unable to do so for yourself. This means, anytime you are having surgery and being anesthetized, are unconscious briefly or for an extended period of time, or are declared mentally incompetent to speak for yourself. If you don’t have this form filled out in advance of need, then you forfeit the opportunity to exercise your right to choose a spokesperson.
• Remember, according to the U.S. Census Bureau, 28% of us die before reaching the age of 65 – so do yourself and your family a great service by educating yourself and them about Advance Healthcare Planning.
• When selecting your healthcare proxy and alternate proxy, your obvious choice is often not the right one. Don’t worry about offending anyone for not choosing them, but be sure to explain to them why you made another choice. For example, my brother was my obvious choice, but when I reflected on how hard it was for him to be around our mother when she was dying, I realized how hard it would be for him to serve me in that way and chose someone else, but have made sure he will be well-informed and able to just focus on being my loving brother. Other than the legal criteria spelled out by your state laws, consider the following in choosing your proxy. Pick someone who:
• Knows you well and will respect your wishes and needs even if they would make different personal choices.
• Can provide a safe emotional space to share your thoughts and feelings without imposing theirs on you.
• Will be able to take care of him or herself while serving in this capacity for you.
• Will support your needs even when the going gets tough.
• Will be able to speak up to doctors and caregivers to be sure your wishes are honored.
• Will stay informed of your condition and be available to make important decisions.
• Is likely to be available in the future. For example, does he/she live close by? If not, will they come if needed?
• Will be able to be assertive in handling potential conflicts between your family, friends, doctors, and/or caregivers?
• A Living Will is not always considered a legal document, but is intended to provide clear and convincing evidence of your wishes regarding care and treatment in the event that you are deemed to have no reasonable expectation of recovery. The purpose of a living will is to exercise your right to instruct your doctors and caregivers to withhold or withdraw treatments that would simply prolong your life under such conditions and to focus instead of keeping you comfortable and pain-free. Specific treatments that are often withheld or withdrawn are:
• Cardiac Resuscitation (CPR) is a group of treatments used when someone’s heart and/or breathing ceases. CPR attempts to restart the heart and breathing through mouth-to-mouth breathing, pressing on the chest to circulate the blood, electric shock, and/or drugs to stimulate the heart. When used quickly in response to a sudden event like a heart attack or drowning, it can be life saving. However, if someone has stopped breathing for more that 4-6 minutes lack of oxygen to the brain may lead to brain damage. It is important to realize that the success rate for CPR is extremely low for people at the end of a terminal disease process – especially for the elderly where successful CPR, if achieved at all, is seldom sustainable and often results in broken ribs.
• Mechanical Respiration involves inserting a tube through the nose or mouth and into the windpipe, forcing air into the lungs. For the dying patient, mechanical ventilation often merely prolongs the dying process until some other body system fails. It can supply oxygen, but it cannot improve the underlying condition.
• Artificial Nutrition and Hydration can save one’s life by supplementing or replacing ordinary eating and drinking when used while the body is healing. It can also be used long-term for those with serious intestinal disorders or an irreversible and end-stage condition. Withdrawing artificial nutrition and hydration does not cause starvation or pain to the patient and no legal or ethical issues exist when this is done in accordance with the patient’s wishes. It is the underlying disease and NOT the withdrawal of treatment that causes death.
• Antibiotics are often used in hospitals and other healthcare facilities where elderly and terminally ill patients are often vulnerable to contagious and opportunistic infections. Antibiotics tend to weaken the immune system and make the patient susceptible to other infections and a downward spiral of one infection and antibiotic after another.
• Maximum Pain Relief, including the use of narcotic medications for the terminally ill patient is considered by many to be truly compassionate and humane. It is indeed for this purpose that these medications exist because they enable doctors to effectively treat most pain and keep the patient comfortable.
2. Fill Out Your Forms: As mentioned in Part 1 of this article, there are lots of wonderful websites to consult about the in’s and out’s of Advance Healthcare Planning. For the state of New York, for example, I recommend going to Excellus BlueCross BlueShield to view their Advance Care Planning booklet which can be downloaded from their site. Similar sites exist for all states and provide detailed explanations of the in’s and out’s of Advance Healthcare Planning and provide the state’s forms.
