2

GROWTH THROUGH
SUFFERING

It goes almost without saying that the long-term effects of turmoil and trauma are usually profoundly negative. You’ve probably experienced these in your own life, or at least been aware of them in people close to you – for example, a soldier who has returned from combat and suffers from post-traumatic stress disorder, a woman who has recovered from an episode of cancer but can’t sleep at night and feels a constant anxiety that the disease will return, a woman who’s been through a painful divorce and feels intense hatred and bitterness to her ex-spouse, or a man who feels depressed after becoming disabled through an accident. As the psychologists Daryl Paulson and Stanley Krippner note, the aftermath of trauma is often ‘anxiety that will not subside, depression that will not heal, or psychosomatic injuries that will not mend’. 1

Another reaction to trauma is dissociation. In order to stop themselves being hurt, some people dissociate themselves from traumatic experiences. They turn off their emotions, make themselves numb and pretend that the experience isn’t really happening to them. This strategy is often used by children who are orphaned, prisoners who are tortured or women who are abused by their husbands. 2 Even when the trauma is over, they often remain emotionally numb for the rest of their lives.

A more extreme kind of disassociation is what psychologists call ‘dissociative identity disorder’, or developing multiple personalities. The personality reacts to trauma by splitting up, as if trying to escape the effects of trauma simply by no longer being there to experience them. This can also be a reaction to childhood trauma: if a child is abused by someone close to them, they may repress their feelings about it, and their memory of it, in order to survive in the relationship, and later these repressed feelings and memories may form a separate personality. Over 100 years ago, the French psychologist Paul Janet described multiple personality disorder as ‘the crucial psychological process with which the organism reacts to overwhelming experiences’. 3

Other people, especially young men, react to trauma by becoming aggressive. The trauma creates frustration and anger inside them, which releases itself as aggression. The aggression can be directed at themselves, expressed as self-hatred and self-harm, or it can be directed at others. That’s why children who are physically and emotionally abused by their parents sometimes become aggressive and abusive to their own children. 4 Research has also shown that traumatized people such as refugees are less affectionate and attached to their children. As a result, the trauma is ‘transmitted’ to their children, and those who don’t have stable personalities are more liable to suffer from depression. 5

POST-TRAUMATIC GROWTH

Terrible though these consequences are, for many people they are balanced by – and even transcended by – long-term positive effects.

In recent years, psychologists have become aware of a phenomenon known as ‘post-traumatic growth’. This term was originally coined by the psychologists Richard Tedeschi and Lawrence Calhoun, who interviewed many people who had suffered traumatic life-events such as bereavement, serious illness (such as cancer), house fires, combat and becoming refugees. They found that for many of these people, dealing with this trauma was a powerful spur for personal development. It wasn’t just a question of learning to cope with or adjust to negative situations; they actually gained some significant benefits from them. In Tedeschi and Calhoun’s terms, they experienced ‘positive life changes’. They gained a new inner strength and discovered skills and abilities they never knew they possessed. They became more confident and appreciative of life, particularly of the ‘small things’ that they used to take for granted. They became more compassionate towards the sufferings of others and more comfortable with intimacy, so that they had deeper and more satisfying relationships. One of the most common changes was that they developed a more philosophical or spiritual attitude to life. Questions of the meaning or purpose of life became more urgent for them. Even if they didn’t find hard and fast answers, the search itself gave them a new satisfaction. In Tedeschi and Calhoun’s words, their suffering led them to a ‘deeper level of awareness’. 6

Another psychologist, Judith Neal, studied the cases of 40 people who went through post-traumatic growth after life-events such as serious illness, divorce or the loss of a job, as well as near-death experiences. Initially, most of them experienced a ‘dark night of the soul’, where their previous values were thrown into question and life ceased to have any meaning. After this, they went through a phase of spiritual searching, trying to make sense of what had happened to them and find new values. And finally, once they had found new spiritual principles to live by, they entered a phase of ‘spiritual integration’, when they applied these new principles. At this point they found new meaning and purpose in life, together with gratitude for being alive, and even for having been through so much turmoil. 7

