In my private practice, I bear witness to difficult realizations about the limitations of human control when it comes to health. I work with a lot of people who are doing everything “right” in terms of diet and lifestyle—and by “right,” I mean that they’re doing what’s appropriate for their own, unique bodies—and yet they continue to struggle with chronic illness or other health challenges.
It is very, very difficult for anyone to contend with a health scenario that can’t be controlled or significantly impacted by lifestyle change. It can be especially bewildering for people who are particularly well-informed about the power of lifestyle to improve health. But it happens.
I don’t have the answers in situations like this. I can only communicate what I believe to be true, based on my experience: it’s positive and empowering for us to do whatever we can realistically do to improve our odds of living well and long. And it’s important for us also to recognize that the body is still a mystery to us in many ways. There are limits to our own powers of prevention and management.
Making peace with this can allay the guilt and self-blame that many people tend to feel when they just can’t seem to feel better, or when an illness worsens unexpectedly. Understanding that we’re not always in the driver’s seat when it comes to health can bring about peace, and it can also help people to forgive their bodies if an illness or health condition has been a source of anger.
I don’t have a lot of personal experience with chronic physical illness. My environmental allergies are the most persistent thing that I deal with, and while they affect my quality of life, they don’t make me extremely sick. Even with them, I experienced a lot of relief when I’d finally exhausted all of the remedies that people told me would cure them (they didn’t) and stopped experimenting on myself. I put trust in my allergist and started focusing on effective symptom management, rather than symptom elimination.
My mental health struggles do give me a window into how it feels when we can’t make something chronic go away. I can trace the roots of depression anxiety to my earlier life, but they’ve become louder since my eating disorder recovery, probably because my ED distracted me from underlying sadness and fear. I struggled more than usual last summer. I’m doing much better, but I accept that depression is a part of my life, and it probably always will be.
A few weeks ago I felt depression flaring up again, maybe at random, maybe sparked by the duration of quarantine and all of the pain in the world. As soon as I felt it, I thought about whether there was anything I could to do keep it from worsening quickly. I knew from experience that certain things help: being honest in therapy, sticking to a consistent sleep schedule, and maintaining structure in my days. I do well when I commit to enough daily tasks that I feel a sense of self-efficacy, but not so many that I get overwhelmed. Nourishment from food is non-negotiable.
These things—sleep, hydration, nice meals, a little doing, a little rest, making the bed, getting out of my pajamas, taking a walk, taking a deep breath—they seem so obvious, right? But it’s funny how in some ways we’re not really taught how to maintain them when real life gets hard. I often hear clients apologize and express shame over the fact that they’ve neglected some basic form of self-care or another. I don’t think I’d hear that apology so often if self-care were obvious or easy.
Self-care isn’t obvious or easy. And it’s not always enough to make suffering go away. But I think it almost always makes a positive difference, in that it gives us more of what we need to keep going. I’ve been reminded of that this month. Thanks an established self-care routine, I’m feeling a little more emotionally resilient than I was a year ago.
Melody Beattie says that, as we unlearn our own negative beliefs about ourselves, we learn to ask ourselves two questions: “what do I need to do to take care of myself?” and “what am I supposed learn?”
I don’t always know what I’m meant to learn from struggle, and when I work with a person who is suffering, I’m not always able to discern a lesson there, either. But I have learned that “what do I need to do to take care of myself?” is the best question I can ask myself no matter what I’m up against. As we begin a new week, I offer that same question to all of you, with the hope that each person reading will be able to take some small, loving action on the answer.
Here are some recipes and reads.
This vegan seitan steak looks so juicy and hearty!
Speaking of seitan, this Massaman curried seitan is calling to me.
I can’t wait to try Brandi’s bright, vibrant summer corn soup (with plenty of zesty black pepper).
Will be making Ali’s easy, puffy, pillowy pita ASAP.
And lastly, the most perfect looking vegan snickerdoodles I’ve ever seen.
1. An interesting interview with science journalist Stephanie Lee, which illuminates the importance of good study design and good science reporting in general, and especially during a public health crisis.
2. If you’ve been wondering how to clean your cloth mask, I have been, too! Here are some tips from doctors.
3. It will now be standard practice for newspapers to capitalize the “B” and “I” in Black and Indigenous people. Jenice Armstrong reflects on the news and the fact that it took far too long to happen.
4. Via the New York Times, an examination of how and why health officials dismissed the possibility of widespread, asymptomatic transmission of Covid-19 in the early stages of the pandemic, with grave consequences.
5. Three Black doctors explain how the Covid-19 crisis has revealed vast racial disparities in healthcare. This is in addition to reporting describing how Covid-19 testing has failed Black communities.
Two action promptis I got from Nicole Cardoza’s anti-racism email today: first, you can find out whether your state and city have equity task forces for addressing Covid-19, and contact local authorities to request one if not. Also, you can check out the Black Lives Matter petition demanding that the government collect and release demographic data on the coronavirus.
OK, friends. I’ll be back with some fun, summery food this week. Wishes for a peaceful Sunday eve to you.
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Whenever I write about my experience of eating disorders, I make a point of saying that the healing process isn’t linear. It’s full of odd, surprising twists and turns, realizations and moments that take one by surprise. Still, it’s natural to hope that a linear trend will emerge. After all, it’s the promise of change, of transformation, that keeps us going when the process is at its ugliest. When recovery was at its worst for me—when I was feeling the most robbed of…
I’m not sure whether I’ve ever mentioned this, but I can be amazingly visually unobservant. When I’m walking around here in NYC, I’m conscious of things like cars and the foot traffic of other pedestrians, but I don’t frequently notice things like architecture or foliage. I’ve become aware of this trait only by noting how different my orientation is from that of other people. My mom, for example, sees everything, from the shapes cast by shadows on the sidewalk to each and every…