3. Communicate Effectively
Talk to your healthcare proxy, family, loved ones, and doctors about the specifics of your wishes regarding end-of-life care. Don’t be surprised if they resist and/or insist they don’t want to talk about things like that. Ask them to listen for you because it is important to you and because you do not want any squabbling or misunderstanding over your wishes regarding care and your choice of a Healthcare Proxy.
4. Distribute and Enforce: Plain and simple – what good are your forms if no one knows where they are or what they say? You need to know where your forms are and you need to make copies and distribute them to your doctor(s), proxy and alternate proxy, and bring a copy when being admitted to the hospital or having a same day surgery – in other words, any time you might be put under anesthesia. Get a business card-size proxy form for your wallet. There is one, for example, that can be used for anyone from any state at the end of the Excellus BlueCross Blue Shield Advance Care Planning booklet mentioned in #2 above. Also, keep a copy of your proxy and Living Will in the glove compartment of your car and bring them with you whenever traveling – especially overseas.
5. Review Your Decisions at Least Each Year: When looking over your forms each year, be sure to check online to find out if there have been any changes in your state’s laws regarding AHP. If so, review those to be sure your forms and understanding of the laws are up to date. If needed, redo your forms and redistribute them as discussed in #4 above. Each year and whenever there is a major change such as a change in the law or a new medical treatment option that might affect your choices or you receive a terminal diagnosis, have a change of marital status, relationship, or a change of heart review your Healthcare Proxy and Living Will to be sure they remain an accurate reflection of your wishes.
Advance Healthcare Planning is your right, but it is your responsibility to get in the driver’s seat and exercise that right. That is not a one-time thing. Circumstances change and so do our minds. Pay attention and take care of your precious self so others can take care of you according to your wishes if such a time comes.
Please circulate this article among your social network – it might save someone’s life or at least save them from a lot of heartbreak.
Never Forget These Two Numbers: 11 Million and 40. They Rule Your Life
When Your Dreams Don’t Come True
Just because we want something doesn’t mean it will show up in our life. The key to handling this effectively is to acknowledge and accept your disappointment, and to find appreciation for other things that are present in your life. A 12-year-old contestant on America’s Got Talent taught me a powerful lesson about this recently. While singing her heart out, she was interrupted when Simon Cowell stopped the music. He told her the background track was awful and would she please sing her song a cappella. She looked like a deer in the headlights and after a moment simply said, “Well, that just happened!” She regained her composure and sang beautifully.
There is a fundamental dynamic that occurs when we encounter disappointment. As depicted below, Point A is where you are and Point B is your unfulfilled dream.
In the process of trying to make sense of our lives, we spend a lot of time connecting the dots between where we are and where we want to be or to go. When the distance between the two is too far apart, we tend to connect the dots by experiencing a lot of negative emotions because we are caught in the dissonance between where we are and where we want to be.
Alternatively, like the girl mentioned above, we can acknowledge where we are, gather our composure and capabilities, and do our best in the moment. This way we don’t postpone and limit our happiness by limiting it to a particular dream coming true.
No matter how much you want your dream, holding onto it too tightly diminishes your ability to do your best with what is so for you in the present moment. Here’s a typical example. Cynthia is in her early thirties and has always wanted to get married and have children. She is aware of her biological clock ticking away and is distressed that she hasn’t yet found a partner. She believes she has done everything “right” to make her dream come true, yet she remains alone and sees her chance to fulfill this dream slipping away.
Holding on too tightly to her dream has prevented her from appreciating the life she has. Some part of her believes she can only be really happy if her dream comes true. The flaw in her approach is that she is preventing herself from finding happiness in her actual life.
When you hold reality up to the standard of an unfulfilled dream, it will always fall short and be a disappointment.
A perpetual state of disappointment can easily lead to depression and despair. I’ve had clients who were so devastated by their unfulfilled dreams that they numbed themselves from feeling their despair. They distracted themselves with unrealistic To-Do Lists and saying “Yes” to whatever anyone else wanted them to do, just to avoid feeling their accumulated misery.
It is critically important to be honest with yourself about how you feel. Doing so will bring you home to the present moment. I often suggest that clients throw themselves a pity party for 10 minutes or so and really wallow in their misery – give voice to it and cry a river if you need to, so you can release the pent up and unexpressed disappointment. Then, get on with being where you are in your life and making delicious lemonade out whatever lemons you think life has dealt you.