In some ways, it seems, suffering can deepen us.The German philosopher Friedrich Nietzsche was certainly no stranger to suffering. For most of his life, he suffered from excruciating migraines which left him incapacitated for days, as well as terrible stomach pains. He was forced to retire from his university professorship at the age of 35 due to his ill-health and spent the rest of his life in isolation. He never found a wife or girlfriend, was ostracized by his intellectual peers – because of his unconventional ideas – and had very few friends. He was so unsuccessful as an author that he had to pay for his books to be published, and even then many of them were pulped by the printer. Eventually his writings did begin to filter through to appreciative readers, but by then he was showing signs of mental instability. At the age of 45, he had a complete mental breakdown and spent the last ten years of his life in a catatonic state, living with his mother.

However, Nietzsche had remarkable powers of resilience and always thought that his suffering was beneficial to him. He believed that he was ‘more deeply indebted to the hardest years of [his] life than to any others’ since his illness had given him a ‘higher kind of health, a sort of health which grows stronger under everything that does not actually kill it!’ He saw his suffering as ‘the ultimate emancipator of spirit’ which was essential for his philosophy, since it ‘forces us philosophers to descend into our nethermost depths… I doubt whether such suffering improves a man; but I know that it makes him deeper .’ His experience was that when a person emerged from episodes of illness, isolation or humiliation, he was ‘as though born again, he has a new skin’, with a ‘finer taste for joyfulness’ and an ‘innocence in gladness; he is more childish too, and a hundred times more cunning than ever he had been before’. 8 In The Prophet , Kahlil Gibran makes a similar point when he writes that ‘The deeper that sorrow carves into your being, the more joy you can contain.’ 9

This deepening is perhaps why there seems to be a connection between suffering and creativity. Composers, poets and songwriters often seem to do their best work in response to turbulence. Whereas creative powers sometimes grow dormant when we’re comfortable and contented, psychological turmoil can reawaken them. It can break up habitual patterns of thinking and feeling, giving us access to new reserves of insight and vision. This is probably the origin of the myth of the ‘tortured artist’ – the artist who is unstable and neurotic and flits from deep depression to ecstasy.

It isn’t enough just to suffer, though – the artist has to work through their suffering and emerge on the other side stronger and more integrated. Great ‘tortured artists’ like Van Gogh, Dostoyevsky, Schumann or Beethoven weren’t just neurotic and depressive – they used their art to help them stabilize and integrate themselves again. Their art enabled them to transcend their suffering, if only temporarily.

A similar thing can happen on a social level. Crisis often creates a spirit of togetherness in communities. Strangers help and empathize with each other and so become bonded. Their shared suffering breaks down their separateness and the whole community shifts to a different level, becoming a real collective entity rather than a collection of individuals. This is why, paradoxically, people often look back at times of crisis with fondness – in the UK, for example, people still talk about the ‘spirit of the Blitz’ or the ‘Dunkirk spirit’, not just because these were times when people were courageous, but because they also worked together selflessly and altruistically.

Post-traumatic growth often happens while a person is suffering. In that sense the term ‘post -traumatic’ is a little misleading. The negative and positive effects often occur at the same time. As well as causing pain, trauma and turmoil can stop us living on the surface of life and open up deeper levels of our being, so that we become fuller and stronger. They can make us more self-sufficient, more deeply rooted in ourselves and less dependent on other people for our wellbeing. When our life becomes too stable and full of routine, they can jolt us out of our complacency and break up the husk of familiarity which forms over our mind.

The stories we’re going to look at now are especially intense examples of this post-traumatic growth.

THE RECOVERING CAREER WOMAN

Cheryl Brown is 50 years old and lives in a small town between Edinburgh and Glasgow. Until two years ago, she was a high-achieving career woman, working as the development officer for a college. She spent her life rushing from appointment to appointment, with scarcely time to think. She was determined to be the best at everything she did, determined to do everything perfectly, and was a hard taskmaster, expecting the same high standards of everyone who worked with her.

