It is a beautiful New England morning in early June. The sky is blue and cloudless. At 8:15 a.m. people start arriving at the hospital, carrying sleeping bags, pillows, blankets, and lunch, looking much more like a group of campers than medical patients. The Faculty Conference Room is set up with blue straight-backed plastic and metal chairs in a large square around the sides of the room. By 8:45 a.m. there are 120 people in this large, friendly, sunny space, stowing their coats, shoes, purses, and lunches under the seats and sitting on the chairs or on the colorful meditation cushions scattered throughout the room. About fifteen people who have already been through the stress reduction program—we call them “graduates”—are returning to do the day again, or because they missed it the first time. Sam, seventy-four years old, comes in with his son, Ken, forty. Both had taken the program in previous years and decided to come back for a “booster.” They thought it would be fun to do it together.
Sam looks terrific. A retired truck driver, he is grinning from ear to ear as he comes over to hug me and to say how happy he is to be back. He is short and lean, and he appears relaxed and jovial. He looks so different from the drawn, tense, angry man who first entered my class two years earlier with his face knotted and his jaw characteristically clenched. I marvel at the transformation as I recall momentarily his problems with anger and the story of how hard he was on his wife and children—by his own admission he had been “impossible to live with” since his retirement, “a real son of a bitch” around the house but a total “nice guy” to everybody else.
I comment on how good he looks, and he says, “Jon, I’m a different person.” His son, Ken, nods his agreement, saying that Sam is no longer hostile, cantankerous, and hard to reach. He is getting along well with his family now, happy and relaxed at home, even easygoing. We banter a little before the session gets down to business at nine o’clock sharp.
As the teaching staff of the clinic gets ready to start the day rolling, we look around the room. Aside from the graduates such as Sam and Ken, the rest of the people are currently in their sixth week of the MBSR program. They have two more weeks to go to finish it after today. We have combined all the separate clinic classes this Saturday for the all-day session. It is an integral and required part of the course and always takes place between the sixth and seventh classes.
There are a number of physicians in the room, all of whom are enrolled in the program. One is a senior cardiologist who decided to take the program himself after sending a number of his patients. He is wearing a cutoff football jersey and sweatpants and has his shoes off, as we all do. This is quite a change from his usual hospital attire, with the necktie, the white coat, and the stethoscope hanging out of the pocket. Today the doctors in the room are just regular people, even though they work here. Today they are here for themselves.
Norma Rosiello is here today as well. She first took the program as a pain patient, in the same class as Mary, who we met in Chapter 5. Now she works as our secretary and receptionist in the clinic office. In many ways, Norma is the heart of the clinic. She is the first person the patients usually talk with about the program after they have been referred by their doctor, so she has spoken with most of the people in the room at one time or another, often providing them with comfort, reassurance, and hope. She does her work with such grace, poise, and independence that we hardly notice how much work she actually does and how critical her work is in ensuring that things run smoothly.
When she first came as a patient with diagnoses of facial pain and headaches, she was winding up in the emergency room like clockwork, at least once a month, with pain that she could not bear and had no way of relieving. She was working as a hairdresser a few times a week but was constantly missing work because of her pain condition, which she had had for fifteen years and for which she had sought help from many specialists. In the Stress Reduction Clinic, over a relatively short period of time, she was able to get her pain under control using meditation instead of hospital visits and medications. Then she started working with us as a volunteer, coming in from time to time to help out. I finally persuaded her to take on the job as our secretary and receptionist even though she was a hairdresser, couldn’t type, and knew nothing about working in an office. I thought she would be the perfect person for the job because she had been through the clinic herself and would be able to talk with the patients in a way that someone doing the work as “a job” wouldn’t be able to do. I figured she could learn to type and to do the other things the job required, and she did. Moreover, from the time she began working in the clinic, she missed only a small number of days in the first few years due to headaches and facial pain, and none after that. As I look over at her now, I marvel at her and am very happy to see her here. She has come on her own time to practice with us today.