Another typical dashed dream is that our lives should be easier than they are. We often make an assumption that getting from here to there will be uneventful and easy. Chances are it won’t be. Life is full of twists and turns.
Assumptions and expectations often blind us from what is actually going on in our lives.
Take your life as it comes. Do your best. Let it be a great adventure. And keep your focus on the present so you can respond to the reality of your life rather than trying to force your dreams to come true.
My spiritual teacher, John-Roger, taught me to express my hopes and dreams in a prayerful way that asks, “May this or something greater that is for my highest good come forward.” Then, let it go, and put one foot in front of the other, staying present in my life.
For further insight into mastering the art of being you, read more here. If you’re feeling social, I also provide daily wisdom and tidbits on my Instagram account. Give me a follow so we can thrive together!
What’s Wrong with Right/Wrong Thinking?
Until we become aware of how our internal data processing determines the reality we perceive, we think we are reacting to an external reality rather than determining what that reality appears to be
For most of us, our socialization includes indoctrination into a binary model of consciousness. In other words, we are taught to sort people and experiences into right/wrong, beautiful/ugly, desirable/undesirable, good/bad, and so on. In fact, life is far more complex and messy than that. Learned biases and preferences short-circuit the process of developing curiosity about those differences that we are taught to reject. There is a built-in bias against diversity in this way of encountering unfamiliar people and experiences. Therefore, diversity requires a new way of perceiving beyond our autopilot right/wrong sorting process. In a binary approach there are only two choices. That means if we encounter someone who is different, we can’t both be “right” or “OK.” As a result, we develop very narrow tolerances for differences, rather than nurturing our curiosity and openness to all kinds of people and experiences.
The best way to tame your inclination to judge anyone who is different than you or any experience you don’t like is to become really curious and to call upon your inner detective. When we are quick to judge, we shut ourselves down. We also close ourselves off from additional information available to us. And our myopic view blinds us from alternative ways of seeing ourselves, the other person, and the situation itself.
When we become curious, we open ourselves up, and draw ourselves closer to those we don’t understand rather than shutting them out or pushing them away.
Curiosity may have killed the cat, but it can save us from many a faulty assumption, preconceived notion, and narrow-minded interpretation of our shared reality. It is also the vital key to rising above the limitations of right/wrong thinking.
By about the age of five or six, we have the foundation of our self-image in place, and we begin to unconsciously protect, conceal, or improve our image of ourselves and to become competitive with the self-images of others. We spend most of our time focused outwards through our self-image as we navigate our way through the world and relate to the imagined self-images being projected by others.
We learn to live in a world that is a collective figment of our imaginations in which we attempt to defend and elevate our status relative to that of others.
We selectively filter our perceptions in such a way that we see things that support our existing beliefs and filter out things that do not agree with our way of seeing things. Learning how to become more conscious of our own unique data sorting process is essential to mastering the art of being who we authentically are.
Thriving involves consciously and intentionally developing our ability to override our usual way of being and perceiving. It requires looking within rather than being drawn to an external focus by the dominance of visual sensory input we receive. It means cultivating a non-judgmental perspective towards differences and an awareness of a level upon which we are all the same. This requires cultivation of a childlike curiosity rather than a defensive and competitive stance regarding our perceptions versus those of others.
Next time you encounter someone or something that threatens your preconceived notions of how things are and should be from your point of view, practice developing greater tolerance of differences and curiosity about how others see and experience our shared world. See if you can expand your comfort zone by choosing a both/and rather than an either/or state of mind. Instead of making different perspectives wrong, inquire and invite dialogue for the purpose of gaining a deeper appreciation for other points of view. The simple fact is that differences do exist. They don’t have to be perceived as a threat to our differing point of view. It’s how we choose to respond to that fact that makes all the difference in the world about our ability to peacefully co-exist or to wage wars against each other.
For further insight into mastering the art of being you, read more here. If you’re feeling social, I also provide daily wisdom and tidbits on my Instagram account. Give me a follow so we can thrive together!
When a Difference of Opinion Threatens a Friendship
What happens when you have a significant difference of opinion with someone you care deeply about? How do you evaluate what is going on? How do you treat each other? What kind of outcome can you expect? 20/20 hindsight gives us a much clearer understanding than what we see in the midst of a heated disagreement.
