Appendix:
Finding Your Own Last Best Cure
Each person’s journey toward the last best cure will be unique to his or her needs and circumstances. As you begin your own quest for a greater sense of emotional and physical well-being, ask yourself a few essential life questions. Looking to the years ahead, how do you want to live out the rest of your life? What state of mind would you like to be in as you go through each day? Do you feel a longing to start enjoying being right here, right now? And what steps—of the many you’ve read about in these pages—appeal to you most as you seek to shift from the Pain Channel to the Life Channel?
The exercises and steps that follow will help you to discover more about how your mind and body might have been impacted, if at all, by any childhood experiences (60 percent of us have an ACE score of 1, and 40 percent have a score of 2 or more); what your general mindset tends to be most of the time; and how to jump-start your own search for the last best cure.
1. Find Out If You Have an ACE Score.
The ACE score is a diagnostic tool developed by the ACE Study, a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente. Lead investigators Robert F. Anda, MD, MS, and Vincent J. Felitti, MD, have set out to help unveil the link between childhood adversity and adult health consequences.
They look at whether individuals experienced any of the following situations in their home prior to the age of eighteen: emotional or physical neglect; recurrent emotional or physical abuse; contact sexual abuse; living with someone in the home who is chronically depressed, mentally ill, institutionalized, or suicidal; living in a home in which there is an alcohol/and or drug abuser, or an incarcerated household member; living in a home where the mother in the home is treated violently; or having one or no parents.
What’s My ACE Score?
PRIOR TO YOUR EIGHTEENTH BIRTHDAY:
1. Did a parent or other adult in the household often or very often . . . Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
Yes No
If yes, enter 1
2. Did a parent or other adult in the household often or very often . . . Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
Yes No
If yes, enter 1
3. Did an adult or person at least five years older than you ever . . . Touch or fondle you or have you touch his or her body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?
Yes No
If yes, enter 1
4. Did you often or very often feel that . . . No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?
Yes No
If yes, enter 1 5. Did you often or very often feel that . . . You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
Yes No
If yes, enter 1
6. Was a biological parent ever lost to you through divorce, abandonment, or other reason?
Yes No
If yes, enter 1
7. Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? Or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
Yes No
If yes, enter 1
8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
Yes No
If yes, enter 1
9. Was a household member depressed or mentally ill, or did a household member attempt suicide?
Yes No
If yes, enter 1
10. Did a household member go to prison?
Yes No
If yes, enter 1
* * *
NOW ADD UP your “Yes” answers:______This is your ACE score.
As we’ve seen, the higher one’s ACE score, the more likely one is to experience illnesses including medical conditions and depression in adulthood. If you find you do have an ACE score, before going forward, consider talking through the results and how the past might be impacting you now with a trusted professional counselor or therapist. You can find out more about the Adverse Childhood Experience (ACE) Study at www.acestudy.org.
2. What Is Your Daily Joy and Contentment Quotient?
The following quiz will help you to gain insight into the way in which you relate to and react to the world around you, and how it reflects on your general state of contentment and capacity for joy. The joy quotient is an insightful gauge. In the course of my one-year journey my joy score doubled, taking me on Sanzone’s scoring scale from “few moments of joy” and “a tendency toward pessimism” to a “considerably higher sense of contentment and fairly frequent experiences of joy.”
Sanzone Joy and Contentment Quotient–Inventory
(SJCQ-Inventory)
Circle 1 to 10, according to the degree to which each statement applies to you or accurately describes your recent (past three months) perception(s).
1 = does not apply to me much at all/hardly describes my perception at all
10 = nearly completely describes my perception/applies to me
1. I feel deserving of a calm mind and a joyful life.
1 2 3 4 5 6 7 8 9 10
2. I am more self-critical and judgmental than I wish I were.
1 2 3 4 5 6 7 8 9 10
3. I recognize and value unique contributions I bring to the world.
1 2 3 4 5 6 7 8 9 10
4. In general, my negative feelings and thoughts impact my ability to fully engage with my life, including but not limited to people and situations or events.
1 2 3 4 5 6 7 8 9 10
5. I am more critical and judgmental of others than I wish I were.
1 2 3 4 5 6 7 8 9 10
6. Daily, I am touched or moved emotionally by things in my environment to a degree that reminds me of the goodness around me.