However, three years ago, her successful, work-driven life began to unravel due to health problems. She began to suffer acute stomach pain, followed by other problems such as macular degeneration (an eye condition which doesn’t normally occur until after the age of 70) and disease of the colon. She felt incredibly tired all the time and was eventually diagnosed with ME, or chronic fatigue syndrome.

She left her job to try to recuperate, but unfortunately her condition hasn’t improved. She still suffers from a whole range of symptoms and often only leaves her house twice a week to go shopping. Sometimes she spends the whole day in bed.

At first she found the loss of her independence difficult to cope with. ME is difficult to adapt to, because sometimes you feel better, almost as if you can start your life again. But usually as soon as you do so, the symptoms return and you’re thrown off course again. As a result, it’s difficult to make plans or to make adjustments to your life. The worst thing, Cheryl says, is the loss of status through not being able to work: ‘I’ve lost all of the things which your work gives – your self-worth and the values that society places in you. I’ve lost a lot of credibility. That’s partly because of ME as well. It’s an illness which is not understood. You can look perfectly well but feel terrible.’

But despite these appalling difficulties, there have been positive aspects to Cheryl’s illness. It has given her a new ability to live in the present, a new appreciation of life and of the beauty of her surroundings, and a new sense of connection. As she describes it:

It’s as if the universe hits you on the back of the head and tells you to stop. I was on a treadmill rushing around, doing a dozen projects at once, and I had to stop.

Having suffered all of these losses, there is not a lot left. With ME, you spend a lot of time doing nothing, because it affects your ability to concentrate. Your cognitive functions are not what they were. It leaves you with a lot of time to do nothing. So I’ve had a lot of time to reflect and to come to terms with the loss.

All the things that I’ve lost are connected to the ego. What’s left when these things are gone is what’s behind the ego. It’s an awareness that we’re not individuated – that you and I are the same consciousness. I feel like I’m part of something greater than myself.

I wasn’t brought up with any religious values, but since my illness I’ve become aware of something common to all religions, something fundamental, related to goodness and intelligence. It’s the universe which we are part of working for the good and the feeling that this illness did happen for a reason.

I’ve been told not to expect to recover fully, and even if I do I don’t want to live at the pace I was before. I’m sure that I can be a force for good by not pushing myself, just by going with the flow.

I feel I’m just beginning on this path and I’ll let the universe take me at its own pace. I’ve come to this realization that striving is not productive – that the more you try to force things, the more damage you do. I actually want my recovery to take longer – I feel as if I’m not quite ready yet.

There are days when I feel absolutely awful, when the pain is unbearable. But that’s OK. As long as I accept it, don’t try to push it away, then I can get through it.

I think it’s made me a better person. It’s definitely improved my relationships with other people. When other people are ego-driven, I can spot this rather than react to it. I don’t confront them or try to belittle them. I recognize that other people are part of the same substance as me, so I respond with compassion to them.

Now everything seems more real. I go to the country park near where we live and it’s been great because I’ve been watching the trees and the flowers and the birds and squirrels. I’ve been managing to go out a couple of times a week and I’ve been watching the seasons change and finding more like a child’s view. Days like this are wonderful and I really appreciate the warmth of the sun, even in the winter. Even when it’s cloudy and raining, I still think it’s beautiful. I feel more of a connection to nature.

It seems to have developed over the past year or so, this heightened awareness and great joy in everything. I appreciate things I used to take for granted. My husband has been wonderful and I’m more aware of the people around me and how fortunate I am to know them.

I also feel that my body has become more sensitive. I became a vegetarian a few months ago and I try to eat organic food and as much raw food as I can. I don’t want to put unnatural things in my body or in my house. It’s as if through being more connected to things, I’ve become more aware of the difference between natural and unnatural.

So I don’t regret getting ME at all. Something was missing from my life, a sense of meaning, and now I’ve got it. So to me the illness has been a gift.

THRIVING

Of all diseases, the one that is most likely to bring posttraumatic growth is cancer.