Here’s what I think is important to consider in dealing with a heated disagreement with someone you deeply care about:
1. You are not seeing the same situation the same way.
2. Each person has their own habitual ways of reacting.
3. The way out is not by making one person right and the other one wrong.
4. Behaviors have consequences.
5. You are responsible for the choices you make. And sometimes when we get hot under the collar, we don’t make very good choices. Nonetheless, we are responsible for our attitudes and behaviors.
I’m currently sorting my way through a disagreement that resulted in a 35-year precious friendship irreparably blowing up. I cannot speak to what the other person involved was experiencing and why she refused to try to heal what was happening. On my final appeal to her to do so, she responded, “Not in this lifetime.” No matter how unreasonable such a response might seem, I recognize that she has a right to make that choice.
Each person has their own way of reacting to a difference of opinion where the outcome is particularly important to them. For example, I first became aware of the problem with my friend when she expressed anger and judgement towards me and blamed her unhappiness on me. I reacted with shock and kept trying to share my very different perspective on what was going on, but she refused to hear it.
When one person refuses to seek healing and reconciliation, the other is forced to move forward without any shared resolution. For me, this is the hardest part – to have no hope and to be left to grieve a friendship I treasured. But life doesn’t always make sense. Our relationship is over, and there is nothing more for me to do about that. But there are life lessons for me to learn here about how I engage with others while remaining true to myself. Here are some of the things I am looking at:
None of us are perfect. I do believe that we are all doing the best we can, and this is what that looks like. All we can really ask of ourselves is to remain true to ourselves, be kind to each other, and stay open to learning our life lessons as we move through our experiences. Trials and tribulations are a natural part of life, and so it behooves us to build skill in meeting life’s challenges.
Being of Two Minds
Essentially, there are two contrasting frames of mind through which we perceive ourselves, our lives, environment, and each other. Leading edge thinkers in the field of human consciousness are encouraging us to do two things:
Think of these two states of mind existing on a continuum. At any given moment, you are functioning somewhere along that range. What we typically refer to as “awakening” or “becoming more enlightened” involves moving along this scale towards a greater ability to be fully present.
However, this does not require that we annihilate our ego. Rather, we learn to transcend its limitations. Both states of consciousness are always present. The ego strengthens our sense of self as a separate and unique being. Our process of individuation from infancy to adulthood relies on the ego’s reinforcement. However, there is a point at which we either fall into the trap of thinking we are only our ego/personality or we begin to suspect and explore our suspicion that there is more going on here – another dimension of being beyond our physical senses and what we perceive through the ego. This typically is motivated by a yearning for greater authenticity – a desire to nourish a truer and deeper part of the self than what is being perceived through the ego.
Those who are working to raise their state of consciousness are increasing their ability to be fully present and decreasing their inclination to act primarily out of their ego. Exploring and strengthening this ability to perceive life through this other state of consciousness is often referred to as awakening, enlightenment, or reaching a higher state of consciousness. It is a kind of self-realization and empowerment – what I call in my work, mastering the art of being you. It is characterized by a kind of alert awareness in the present moment that enables us to experience more dimensions of the human experience and to master the art of being who we are and living according to what deeply matters to us. Alternatively, those who do not pursue this kind of awakening tend to remain stuck in a repetitive, self-fulfilling prophecy of their ego’s perceptions and desires.
The following chart provides a comparison of these two states of mind.
Being of Two Minds
Alert
Beliefs
Resonance
Our egos are focused outside of ourselves and are all about preserving our sense of personal identity in this world – not only in and of ourselves, but in comparison and relationship to others. We perceive and register everything in terms of polarized thinking – I like this/I don’t like that; self/other; right/wrong; desirable/to be avoided. This process of categorizing our experiences relative to what we have known in the past or what we are seeking to create in the future directs us according to the perceived relative merit of the experience or person being encountered. We grade everything and compare our experiences to our expectations and desires. Our sense of well-being is conditional and fluctuates depending on what is happening in our outer lives. So, we go about life trying to control what comes our way and striving to manifest more happiness and less unhappiness.
In contrast, when we are being fully present we are immersed in the experience of the present moment itself – suspending judgment and categorization. We do not filter out or avoid “undesirable” experiences and individuals, but rather learn how to be in their presence without losing our sense of well-being. We are not trying to sanitize our lives of all unpleasant experiences, but rather building the inner strength and wisdom to effectively encounter all of life.