1 2 3 4 5 6 7 8 9 10
7. Generally speaking, my feelings or emotional states overwhelm me.
1 2 3 4 5 6 7 8 9 10
8. At least once a week, I allow myself to be spontaneous and playful without feeling guilty, despite my daily obligations and responsibilities.
1 2 3 4 5 6 7 8 9 10
9. My feelings provide me information, but they do not control me nor my decisions.
1 2 3 4 5 6 7 8 9 10
10. In going about my daily routine I have difficulty being productive or completing necessary tasks without detaching from or shutting off my emotions.
1 2 3 4 5 6 7 8 9 10
11. I know specific things I want or need to change in my life, but I have a hard time putting forth sufficient effective effort to effectively implement them.
1 2 3 4 5 6 7 8 9 10
12. I am open to new and different interpretations of my experiences.
1 2 3 4 5 6 7 8 9 10
* * *
SCORING:
For questions 1, 3, 6, 8, 9, 12: add up the exact numerical value of each answer you circled. For instance, if you circled a 4 for question 1, and a 7 for question 3, add 4 and 7 together and continue adding the number value of each answer for these questions.
Put your score here
For questions 2, 4, 5, 7, 10, 11: add up your scores in the reverse direction. In other words, a 1 gets 10 points, whereas a 10 gets 1 point. A 2 would be an 8. A 4 would be a 7, and so on.
Put your score here:
Now, add up your two scores:
Less than 38 total points: Significantly less contentment and considerably fewer moments of joy than most report experiencing. Could benefit from concerted effort toward increasing both greater life satisfaction and feelings of well-being.
39–59 points: Occassional but not frequent sense of general contentment, and few moments of joy that you are likely not inclined to expect. Average or “middle-of-the-road” sense of life satisfaction and well-being. You may desire more experiences of joy and an increased sense of happiness, but may recognize a tendency toward pessimism and a general belief that you don’t deserve or shouldn’t expect more positive experiences than you have.
60–78 points: General sense of contentment and occassional moments of joy that you look forward to and work toward. Above average sense of life satisfaction and overall positive view of self and the world around you. You believe you deserve a satisfying life, generally are not overly pessimistic, and at times have a relatively optimistic but not idealistic worldview.
Above 79 points: Considerably higher sense of contentment and fairly frequent experiences of joy. Greater general life satisfaction and well-being than most. You tend toward optimism and at times even idealism, which you are likely to find refreshing and fun.
Copyright Marla Sanzone, PhD, 2013
If you find that your scores reflect less of a sense of overall contentment than you’d like to have, it can be a good idea to go over these results with a professional.
3. Set a Goal.
You don’t have to do everything. My journey lasted a year—but really it continues each day of my life. The benefits of the practices I’ve begun expand into my life in ways that make being here, right now, richer, more meaningful, and just more fun. Every day I have to learn it all again—it’s just a little easier than it was the day before to stay with the program. The important thing is not to feel overwhelmed. Start where you are. Ask yourself: How much can you do? What are your physical limitations? What can you afford? Here are a few suggestions for how to get going right now—regardless of any difficult circumstances you may face.
4. Find a Mindfulness Teacher Whose Style You Love.
Mindful breathing is a technique learned and relearned every day over a lifetime. It’s hard, if not impossible, to pick up and stick with such a life-altering practice simply by reading about it on the page. We all need a voice to follow, a teacher to model for us how to catch and stop the insidious voice within—the voice of not okay-ness—to learn to name our emotions, and stop “drinking the poison” of our own ruminating thoughts.
To find an MBSR class near you visit the Center for Mindfulness in Medicine, Health Care and Society Web site run by the University of Massachusetts Medical School (that’s where Jon Kabat-Zinn first developed and founded the mindfulness-based stress reduction program) at http://w3.umassmed.edu/MBSR/public/searchmember.aspx. Fill in the “Search MBSR Member in your area” form. Most MBSR classes cost around $400 to $500 for a six – or eight-week intensive program. Some teachers offer discounts and scholarships for those in special circumstances. You can also call your local hospital or community center to see what courses they offer. If you prefer a drop-in meditation class, check out schedules at local yoga and meditation centers. Try several to see what meditation teaching style appeals to you. Many are offered for free, or for a donation only. You’ll know when the teaching voice you hear as you try to settle into mindful breathing feels clear, grounding, and nurturing.