I certainly don’t want to suggest that there’s anything positive about having cancer; I know many people for whom cancer has just been an intensely painful and miserable experience, as I’m sure you do too. Even after recovery, they don’t feel changed for the better, just more vulnerable and anxious. Nevertheless, for some people, cancer certainly can have positive effects. After an initial stage of devastation and anxiety, and despite the pain and discomfort the illness brings, many cancer patients go through a profound journey of self-discovery which changes them radically.

This doesn’t just happen once a person has recovered – it can occur while they are still ill, even while they’re faced with the possibility of imminent death. Research has found that after being diagnosed with cancer, people gain improved relationships and greater self-confidence, with higher levels of spirituality and appreciation for life. 10 The psychologist Rurhanne Kastner studied a group of breast cancer patients and coined the term ‘thriving’ to describe their experience of personal development. She found that they lived more authentically, took more responsibility for their own lives and had a more accepting attitude to death and a stronger relationship to the ‘divine’. 11

It’s because of this that survivors of cancer sometimes talk about the illness in almost spiritual terms, as a ‘great teacher’ or even a gift. The famous cyclist Lance Armstrong, who survived testicular cancer at the age of 25, has said that getting cancer was the best thing that ever happened to him. After thinking about little else apart from his sport, he gained a wider perspective and a deeper sense of appreciation. He has said that since having cancer, he cares much less about what people think of him and has become ‘more complete, compassionate and more intelligent, and therefore more alive’. 12 He has learned that ‘We are much better than we know. We have unrealized capacities that sometimes only emerge in crisis.’ 13 Every year, on the anniversary of his cancer diagnosis, he and his wife ‘spend that day reminding ourselves to celebrate our existence’. 14

As late as the 1970s, breast cancer was still a taboo subject in the US. One of the first women to write publicly about the illness was Betty Rolin, an NBC journalist who was diagnosed with it at the age of 29. In her book First, You Cry , she writes that ‘the source of my happiness was, of all things, cancer – that cancer had everything to do with how good the good parts of my life were’. 15

Similarly, in her book The Gift of Cancer: A Call to Awakening , the breast cancer survivor Anne McNerney writes that ‘Cancer is your ticket to your real life. Cancer is your passport to the life you were truly meant to live.’ She goes much further than Armstrong or Betty Rolin and even writes that ‘Cancer will lead you to God… Cancer is your connection to the divine.’ 16

The connection between suffering and liberation seems paradoxical enough, but these statements seem even more so. To people who have cancer but only experience pain and misery, they probably seem downright bizarre, even offensive. But the next two stories we’re going to hear are good illustrations of the transformative power of cancer.

‘I WANT MY OLD DAUGHTER BACK ’

I recently discovered that a student of mine, Iris, had experienced post-traumatic growth. In fact, as I found out later, that was the very reason why she was a student.

At the end of a lesson one day she said to me, ‘Sorry if my essays are all over the place – it’s probably because I write poetry.’ I asked her how long she’d been writing poetry and she replied, ‘It started four years ago, after I was diagnosed with breast cancer.’ We both had some free time, so she stayed behind after the lesson and told me how becoming ill with cancer had transformed her.

She told me that as soon as she had been diagnosed with breast cancer she felt like a different person. ‘It’s weird – you go into the consulting room as one person and you come out of it another one.’ She was told she had a very aggressive form of cancer and decided to make changes to her life straightaway, assuming that she didn’t have much time left to live. She was a businesswoman, running a car panel company and working six days a week. But straightaway she decided to sell her business.

At first she ‘wallowed in a hole of despair. I felt like I was in a vacuum and didn’t want to let anyone in. I isolated myself. I didn’t want people to come and see me. I didn’t even want to see my grandchildren because I thought I was going to die. I thought that if I pulled away they wouldn’t miss me as much.’ This was when she started writing poetry – angry and bleak poems that reflected her fear.

Shortly after her diagnosis she had a mastectomy and courses of radiotherapy. And to her amazement, only three months later, she was told she no longer had signs of cancer. It hadn’t spread to her lymph nodes or to her other breast.