We live in a society that seduces us to seek validation and fulfillment outside ourselves. It does so without first nurturing us in getting to know ourselves. Most of us are not guided in developing the inner confidence, discernment, resilience, and inner infrastructure needed to effectively maintain our well-being, while navigating life’s ordinariness and challenging transitions. As a result, we often lose track of ourselves and experience all kinds of unnecessary frustrations, disappointments, sadness, self-doubt, and hopelessness that could have been avoided if we were only better acquainted with ourselves, and knew how to thrive in our own skin through all that life brings our way.
It is important to learn how to distinguish between what we think we know through the filter of our ego and what we know to be true from a deeper place within us. This profound kind of knowing usually shows up effortlessly. For me, there is typically an inner calm that comes over me and a resonance within that recognizes truth when I encounter it. It feels like tapping into wisdom rather than learning information.
Is Your God Too Small?
As a mentor and grief counselor, I hear a lot about people’s deepest beliefs and fears and how they are challenged when life gets hard. I am particularly fascinated by how those who profess a belief in god integrate that belief into their lives.
What does it mean to believe in god? In its broadest sense, it means having a worldview that includes the existence of god. Merriam-Webster dictionary defines god as “the Being perfect in power, wisdom, and goodness who is worshipped as creator and ruler of the universe.” Inherent in this definition is a hierarchical relationship to god in which we are inferior or less than god. Perhaps that accounts for our humanity and our inability to ever achieve perfection in our personal power, wisdom, and goodness.
Indeed, there are many things that we do not or cannot know. This is the territory of faith, trust, and surrender. Yet, some people lose faith in god when things happen that they do not understand or are unable to comprehend. For example, when a child dies. Some people lose their faith saying things like, “What kind of a god would let a child die?” Others give up on god because they cannot abide by the hard knocks they have encountered in their lives. They stop believing in god because they have a stronger belief that god has failed them. So, they fire god and declare themselves the god of their life. These gods are way too small.
When we require god to make sense to us, we limit god to our perceptual abilities.
In his book, The Idea of the Holy, German theologian Rudolph Otto ponders how we are to stand in relationship to god. He concludes that we should stand before god in drop jaw awe – beyond words and concepts. I agree. When we realize that god is beyond our comprehension, we stand at the edge of our unknowing either in fear or trust, depending on whether we imagine a wrathful or a loving god.
Here are some questions to ask yourself:
ï Why do I or don’t I believe in god?
ï In what ways do I try to limit god?
ï How is my relationship with god evident in how I live my life?
ï Is your god unfathomable? If not, why not?
I would love to hear your thoughts about god. What do you believe and why?
The Day I Stopped Believing in God
Until 1997, I had a strong belief in god. When I was a child, my god was the god of The Ten Commandments movie — much like Charlton Heston on a cloud. As I matured, so did my concept of god. My god became less imaginable in the image of a person and more of an invisible force. I always imagined god to be benevolent and capable of awareness of each and every one of us simultaneously. The closest I could come to defining god was love – the experience of two or more gathered in goodness.
Then, one day in March, 1997, I was driving south on the Taconic parkway in New York on my way to work. I hit black ice going 60 mph. I no longer had any control over the direction or speed of the car — I was suddenly a passenger and not the driver.
My car crisscrossed the road four times, and when it was clear I was about to go down a ravine into a swamp, a voice cried out from my belly saying, “I’m not ready to go yet, so you’ve got to take care of me. Please take good care of me.” In that moment, my car did what a mechanic later told my friend was mechanically impossible — it went into reverse. I hung on to the steering wheel while the car made a complete circle going rear first down the ravine and into the swamp. The trunk of the car was sliced all the way through by the tree that stopped the car. The rear window broke into a million pieces. My earrings and glasses flew off my head, landing in the foot area of the front passenger seat. My seat broke, and I was lying face up under the broken rear window, yet I didn’t have a scratch on me, nor was there any glass in my loose-weave wool coat.
I remember my euphoria when I realized the car had stopped. I touched myself and marveled, “I’m alive!” I sat up, retrieved my glasses, earrings, and briefcase and stepped out of the car into the swampy ground. Each step made a loud, moist, suctioning sound as I lifted each foot. I was in total shock, operating on auto pilot. I walked up to the road where the car that had been traveling behind me had pulled over, and this very nice woman beckoned me into her car to wait for the police and ambulance she had called.