As I look around the room, I see a mix of ages. Some people have shining white hair, while others look about twenty-five years old. Most are between thirty and fifty. Some come on crutches or with canes. Amy, a graduate of the program who has cerebral palsy and who has come to each one of our all-day sessions in her wheelchair since she took the program several years ago, is not here, and I feel her absence. She moved to Boston recently, where she is in graduate school. She called yesterday to say she wouldn’t be coming because she couldn’t find someone who could come with her for the whole day. She has her own van with a special wheelchair lift, but she needs another person to drive her. As I look around the circle of faces, I find myself recalling her determination to participate fully in the activities of the day each time she came, even though it meant letting one of us feed her lunch, wipe her mouth, and take her to the bathroom. Her courage, perseverance, and lack of self-consciousness about her condition had become part of the meaning of the all-day session for me, and I am sorry she isn’t able to come this time because she always taught us a lot through her being. Although it is sometimes difficult to understand her when she talks, her willingness and courage to speak out, to ask questions, and to share her experiences at the end of the day in such a large group had been inspiring to all of us.
At nine o’clock my colleague and friend Saki Santorelli welcomes the group and invites us to sit, that is, to begin meditating. The sounds in the room from everybody talking quiet some when he speaks, but they disappear completely as he suggests that we sit up in our chairs or on the floor and come to our breathing. You can actually hear a wave of silence rise in the room as 120 people bring their attention to their breathing. It is a crescendo of stillness. I am always moved by it.
So begin six hours of silent mindfulness practice on this beautiful Saturday. All of us have other things we might be doing today, yet we have all chosen to be here together, befriending our own minds and bodies as we practice paying attention from moment to moment for an entire day, gently exploring and perhaps deepening our ability to be still and simply rest in awareness with whatever might unfold inwardly and outwardly, in other words, relaxing into just being ourselves, just being present.
We have drastically simplified our lives for today just by coming, as Saki explains after our first sitting. By being here, we have made the choice not to run around doing the usual things we do on the weekend, such as errands, cleaning the house, going away, or working. To simplify things even further so that we can benefit the most from this very special day, Saki now reviews certain ground rules for the day, among which are no talking and no eye contact. He explains that these rules will allow us to go more deeply into the meditation practice and to conserve our energy for the work of mindfulness. In six very concentrated hours of “non-doing,” just sitting and walking and lying down and eating and stretching, a lot of different feelings can come up. We like to stress that whatever arises during the day becomes de facto the “curriculum” of the day, because it is already here, it is what has arisen, and therefore it is what we get to work with. Many of the feelings that arise can be quite intense, especially when all of our usual outlets such as talking, doing things, moving around, reading, or listening to the radio are intentionally suspended and unavailable to as outlets or distractors. While many people find the all-day session enjoyable from the very start, for others the moments of relaxation and peace, if any, may be interspersed with other experiences that may be a lot less enjoyable. Physical pain can well up for extended stretches; so can emotional pain or discomfort in the form of anxiety, boredom, or feelings of guilt about being here rather than someplace else, especially if someone had to give up a lot to come today. It’s all part of the curriculum.
Rather than commenting on such feelings to a neighbor and perhaps disturbing someone else’s experience as well as compounding our own emotional reactions, Saki counsels us for today just to watch whatever comes up and simply to accept our feelings and our experiences in each moment. The silence and ban on eye contact will support this process of looking into and accepting ourselves, he says. They will help us to become more intimate and familiar with the actual comings and goings of our own minds and bodies, even those that are sad or painful. We can’t talk with our neighbor about them; we can’t complain or comment about how things are going or what we are feeling. What we can do is practice just being with things as they are. We can practice being calm. We can practice putting out the welcome mat for whatever arises. We can practice in the exact same way that we have been practicing the meditation over the past six weeks in the MBSR classes, only now over a more extended period of time and under more intense, perhaps even stressful circumstances.