At first she was quite angry – she felt she’d wasted three months wallowing in self-pity, worrying about her children and grandchildren, filled with anxiety and fear. But then she began to feel as though she’d been given a new lease of life. She’d always worried about what other people thought about her, putting more effort into pleasing them than pleasing herself. But now she felt as though she didn’t care how she appeared in anyone else’s eyes. In the past, she’d never left the house without make-up, but now she stopped wearing it. She decided she was going to live more authentically and do exactly what she wanted. She wrote a ‘wish list’ of all the things she’d wanted to do but never got around to and slowly worked through them: she went skydiving, did a parachute jump, went whitewater rafting and went away for the weekend on her own for the first time.

The downside was that the people around her didn’t accept her new self. Her relatives were so used to her giving so much that now they thought she was being selfish. Her mother told her, ‘I want my old daughter back.’

Iris felt guilty, but also felt as though she didn’t have any choice. ‘Your daughter’s not coming back,’ she replied. ‘I’m someone else now.’

After a year, she was told for certain that the cancer had gone. Shortly afterwards, she went to a country park and had what she describes as an ‘epiphany’: ‘The sky was a beautiful blue and I could see all the different leaves on the trees and all the different colours and the grass was different and it was just like everything suddenly came alive again.’

She decided that even though the cancer had gone, she was going to carry on living in this new way. She decided to train to be a counsellor (it was four years later, when she was doing the last year of her counselling training, that I met her). She continued to write poetry, but now the poems were more uplifting, filled with descriptions of the beauty of nature. She wrote poems describing the joy of seeing a rainbow or a waterfall and becoming aware of the preciousness of life. As she writes in one poem, ‘Treat every moment as if it is made of gold.’

This has been one of the biggest changes: now she feels that she sees the world in a different way:

It’s completely different. I definitely take in things a lot more. When other people see a bird flying they just think it’s a normal thing, but I feel like I see it in perspective, as if it’s more real. When I’m out in the countryside and I see animals I feel that I really see them. It’s difficult to describe, but it’s like there’s an extra dimension. Water looks different – it’s more see-through. When you look at a stream you normally just see the stream moving, but I see the layers of the stream and the flotsam and the tones in between.

In one of her poems, she expresses very vividly how a new dimension of reality has opened up to her:

The trees of green, of brown, of bare
That change each season, every year
Why do I see it now, so clear?
Why didn’t I see it before?

The beat of the wings on birds on high
The flutter of the leaves that drop
The shades, the veins, the shapes, the feel
So different from before.

All the new and different sights to see
The same, but from a different view.

The other main changes are a new sense of values and a sense of the preciousness of life:

I used to be a bit materialistic – well, it was probably my husband more than me – but now I know that money isn’t important, that it’s time that really matters. I used to have expensive foreign holidays twice a year, but now I haven’t been on a proper holiday for four years and I don’t really mind. I’m happy as long as I’ve got enough money to get by, but I don’t need anything else.

I really want to use my time productively. I really want to make the most of life. I wasn’t doing that before. I know that time is really precious and that before I wasted it by not really being myself. To waste my time doing something I don’t want to do is not a good idea.

Before, she hardly ever spent time alone, but now she enjoys her own company:

The old me tried to avoid being by myself – although I hardly ever got the chance anyway – but now I’m quite happy to do nothing on my own. I’m happy just to sit on my settee, reading or watching a bit of TV, talking to my dog, drinking a bit of wine – and I can really feel fulfilled.

Other people have noticed the change in her too. Her son says she has more of a sense of humour and laughs a lot more now, while her brother says she’s like she was as a girl, more carefree and relaxed and less stressed.

However, although she is happier in most ways, Iris told me that there have been some downsides to her experience. She feels insecure because of the changes to her body and finds it difficult to get into relationships. She feels less trusting of people, partly because she’s never sure of how they will react when she tells them about having cancer. Nevertheless, she feels that becoming ill with cancer was a ‘massive life-changing experience which has woken me up and given me a new life’.

CARRIE’S EXPERIENCE OF THRIVING

One woman who has been through a very powerful process of ‘thriving’ – to an even greater degree than Iris – is a television writer named Carrie Mitchell, who lives in Yorkshire and is in her early forties. She was diagnosed with breast cancer in September 2007, but even before then she had been through a great deal of suffering and trauma. When she was a young child, her younger sister died at the age of six. She became ill one night and died the following morning, in their mother’s arms, from viral meningitis. Their mother was completely devastated; she broke down in front of Carrie and was never the same person again.