If you’re having trouble finding a class, or can’t leave the house, consider starting with a set of CDs. (And even if you do take a class, stock up on downloads and CDs for those days when you don’t have class.) MBSR courses often provide daily practice CDs with course materials. And most local libraries offer general meditation CDs. Best of all, some of the most powerful teachers, such as Tara Brach, make their guided meditations available to all for free via their Web sites—with donations welcome. (I listen to Tara Brach’s podcasts whenever I take the dogs on a long power walk. Her teachings are astonishingly restful and awakening at the same time.)
Here are a few of my favorite mediation resources:
Tara Brach, PhD
To find out about Tara Brach’s teaching schedule, free downloadable talks, and meditations, go to her Web site: www.tarabrach.com. Pick up her books Radical Acceptance (Bantam, 2003) and True Refuge (Bantam, 2013). And check out her blog at blog.tarabrach.com.
Trish Magyari, MS, CGC, MS, LGPC
Learn more about Trish Magyari’s guided meditations, which are available on CD, at trishmagyari.com. You can also find out more about her mindfulness-based stress reduction (MBSR) courses, counseling services, retreats, and trainings.
Sharon Salzberg
One of the greatest meditation teachers of all time, Salzberg offers meditations for download at no cost, as well as CD offerings and books for purchase at her Web site. She also teaches at retreats nationwide. See www.sharonsalzberg.com.
Pema Chödrön
Chödrön’s talks are available for purchase on CD or as audiobooks through her foundation’s Web site, www.pemachodronfoundation.org. I am particularly fond of True Happiness.
John Makransky
Author and meditation teacher Makransky teaches a beautiful and moving meditation called “Identifying Benefactors and Receiving Love,” which can be downloaded for free at his Web site, www.john makransky.org. This meditation practice involves recalling those people in your life who have made you feel particularly safe and loved—in whose presence you’ve felt deeply valued for who you are, such as a favorite aunt or teacher or grandparent. Makransky walks you through this guided imagery exercise in which your “benefactors” make you the focus of their compassion meditation. It has a powerful impact. Makransky’s books and CDs are also available for purchase at his Web site.
5. Track Your Happiness.
Trackyourhappiness.org is a new scientific research project that “investigates what makes life worth living.” If you have an iPhone, use the app to try and get a better sense of how often your mind is in the present, and how it feels when it is and when it isn’t. Bear in mind this isn’t a scientific gauge; just the knowledge that you’re checking in at regular intervals can skew your perspective on how you feel—but it’s nevertheless a way to gain eye-opening insight into how much of your time is spent ruminating rather than engaging in what you’re actually doing right now.
6. Move Mindfully.
There are three things to bear in mind when finding a yoga class: what style is right—and safe—for you, what can you afford, and who you gravitate to as a teacher. In order to find the two teachers and classes I frequent, I tried seven. Julie and Mira were best for me. I discovered two other teachers whose classes were terrific, but the times and locations, and their vigorous paces, made the classes a difficult fit for my lifestyle and body. Keep looking until you find a teacher who inspires you to keep coming back, whether it’s a gentle yoga class that uses props or a hot yoga class that leaves you feeling cleansed. If budget is key, as it often is for those of us with ongoing medical bills, most yoga studios offer very affordable community yoga classes at night (often at half price or less).
You can also download free yoga clips on YouTube or buy CDs—but they are rarely a substitute for a live class. When the poses are done incorrectly yoga can lead to injury—especially if you already suffer from a chronic physical condition. Still, if you have a lot of yoga experience, videos have their place. Now that I’m familiar with sun salutations, I sometimes supplement my practice with a favorite Shiva Rea salutation I found on YouTube whenever I need to get my mood back on track, and am hungering for a little yoga lift, but don’t have time or can’t get to class. It helps me to achieve what yoga teacher Julie Madill calls the “cessation of agitation”—the gift that comes with our yoga practice. Still, I wouldn’t have dared to try lunging or down dogging alone before I’d been taught by a teacher who could make sure I could (1) do it and (2) do it safely.