Saki reminds us we are intentionally making time for this very process to occur. This is to be a day of mindfulness, a day to be with ourselves in a way we usually don’t have time for because of all our obligations and entanglements and busyness—and also because, when you come right down to it, a lot of the time we don’t feel like paying too much attention to our being, especially if we are hurting, and because in general we would prefer not being still and quiet. So, when we do have some “free” time, ordinarily we tend to want to fill it up right away with something to keep us occupied. We entertain or distract ourselves to “pass” the time; sometimes we even talk about “killing time.”
Today will be different, he concludes. Today we will have no props to help us pass the time or distract us. We will pull on everything we have learned in the program so far, from our five weeks of mindfulness practice. The invitation is to be with whatever we are feeling in any moment and to accept it as we practice staying with our breathing, with walking, with stretching, with whatever the instructors are guiding us through. He points out that today is not a day for trying to feel a certain way but for just letting things unfold. So he counsels us to let go of all our expectations, including that we should have a relaxing and pleasant day, and to practice being fully awake and aware of whatever happens, moment by moment.
Elana Rosenbaum and Kacey Carmichael, the other instructors in the stress clinic today, guide the flow of the day along with Saki and myself. After Saki’s talk, we all get down on the floor on our mats to do an hour of yoga. We do it slowly, gently, mindfully, listening to our bodies. As I begin to guide this part of the day, I emphasize the importance of remembering to listen to our own bodies carefully and honoring them by not doing anything that we know to be inappropriate for a particular condition we might have. Some of the patients, particularly those with low-back or neck problems, don’t do the yoga at all but just sit on the side of the room and watch or meditate. Others do a little but only what they know they can handle. The heart patients are monitoring their pulse, as they learned to do in cardiac rehabilitation, and hold the postures only as long as their pulse rate is in the appropriate range. Then they rest and do repetitions as the rest of us hold the postures a little longer, seeing if we can drop “behind” the intensity of the sensations, noticing how they change as we maintain each pose, resting in awareness.
Everybody is doing as much or as little as he or she feels comfortable with. We are working at our limits, moment by moment with full awareness, then backing off from them just as mindfully, not forcing, not striving, as we go through a slow sequence of yoga postures. We are breathing in to those limits and out from those limits, and becoming intimate with any and all sensations in various parts of our body as we move: lifting, stretching, bending, twisting, rolling, with long stretches of resting in between, all held as best we can within a seamless continuity of awareness. At the same time, we are noting our thoughts and feelings as they arise and practicing seeing them and letting them be, seeing them and letting them go, bringing the mind back to the breath every time it distracts itself and wanders off.
After the yoga, we sit for thirty minutes. Then we walk mindfully in a circle around the room for ten minutes or so. Then we sit again for twenty minutes. Everything we do this day we do with awareness and in silence. Even lunch is in silence, so that we can eat our food knowing that we are eating, chewing, tasting, swallowing, pausing. It is not so easy to do this. It requires a lot of energy to stay focused and concentrated in the present.
During lunch, I notice one man who is reading a newspaper in spite of the spirit of the day and our explicit ground rule of no reading. Our hope is that everyone will see the value, at least as an experiment, of going along with the ground rules for the day and taking responsibility for keeping them. But perhaps it’s too much intensity for him to handle eating mindfully right now. So I smile to myself, observing my self-righteous impulse to insist he do it “our way” today, and let it go. After all, he is here, isn’t he? Perhaps that is enough. Who knows what his morning was like?
One year we had a group of district court judges, for whom we ran a special stress reduction program. They were in a class by themselves so that they could speak freely about their unique stresses and problems. Since the job description for judges is that they “sit” on the bench, it seemed fitting that they were getting some formal training in how to sit and also in how to cultivate being intentionally non-judgmental.* Some were strongly drawn to the concept of mindfulness when we first discussed the possibility of a program for them. To do their job well requires enormous concentration and patience, and both compassion and dispassion. They have to listen to a steady stream of sometimes painful and repugnant but mostly boring and predictable testimony while maintaining equanimity and, above all, paying careful attention to what is actually unfolding moment by moment in the courtroom. Having a systematic way of handling one’s intrusive thoughts and feelings and perhaps strong emotional reactions at times might be particularly useful professionally for a judge, to say nothing of its value in reducing his or her own stress levels.