I was taken to the hospital. It was as though everyone else I encountered was somehow different from me. They were all worried about me and making a medical fuss. Meanwhile, inside of me my euphoria grew and grew and grew. I was totally blissed out. I had had a spiritual conversion experience that I will never be able to translate in a meaningful way to another human being. I know that now, but at the time I just kept telling people that god is real. The doctors responded by wanting to treat me for post-traumatic stress. I wouldn’t let them. Through this accident I came to know that god is real beyond a shadow of a doubt. I no longer believe in god as an intellectual concept. I know god through personal experience. My knowledge was and remains irrefutable.
Nothing else has ever mattered so much to me as that wonderful gift I was given in a car accident that totaled my car to such a degree that the mechanic automatically offered his condolences to my friend who came to retrieve my belongings. He was incredulous when she told him I was home eating a turkey sandwich. To this day I recall the euphoria and the sense of a glass dome covering my body as the car crashed.
My mother and I were very close, and she shared my deep belief in god, but it wasn’t until two weeks before her death in 2012 that she also was given the gift of knowing god through personal experience. For her, it happened during a breathing treatment. She could barely speak at the time, but told me that she realized that god was breathing her. Like me, she was totally euphoric. That whole day she kept telling everyone who came into her room that god is real. Unfortunately, they all responded to what they thought was an elderly woman on morphine. I guess if you haven’t had the experience yourself, you have no frame of reference. All day, my mom kept asking me when they were going to make the announcement. “Who? What announcement?” I asked. The three most important people in the world she told me. I only remember two of them – the president and the pope. She was urgent about the need for them to let the world know that god is real. “People will want to live their lives differently.” she said.
Have you had an experience like this? If so, I would love to hear about it.
Staying in the Here and Now
There is absolutely no place or time you can ever be but in the here and now. And the here and now keeps expiring. We move through space and time, and before we can even get the words “here” and “now” out of our mouths, they have changed. It’s really a very funny business, this existence.
As fleeting as the here and now are, they are the most powerful time and place we can ever be. In fact, they are the only time and place we can ever be. We can involve our minds and emotions in thinking about or having feelings about the past or future, but we can’t go there. We are here. This might seem simplistic, but it is an enormously powerful awareness to work with to bring peace and harmony to our minds and emotions.
Every time we focus on the past or future, we are abandoning the present moment unless we do something about our thoughts in the present moment. If there is nothing to do now to resolve a past concern or to anticipate a potential future one, then thinking or worrying about them only means we are probably making ourselves miserable and vacating the present moment. Our attention is not here, it’s there. So we end up being nowhere when we are worrying about the past or future, because we can’t go there and we aren’t present in the now.
Consider something you are worried about that lies in the future. For example, let’s say you are worrying about whether or not you will have good weather during your beach holiday next week. If you listen to your self-talk, you might hear something like this: “What if it rains? We’re spending all this money, and our holiday will be ruined if we don’t have good weather.” When you become aware of having this kind of thinking, you have an important choice to make. Do you let your worries pollute your experience in the here and now? Or do you nip your worries in the bud. Here’s what these two choices look like. If you feed your worries it will be like adding kindling wood to an already burning fire. Your worries will become bigger and bigger as you fantasize all the ways you might not enjoy your expensive vacation. You are just spinning your wheels in the here and now, making yourself miserable, and your vacation hasn’t even happened yet. In fact, it might turn out to be awesome.
Alternatively, here’s how staying present in the here and now can minimize your worries. Instead of feeding on your worries, when your first concern about the weather comes up, ask yourself “What can I do about this concern in the here and now?” You might decide to look at the weather forecast to get more information. If it looks good, that might stop your worries. If it looks iffy or bad, ask yourself again, “What can I do about this in the here and now?” Maybe the answer is nothing, or you might think, “I’m not going to let that ruin my day today,” or you might decide to pack and plan for bad weather just in case. If there is nothing further to be done in the here and now, choose not to feed your worries so you can enjoy the present. This might seem obvious and simplistic, but it can save the day when autopilot patterns of worrying creep up on you. Try it and let me know how this works for you.