Something else happens when we go to class. We begin to grow as a group. When we’re learning new skills we fire up what are known as “mirror neurons”—a particular type of brain cell that observes and receives signals from those in near proximity to us and triggers similar reactions within us. It’s why we are more likely to start crying—or laughing, or yawning, or tapping our foot (or eating more potato chips)—if a friend is crying or laughing or yawning or tapping his or her foot or eating junk food. Our mirror neurons fire up in response to what those around us are doing and prime us to unconsciously mimic what we see. When we watch and imitate a yoga instructor, or even another student who knows the yoga ropes better than we do, our brain receives the information faster than we can by watching a video. Women have more active mirror neurons than men do, helping us to better imitate instructors. (This gender difference may be part of the reason why women attend so many more group classes, in general, than men do.)
Write down the times for your regular yoga class on your calendar two and three months ahead of time. That way when something else comes up (and it will) that slot is already taken.
If you’re interested in the yoga teachers who’ve taught me, here’s how to find out more about them:
Julie Madill
You can learn more about Julie Madill’s yoga classes at maryland yoga.com. She has a unique ability to mix a gentle approach with difficult moves in a safe setting.
Mira Tessman
For information on Mira Tessman’s yoga classes as well as her meditation retreats and counseling services see wellspringhealingarts .org.
Stan Andrzejewski
Stan Andrzejewski is cofounder of Greater Baltimore Yoga in Baltimore, Maryland. You can learn more about his hatha yoga physical therapy services and yoga classes at marylandyoga.com.
Linda Howard
Iyengar yoga teacher Linda Howard, with whom I also briefly worked, helps ensure that even those facing severe physical challenges can do postures safely with the aid of belts, chairs, and blocks. I often use Linda’s interactive DVD—it allows you to input your physical limitations and select a preferred routine. The DVD program then creates a tailor-made practice for you based on your personal limitations: www.easingintoyoga.com.
Baltimore Yoga Village
Sometimes I take drop-in classes here—the studio and teachers have a special warm charm: baltimoreyogavillage.com. Owner Anjali Sunita is a brilliant teacher of both yoga and yogic deep breathing.
7. Do a Breath Exercise Every Day.
The gateway to calming down the sympathetic nervous system and activating the parasympathetic nervous system in both meditation and yoga is the breath. Which means the breath is the cure. Bring in a specific breath practice every day—and come back to mindful breathing on and off throughout the day.
Here are the breath practices we’ve covered in these pages: basic three-part breath (p. 109), three mindful sighs (p. 109), Tsoknyi Rinpoche’s rapid exhale exercise (p. 112), Andrew Weil’s “relaxing breath” (p. 113), alternate nostril breathing (p. 112), ocean or ujjayi breath (p. 186), and Kapalabhati breath (p. 215).
It sometimes helps me to concentrate on a breath exercise if I place my right hand on my abdomen—and indeed neuroscientists have found that placing a hand on the belly while breathing adds to the calming effect.
There is one more active breath exercise called “breath of joy”—a sequence of four physical movements accompanied by four breath actions—which I’ve come to love. I practice this at odd times—it’s a tool I’ve come to rely on when I need to activate my floating brain, fast:
Stand with your feet hip-width apart, and gently bend your knees.
First practice the four basic arm movements: arms out in front of you; arms out to the side in a T-like formation; arms up above you; and arms down to the side as you bend forward at the waist, sending your arms out behind you.
Practice the breath sequence: a three-part inhalation with one exhalation: in, in, in, out.
Now put it together. Each breath action corresponds to a movement of the arms:
1. Inhale through the nose and gently swing your arms up in front of you, parallel to the floor.
2. Continue the second part of your inhalation while swinging your arms open to the sides in a T-formation.
3. On the third part of your inhalation, swing your arms overhead, hands to the sky.
4. On the exhalation, swing your arms toward the ground letting your upper body fold forward, bending your knees, as you let out a loud “Ha!”
(For visuals, search “breath of joy” on YouTube—there are many examples that will be helpful.)
8. Take Note of What’s Really Working.
Psychologist Martin Seligman, the director of the Positive Psychology Center at the University of Pennsylvania, has developed a technique to help us take in what’s going right in our lives. The exercise is called the “three good things.” I practice it every night. At the end of the evening, I think of three good, positive, happy things that happened during the day. I write them down. They might be as simple as remembering the feel of my daughter’s head on my shoulder while we watched Masterpiece Mystery. Or seeing the first fall leaves flutter down impossibly red and gold in the afternoon sunlight. Or, it might be that for the first time I was able to succeed in a yoga pose I’ve been trying to do for weeks or months. Or I felt calm and at ease earlier in the day on the acupuncturist’s table. It could be a small memory of feeling utterly content, or an event as major as finding out something wonderful has happened, like winning an award.