When they came for the all-day session, the judges were anonymous within the large group of patients. I noticed that they sat next to each other and that they ate lunch together out on the lawn. They commented later, in their next class together, that they had felt a special closeness to each other during lunch as they sat together without talking or looking at each other, a very unusual experience for them.
The energy in the room today feels very crisp. Most people are clearly awake and focused during the sitting and the walking. You can feel the efforts being made to be present and to stay focused. The stillness up to now has been exquisite.
After a period of silent walking following lunch, in which people are free to walk where they please for a half hour on their own, we begin the afternoon with a lovingkindness and forgiveness meditation. This simple meditation (see Chapter 13) often has people sobbing with sadness or joy. Following it, we move once again seamlessly into sitting quietly, and then more slow walking.
We used to do “crazy walking” in the middle of the afternoon to keep the energy up. Almost everybody enjoyed the change of pace, although some people had to sit this one out and just watch. The crazy walking involved walking very quickly, changing direction every seven steps, then every four, then three, with our jaws and fists clenched, not making eye contact, all done with moment-to-moment awareness. Then we did it making intentional eye contact, at the same pace, minding the differences this time. Then we walked backward very slowly with our eyes closed, changing direction when we bumped into someone, after we allowed ourselves to feel the bump, the contact with another body. The crazy-walking period ended with everybody backing up slowly into what they thought was the center of the room with their eyes closed, until we were all in one big mass. Then we leaned our heads on whatever was available for support. There was a lot of laughing at this point. It eased some of the intensity that built as the level of concentration deepened during the afternoon.
Over the years, we have come to abandon this period of fast crazy walking in favor of cycles of simply sitting and walking in silence. It was almost as if the practice itself and the priceless opportunity of these few short hours together in one day had their own compelling logic, calling for less rather than more, no matter how appealing the more was. This is a general principle of MBSR: to leave as much space as possible rather than filling it up, even with compelling and potentially relevant exercises to convey one thing or another. As instructors, we have learned to trust that everything that needs to emerge or be understood by the participants comes on its own with time, out of the basic simplicity of mindfulness practice. So we keep the curriculum of MBSR as simple as possible and leave as much space as possible within it, realizing that in this case less really is more, and that the real curriculum is life itself, and whatever emerges in our experience, moment by moment, when we give ourselves over to it with awareness and with basic kindness toward ourselves.
The longest sitting of the afternoon starts off with what we call the “mountain meditation.” We use the image of a mountain to help people remember what the sitting is all about as the day goes on and a certain fatigue sets in. The image is uplifting, suggesting as it does that we sit like mountains, feeling rooted, massive, and unmoving in our posture. Our arms are the sloping sides of the mountain, our head the lofty peak, the whole body majestic and magnificent, as mountains tend to be. We are sitting in stillness, just being what we are, just as a mountain “sits” unmoved by the changing of day into night and the changes of the weather and of the seasons. The mountain is always itself, always present, grounded, rooted in the earth, always still, always beautiful. It is beautiful just being what it is, seen or unseen, snow-covered or green, rained on or wrapped in clouds.
This image of the mountain sitting sometimes helps us to remember and feel our own strength and intentionality within the sitting meditation practice as the sunlight begins to wane in the room in the late afternoon and our day together moves toward its natural conclusion. It reminds us that we might look upon some of the changes we are experiencing in our own minds and bodies as internal weather patterns. The mountain reminds us that we can remain stable and balanced in our sitting and in our lives in the face of the storms that sometimes arise within our minds and bodies.†
People like the mountain meditation because it gives them an image that they can use to anchor themselves in the sitting practice and deepen their calmness and equanimity. But the image has its limits too, since we are the kind of mountain that can walk and talk and dance and sing and think and act as well as just be still.
And so the day unfolds, moment by moment and breath by breath. Many people showed up this morning anxious about whether they would be able to make it through six hours of silence, whether they would be able to endure just sitting and walking and breathing in silence for much of a day. But here it is three o’clock already, and everybody is still here and seemingly very much with it.