Obesity: Part 2 of 2 A Personal Perspective
I have discovered an understanding of obesity from my own experience that is different from that of those who define obesity as a Body Mass Index (BMI) above 30.0. I do agree that obesity is a disease, but I do not believe that it is purely a physical measurement. Rather, I think one’s BMI is an indicator of the presence of the disease of obesity.
I believe that no matter how much I weigh and no matter what my BMI, I will be obese till the day I die. Here’s why— It seems to me that obesity is not measured in a moment in time, but rather it is a lifelong metabolic condition. I will always have a tendency to gain weight. Therefore, I cannot afford to live a lifestyle typical of our culture. For me that will result in rapid weight gain accompanied by increased risk of diabetes and heart disease, among other challenging physical conditions and side effects.
When I was growing up in the 50s and 60s, considerations such as whether or not your food was organic or non-GMO didn’t exist. We didn’t have gym memberships either, and Jack LaLanne was just starting what would grow into the fitness industry. The diet industry was simply the idea of weight loss by restricting your calories or taking Metrecal or diet pills. The only real consciousness of eating a balanced diet had to do with the food group pyramid and being urged to “eat your vegetables.” I remember what a treat it was to go out to a particular restaurant I loved where I would have a grilled Taylor pork roll sandwich on a hard roll with cheddar cheese and onion rings, followed by pie ala mode.
At age 71, for the first time in my life, I am maintaining a weight loss. However, getting here has been a painful journey mentally, emotionally, and physically. I was always prone to gaining weight and have gained and lost over 100 pounds four times in my life. I’ve tried every kind of diet and exercised terrific discipline during my weight losses, but like 95% of dieters, I was never able to sustain the loss. This was not only physically and emotionally discouraging, but, I also experienced a tremendous amount of shame and humiliation as well. I thought this was all my fault until I landed in an endocrinologist’s office about four years ago. After waiting many months for the appointment, he measured my resting metabolism and found it to be about 1,000 to 1,2000 calories per day. (An average woman needs to eat about 2,000 calories per day to maintain her weight, and 1,500 calories to lose one pound of weight per week,) The doctor assured me that, indeed, it wasn’t my fault that I couldn’t sustain a weight loss. It was because my body could only process this low level of calories and that it would take an extraordinary amount of self-restraint to limit my caloric intake to this degree, day after day for the rest of my life. However, failure to do so would naturally lead to gaining weight. He looked at me with great sadness in his eyes and offered me no hope. He simply wished me good luck.
I went into a deep depression and resigned myself to being fat for the rest of my life. My only hope or sense of control over the situation was the rate at which I would gain weight.
About two years later, I ran into a friend who was also chronically overweight. She had lost over 100 pounds since I last saw her. Not only was she physically beautiful, but she looked so relieved and relaxed in her new body.
We arranged to get together shortly thereafter, and she explained that she’d had gastric sleeve surgery and was involved in a bariatric support program at our local hospital. It was the first time I had experienced any hope about my weight since seeing the endocrinologist. I made an appointment, learned all about the various kinds of bariatric surgeries and their respective rates of success and failure, and what it would take for me to qualify for the gastric sleeve surgery.
I assure you that anyone who thinks bariatric surgery is an easy way out is speaking from ignorance of what is involved. It is a daunting process of attending support groups and education classes about the various stages of dietary change required before and after surgery, as well as a series of doctor’s appointments with your bariatric surgeon, GP, cardiologist, pulmonologist, and a psychologist. For the many patients who fail their sleep study, a diagnosis of sleep apnea delays their surgery date by several months. An endoscopy is also required weeks before surgery. In coordination with insurance company requirements, all patients have to lose a designated amount of weight to qualify for a surgery date. For several weeks before and after surgery, patients are limited to a high protein liquid diet.
The good news is that after all that, I discovered that, if I follow the rules, I can have long-term success. I was also able to eliminate four of the seven medications I was on. The surgery itself was not the solution. Rather, it was one of several key ingredients combined that made up my recipe for success. In addition to the surgery, I have discovered that my long-term success requires that I keep the following four areas of my life in balance:
So far, so good. I had my surgery over 15 months ago and have lost 112 pounds. For at least five months now, I have maintained exactly the same weight and feel confident in my ability to sustain this success.
For further insight into my journey, and to learn more about mastering the art of being you, read more here. If you’re feeling social, I also provide daily wisdom and tidbits on my Instagram account. Give me a follow so we can thrive together!