Carrie didn’t realize how affected she had been by this bereavement until 30 years later, when there was another death in the family. This was her nephew, who had been born prematurely and always had breathing difficulties. At the age of 18 months, he caught a chest infection and spent months in hospital, with his life in danger. Carrie was very close to her sister and her family, and visited her nephew almost every day, often staying overnight. When he died, she had grief therapy for more than a year, which also helped her to come to terms with the loss of her younger sister.

Her nephew’s illness also had terrible consequences for the health of her sister, who was diabetic. Inevitably, as she was so preoccupied with the welfare of her son, she neglected her own health, and developed an eye condition which led to her becoming blind. She lost her sight within five months and also suffered serious heart and kidney problems. She had to have kidney dialysis three or four times a week for 18 months, until she had a double heart and kidney transplant.

Carrie was looking after her sister – she drove her to hospital for dialysis three times a week – and trying to lead her own life at the same time. Before this trauma, she’d been leading what she calls a ‘consumerist’ lifestyle. She had made a lot of money writing soap opera episodes for TV and felt obliged to spend it. As she describes it, ‘I bought my own house and got caught up in the whole thing of buying stuff I didn’t really need and filled my house with furniture and all kinds of “nice” things.’

But now she started to feel disconnected, as if her life didn’t have any meaning any more. Her bank balance kept increasing, but she stopped spending her money. She was suffering from depression – although she didn’t realize it at the time – and threw herself into work as a way of anaesthetizing herself to the pain. As she describes it, ‘I just lived in this fictional world of soap-opera characters and tried to forget about everything else.’

On a visit to her bereavement therapist, Carrie told her that she felt completely broken. She said she had lost all ambition and all interest in the world around her, and that it was as if she was looking at the world though a window. And then, just a few days later, she was diagnosed with breast cancer.

It was a massive shock, partly because in her family she’d always been the person who didn’t get ill, the person who cared for everyone else. It was a role reversal: she lived on her own and now she needed her parents to be there for her, instead of the other way round. She was told that her cancer was an aggressive one which had already spread to one lymph node. She was devastated and scared. ‘It confirmed my fears that my family was doomed,’ she told me. ‘I thought it was another terrible tragedy that my mother was going to suffer.’

After being diagnosed, she wanted to know why she’d got cancer. She didn’t fit any of the normal criteria – she wasn’t overweight, didn’t drink too much and didn’t have a bad diet – so why had her body decided to malfunction? She started to read books about healing and the link between the mind and body. She read a book which said that cancer was often the consequence of a lot of unresolved emotional sadness. She thought this applied to her – she had been carrying around stress and trauma inside her body since she was six years old. She decided that if she wanted to heal herself she would have to deal with this stress and trauma. So she decided to address what was happening to her emotionally.

She started to meditate regularly and began to feel the benefits straightaway. She found that by keeping herself calm through meditation she could create a more positive attitude. She did a lot of relaxation exercises too, and positive visualizations, along with having chemotherapy and radiotherapy. And after a year she was told that there was no more cancer in her body.

Now Carrie is technically in remission, even though she has to take medication for another five years. And, like Iris, she is now a different person:

I’ve had a weird but wonderful journey, hitting rock bottom and going back up again. It’s quite amazing how things have turned around. It’s been very liberating, and led to a massive change in my values and my ambitions. I feel as if I’ve woken up to something.

I used to be really ambitious – I used to really want to write a soap that won a BAFTA – but now I don’t want to win an award for anything. I’m interested in living as harmonious and peaceful a life as possible.

Now I feel as if I’m rejecting material things too. I’m backtracking. I’ve got a big house, but I’m going to put it on the market soon. I’m not interested in the idea of having a mortgage. I’m questioning a lot of things like that. I used to spend a lot of time passively watching TV, but I don’t do that any more. It’s got to the point now where I don’t feel comfortable writing soaps, because I don’t want to perpetuate them. I feel like I’m peddling misery and want to do something more positive.