Now we dissolve the silence and the injunction against making eye contact. We do so in a particular way. First we gaze around the room in silence, making eye contact with others and feeling what arises in doing so. Often it is big, wide-open smiles. Then, still in silence, we find a partner and get in fairly close so that we can whisper together, for it is in whispering that we will dissolve the silence of the day. We speak about what, if anything, we saw, felt, learned, and struggled with; how we worked with what arose, especially if it was difficult; what surprised us; and how we feel now. First one person speaks and the other just listens. Then they switch. One hundred and twenty people scattered in dyads throughout the room engage in intimate conversations, all in a whisper, about our direct and very personal experiences of the day. The feeling in the room during the whispering is both calm and electric, like the buzzing of an industrious beehive. After these whispered conversations, we come together again as a group for a larger sharing, this time, in our normal speaking voice. People are invited to speak about their experience of the day in whatever ways they care to, including in relationship to what brought them to the Stress Reduction Clinic and to MBSR in the first place. As hands go up and people begin speaking, the calmness and peacefulness in the room are palpable. There is a feeling of exquisite intimacy, even with so many people. It almost feels as if we are sharing one big mind together around the circle and mirroring different aspects of it back and forth to each other. People are really listening, really hearing and feeling what is being voiced.
One woman says that during the lovingkindness and forgiveness meditation she was able to direct some love and kindness toward herself and that she found she was able to forgive her husband just a little for years of violence and physical abuse. She says it feels good to let go of it in this way, even just a little bit, for it feels as if something is being healed inside her by forgiving him. She says she sees now that she doesn’t have to carry her anger around with her like an enormous weight forever, and that she can move on with her life as she lets this be behind her.
At this, another woman wonders for herself whether it is always appropriate to forgive. She says she doesn’t think it is healthy for her to practice forgiveness right now; she was a “professional victim” most of her adult life and was always forgiving people and making herself the object of other people’s needs at the expense of her own. She says that what she thinks she needs is to feel her anger. She says she has gotten in touch with it today for the first time and sees that she was unwilling to face it in the past. She has come to realize today that she needs to pay attention to and honor the dominant feeling that she has at this time, which is a lot of anger, and that “forgiveness can wait.”
Several graduates say that they came to “recharge their batteries,” as a way of getting back into a daily meditation routine, which some have moved away from. Janet says that our day of practicing together reminded her of how much better she feels when she meditates regularly. Mark says that his regular sitting practice helps him to trust his body and listen to it too, rather than exclusively to his doctors. He says his doctors told him that there were many things he would no longer be able to do because of his worsening spinal condition, known as ankylosing spondylosis, in which the vertebrae fuse together to form a rodlike structure, but he finds he is now able to do many of those things again.
During our hour-long conversation among these 120 people, all present, all listening intently, there are frequent stretches of silence in the group, as if we have collectively transcended the need for talk. It feels as if the silence is communicating something deeper than what we are able to express with words. It binds us together. We feel peaceful in it, comfortable, at home. We don’t have to fill it with anything.
And so the day comes to an end. We sit for a final fifteen minutes in silence and then say our good-byes. Sam still has a big grin on his face. It is obvious that he has had a good day. We hug once more and promise to keep in touch. Some people stay to help us roll up the mats and put them away.
Later in the week, in our regular classes, we discussed the all-day session some more. Bernice said she had been so nervous about coming that she’d gotten practically no sleep the night before. Around five in the morning she’d done the body scan on her own, without the CD for the first time, in a last-ditch attempt to relax enough to feel able to come. To her surprise it worked. But she said that when she got up she still had been in a somewhat deranged state from lack of sleep and almost decided that it would be too hard for her to sit for a whole day with so many people without talking. For some reason that she could not really explain, at some point she decided that she might be able to do it. She got into her car and played the body scan CD the whole way to the medical center, using the sound of my voice to reassure her. She said this sheepishly and laughed along with the rest of the class, because everybody knew that they were not supposed to use the guided meditation CDs while driving.