Then, per Seligman’s instructions, I ask myself “why” each good thing occurred. It might be that I took the time to ask Claire if she wanted to snuggle and watch a show together, or made the effort to meditate outside after walking the dogs so I could drink in the leaves shimmering and dancing on the trees, or that I tried that same yoga pose a hundred times without ever giving up, or that I picked up the phone and made the acupuncture appointment despite my crazy schedule, or that I worked long, hard days with my butt in the chair writing the project that garnered a small award.
I take the exercise one step further. I put the large five-by-seven index card on which I’ve written my three blessings under my pillow. Sometimes I have trouble falling asleep, or wake up in the middle of the night, or too early. There are times when I have so much on my plate—more than can be done—that as I wake I feel my heart beating in my head as if the lining of my brain were the skin of a drum. My sympathetic nervous system is churning up the PIN response before I’m even fully conscious. I can’t get back to sleep. But if I run my fingers over the now crumpled index card beneath my pillow on which I’ve written my three blessings, the lovely moments of the previous day come flooding back. I savor them again. It changes my heart rate. Literally. I can feel my pulse slow down.
Realizing why pleasant things happen in the first place makes me recognize and internalize what I need to do to make more feel-good moments happen tomorrow and the next day. And it does something else. Noticing what’s working, what’s going right, helps us to figure out what we love. The next day, and the day after, we gravitate to doing more of what yields that feeling of pleasure, because we are more keenly aware of what that is. We’re on the lookout for the good moments that saturate us with joy and well-being—instead of being on alert for the next bad thing. It helps us to right the neurological imbalance that comes with the negativity bias we all have due to our evolutionary biology. We set in motion a positive feedback loop. We make the pathways in the brain that help us to gravitate to our positive experiences deeper, faster. We become a little bit more like Velcro for the good stuff.
9. Whatever You Do, Do It in Nature.
Nature nurtures, accelerating healing. Practice your mindful sighs while sitting outside in the backyard, or meditate from your beach chair as you sit beside the ocean. Do a little investigating. Find out more about the “nearby nature” parks nearest to you and take walks on their gentle hiking trails. Go for a walking meditation in the woods and drink in the sounds of nature. Forest bathe. Stare at the ribbons of light pouring down in a pine forest. Whatever beautiful natural vista is near you, go there. I’ve found a nearby nature sanctuary that offers a walking trail that winds back to a Japanese peace garden, a meditation bench in the woods, and a labyrinth. When I practice meditation, or walking meditation, in nature, I allow the positive effects that come with each to become more potent.
10. Remember the Rule of Three.
Pick three things from your toolkit to do every day. Go to yoga class, practice three mindful sighs at a traffic light, walk the dogs on a wooded path. Or do a morning meditation, practice breath of joy during a brain-fog moment in your workday, or do mountain pose while you wash the dishes. Fitting in the rule of three doesn’t have to take up a lot of time—certainly no more than, say, going to physical therapy. Try to work your practices in wherever you are—at the grocery story, on the sidelines of your child’s sports game. Be creative as you pull these practices into your life in small, but life-changing ways.
The point is this: to kick your parasympathetic nervous system and positive floating brain into gear, you have to get up and do something different. You can’t just keep ruminating in the same old way and expect something new to happen. The strategies and tools are there for you to use; you just have to put them into action.
If you don’t feel in the mood to practice a thing, try “inside-out practices.” Smile until you feel like smiling. Laugh until your laughter become real. Science tells us that inside-out practices coax our mood along before we even realize our mindset is changing. Gradient, or faked, laughter leads to authentic laughing. Just holding a pencil between your teeth (which activates the smile response muscles) puts us in a more positive mood within moments; we think more happy thoughts. Don’t wait until you feel like adding in practices. Add them in and see how it makes you feel more like doing them.
11. Retake the Joy Test.
After a period of six months, retake the joy test. Where are you now? How has the hard work of practicing these methods paid off in terms of feeling more joy and well-being as time went by? Have your efforts provided any palpable relief? What exercises do you want to make sure you keep practicing—in order to live the rest of your life meaningfully and with an enhanced sense of joy?
For more information and inspiration join me online at lastbest cure.com. I’ll see you there—and we’ll continue the journey together.