I have a completely different attitude to nature. I walk every day with my dog, but before I would think of it as a chore, whereas now it’s the best part of my day. After my diagnosis I went to Cornwall for six months and I just spent the whole time by the sea. I felt a really strong connection with nature, feeling a part of it for the first time ever. It felt joyous to be outside.

Now I live very much in the present. When you have a realization of what really matters, it stops you getting lost in negative thoughts, which I used to do. I’m always reminded of how lucky I am. And that helps me to enjoy things for what they are. If I’m with friends and I catch myself thinking about something else, I can bring myself back to the present. Before, I’d just follow my thoughts. And because I’m more present with other people, I’m connecting with them more. They’ve responded to the change in me and become more present as well. So my relationships have definitely improved.

When you’ve been really low, everything is good in comparison. I feel a lot freer, a lot less encumbered by anxiety and fear of death. When I was diagnosed, I was terrified of death. I don’t think I’m completely free of it, but I feel much more connected to a wider whole, as an ongoing process of life and rebirth, so the fear has almost gone. I’ve had enough of suffering and being caught up in negative thought patterns. I’ve let go of them. If you live in the moment, you realize that there’s no point projecting into the future. Whatever happens is going to happen, so there’s no point worrying about it. You just have to accept it. Even if the worst happens, I know I will get through it.

I’m very much aware that I used to live a very egobased kind of life and I feel that through being aware of it, I can drop it. Now I see myself as part of a whole. I see my life in a universal context, whereas before I didn’t think beyond my own desires.

If this is what having all these traumas has led to, then I guess I’m very lucky I’ve emerged from the experience a rather different, more ‘evolved’ spiritual person.

The only negative side to Carrie’s experience is that, as Iris also found, her transformation has created a distance between her and her family and old friends. It may take some time for them to fully understand or accept her new self.

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Cheryl, Iris and Carrie have all transformed in very similar ways: they have all felt reborn, as if they have been given a new lease of life. They have all found a new contentment and meaning, including a new appreciation of the fact of being alive, and of the ‘small things’ they used to take for granted. They have become less materialistic and ambitious, and now feel a sense of connection to something larger than themselves. They no longer experience life as an isolated ego, separate from a world ‘out there’. Carrie mentions that she feels a new connection to nature, while Cheryl describes her awareness that ‘You and I are the same consciousness. I feel like I’m part of something greater than myself.’ In addition, they have all learned to ‘step back’, to stop striving and allow things to happen, trusting in the future rather than worrying about it. Perhaps most significantly, though, they have all gained a new perception of reality. The world has become a much more real and beautiful place to them. As Iris describes it vividly, ‘When I’m out in the countryside and I see animals I feel that I really see them.’

I’m going to save my full discussion of the reasons for this transformation for the final section of this book, but at this stage it’s perhaps worth highlighting the importance of attention . One of the reasons why Cheryl, Iris and Carrie have ‘woken up’ to the is-ness and beauty of the world is simply because they now pay more attention to it. For Cheryl this is because she is no longer so immersed in her job and so busy rushing from one task to the next; she has slowed down and learned to focus on the present moment and her immediate surroundings. In a similar way, Carrie has learned to live in the present rather than to distract herself through writing or to focus on her future ambitions. She has also become less immersed in her own thoughts and so more attentive to her surroundings and her experiences.

An important part of Iris and Carrie’s experiences in particular is that they were told they might only have a certain amount of time left to live. As well as suffering the trauma of illness itself, they had to face possible death. As we’ll see later, becoming intensely aware of death makes us more attentive to our surroundings because it makes us aware of the preciousness of the world. Through coming close to death, we realize that life is temporary, that we will only be able to experience the world for a certain amount of time. As a result, Iris and Carrie have begun to pay more attention to it, in the same way that a person who’s moving to a different country really savours the last few days with his family and friends at home. Iris and Carrie – and Cheryl too – have made an unconscious decision to focus on the present rather than to let their attention be immersed in thoughts and daydreams.