During the morning, Bernice went on, there had been three separate times that she almost bolted from the room in a state of sheer panic. But she didn’t. Each time she told herself that she could always leave if she had to, that there was nothing holding her prisoner in the room. Reframing the situation this way was enough to help her stay with her anxious feelings and breathe with them when they welled up. In the afternoon, she experienced no feelings of panic at all. Instead she felt peaceful. She discovered for the first time in her life, she said, that she could actually stay with her feelings and watch them without running from them.
Not only did she discover that they eventually subside by themselves, she also discovered a new feeling of confidence in her ability to handle such episodes. She saw that she could have long stretches of relaxation and peace in the afternoon, even though she had had almost no sleep the night before and therefore had every “reason” to expect things to be “bad.” She was thrilled to make this discovery and feels that it is going to have relevance to other situations in which, in the past, she has been controlled by her fears.
Bernice was particularly pleased with this discovery because she suffers from Crohn’s disease, a chronic ulcerative disorder of the intestines that gives rise to intense abdominal pain whenever she is tense and stressed. She had had none of her usual symptoms during the all-day session, as she managed to ride out and regulate her feelings of panic that morning.
Ralph then told a story about jumping out of his parents’ car as a child when it was stuck in traffic in a long tunnel and running toward the end of the tunnel, driven by an uncontrollable fear. This recollection struck a chord in Bernice, who confessed that she won’t go to Logan Airport in Boston because she has to go through either the Callahan or the Ted Williams Tunnel. But later, before the class ended, she said that going through a tunnel would probably be similar to making it through the all-day session. Since she did that, she decided, she can probably go through one of those tunnels. It seems she is thinking about doing it now, almost as a homework assignment for herself, a rite of passage to test her growth in the program.
Fran said that her experience of the all-day session was one of having a “funny” feeling that she didn’t want to call relaxation or peace; it was more like feeling “solid” and “free.” She said that even lying down on the grass outside after lunch felt special. She hadn’t lain on grass and just looked up at the sky since she was a little girl. Now she is forty-seven. Her first thought after she realized how good she was feeling was “What a waste,” meaning all those years she had felt out of touch with herself. I suggested that those years were what led up to this present experience of freedom and solidity and that she might bring her awareness to the impulse to label them as “bad” or “a waste” just as she would if we were meditating. Perhaps then she could see those years with greater acceptance, as what she was able to do then, seeing things as she did at that time.
The cardiologist said he realized that his whole life was spent trying to get somewhere else, using the present to achieve results that would bring him what he wanted sometime later. During the all-day session, he had seen that nothing bad would happen to him if he started living in the present and appreciating it for its own sake.
A young psychiatrist spoke of how discouraged she had felt on Saturday doing the meditation. She had had a hard time keeping her attention focused on her breath or on her body. She described it as feeling just like “slogging through mud.” She said she kept having to “start over, again and again, from the bottom.”
This image became the subject of some discussion, since there is a big difference between “starting over” and “starting from the bottom.” Starting over implies just being in the moment, the possibility of a fresh beginning with each inbreath. Seeing things this way, coming back to the breath in each moment that the mind wanders, would be relatively effortless, or at least neutral. Each breath really is a new beginning of the rest of our lives. But the words she used carried a strong negative judgment. “Starting from the bottom” implies that she felt she had lost ground, has been submerged, has to rise up. Taken with the weight and resistance of the mud image, it was easy to see why she might have felt discouraged about bringing her mind back to her breathing when it wandered.
When she saw this, she laughed good-naturedly. The meditation practice is a perfect mirror. It allows us to look at the problems our thinking creates for us, those little or not-so-little traps that our own minds set for us and in which we get caught and sometimes stuck. What we ourselves have made laborious and difficult becomes easier the moment we see the reflection of our mind in the mirror of mindfulness. In a moment of insight, her confusion and difficulty dissolved, leaving the mirror empty, at least for a moment, and her laughing.