There were a number of ripple effects following the onset of my chronic fatigue syndrome (CFS) and the accompanying symptoms of back pain and grief (see my CFS story 1). The first was that the discomfort of my symptoms quickly became stronger than my fear of following my heart. And so I started saying no, simplifying and slowing down. In 1997 I wasn’t actively trying to implement the tools we now recognize more readily as stress reduction techniques but they were on my radar and they were the things that called to me. It turned out, however, that decreasing my stress wasn’t enough to heal my symptoms. It was what I did with the space that stress reduction created that started to truly change my life for the better. In that space I learned about the act of listening – to my patients, to my longings, and ultimately, to my heart. The act of listening is what enabled me to begin to heal.
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My chronic fatigue has been the most tenacious of my symptoms and it worsened for years, long after my back pain and grief had resolved. But then I turned a corner. In today’s post I want to share some of the first lessons my symptoms of CFS taught me as it invited me to face the unknown and gave me the keys to begin to truly heal.
Symptoms as Motivators to Reducing Stress
At the time that my intermittent symptoms of fatigue first showed up I prided myself on my ability to work long hours and to be there for my patients and my colleagues. But being tired quickly taught me that I needed to listen to what my body was saying. I started to learn how to pace myself, became more flexible when I made plans and learned how to prioritize what I most loved by experimenting with my “no” as well as my “yes.” I started getting a sense of when to push a little for something I really wanted. And when to let go and relax as I began to recognize that there were things I did more out of fear of missing out than because they appealed to me.
As my evolving symptoms of fatigue slowly progressed over those first couple years I believed, at some barely conscious level, that I was experiencing burn out. As a result of these symptoms I cut my hours as a family doctor teaching full-time, bought my first home, and planted my first garden. I started cooking more meals and spending more time with friends. I followed the urge to lighten my load and declutter. I got rid of clothes and tchotchkes and stuff I didn’t love even though I didn’t own much. I cleaned. Simplified. I organized my finances, my music and the loose little bits that littered my drawers. I also started taking naps and I went to bed early when I was exhausted. When I had days off and felt good it was like catching up with lost time from all the hours in medical training and in my first years of practicing medicine out on my own and I read or watched TV into the wee hours. Mostly, I enjoyed spending quiet hours alone at home. It was such a gift to have time and space.
I figured that I just needed to give myself time in order to recover. But slowing down, reducing stress and creating space was only the beginning.
The Act of Listening
As I recognized the richness of what it was like to be truly listened to in my work with Kevin things started to shift. I had created space by reducing a great deal of the stress in my life but my symptoms hadn’t changed. It was through learning the act of listening to myself, with respect, with curiosity, and without judgment, that things truly began to move.
First, I started to see how the act of listening was missing in some of the key relationships in my life. When on the phone with my parents, for example, I realized just how distracted my father often was. It meant that I was regularly interrupted in the middle of a sentence or when I was trying to convey an idea. It made me irritable. I recognized how my mother spent much of her time second-guessing what I was saying and giving me advice. I started noticing how my belly and chest would tense in response to these recommendations. I also began to experience how many of my conversations with relatives were also lop-sided and that it was more about delivering information to me than about listening.
The Act of Listening to and Learning from My Patients
The other shift that happened as I began to experience what it felt like to be listened to was how much meaning I derived from listening to my patients’ stories. Like my talks with Kevin that helped me find my way, get new insights, and to feel better, listening seemed to be helpful even when I had little else to offer.
Being listened to opened up my world. And it opened up my patients’ worlds as well.
Listening to One Particular Patient
During one woman’s second hospital admission for a serious, life-threatening rise in blood pressure, I discovered that she had been thinking of leaving her husband for years. She hadn’t been able to figure out how to do it, however, and he had then developed brain cancer. Before her hospitalizations she had been feeling trapped. But feeling listened to helped somehow and she told me how much better she felt. I was surprised to note that even her blood pressure had decreased. I felt a connection with her that hadn’t been there during the previous admission and it felt meaningful. Something about the simple act of listening had had a profound influence on both of us as well as on her body.
I have since learned that we often get stuck and feel trapped when we have too little support. Listening is not a passive thing to be rushed, it is actually a very powerful action.
Listening is an Act of Support
Another woman had come to see me for new symptoms she had recently developed. When she came in for a follow-up and none of her tests showed any abnormalities I wondered whether stress might somehow be playing a role. I asked her to take 10 days off from work to see what would happen. She cried with relief that I believed her. And sent me flowers. After she left the nurses told me that she had lost custody of her grandson a month earlier and that he was now in foster care. I didn’t know then how often stressful events serve as triggers for the onset of symptoms but something about uncovering this profound loss in my patient’s life resonated with me. Rather than making me doubt the validity of her symptoms it confirmed my belief in her. I felt grateful that I’d taken the time to listen.
Listening is an Act of Repair
A man I’ll call Peter was referred to me because he “refused” to take medications and was interested in alternative ideas for high blood pressure he’d had since childhood. It turned out that his refusal had followed a series of negative experiences with doctors and that he was on the verge of calling it quits with medicine. He’d been shamed for expressing concern about side effects, blamed for making health care decisions that only his trained physician should be making, and humiliated for “taking his life in his own hands” when looking for another approach to treatment.
As I listened to his story it seemed to me that he had acted in a remarkably proactive and responsible way in his care. So we started there. Instead of looking for medication to fix his blood pressure we scheduled longer visits so we’d have the time to talk. He told me how our conversations felt healing, in and of themselves. And how each time, he left feeling as though his blood pressure had lowered to normal for a few days. I, too, felt a sense of deep connection and satisfaction following our visits. Peter eventually became interested in finding a medication that could be a good fit for him because he really didn’t want to risk having long-term complications from his hypertension.
I have never forgotten this man and how listening repaired his sense of trust in himself as well as in others. How it supported his deep desire to heal while also being treated as a real human being. And how the act of listening with curiosity seemed to offer something more powerful than medicine.
In listening to my own inner voice I slowly came to realize that this was the kind of relationship I wanted to have with my patients. And it made me question my career as a medical doctor.
Listening is an Act of Healing
And then there was a woman who came to me with headaches and shortness of breath. When her work-up came up negative I explained that stress could be making certain muscles, such as muscles in her shoulders and upper chest, become tense. This could be compressing nerves and leading to her headaches as well as to changes in her breathing patterns. She cried in relief at feeling heard and at having an explanation that made sense of her symptoms.
I’m not sure that I realized during my medical training that listening could be so powerful. Or whether it was something I had always believed in but that had been bled out of me during the long and grueling hours of training and medical practice. But as my fatigue failed to resolve despite my greatly reduced stress and work hours the seemingly small act of listening to my patients, to seeing how it affected them, and to feeling how it warmed my heart and fed my soul began to have an impact on me, too.
The Act of Listening is Powerful
As a doctor in training I was taught that listening with an open mind is important. But in the “real world” there was never enough time. The unspoken message was that listening was a passive process and that patients really just needed us to get on with the act of doctoring by performing tests and examinations so we could diagnose and treat.
The experiences of connection and healing that were happening with my patients from the simple act of listening were few and far between back then and I didn’t connect the dots at first. But the sense of meaning and healing that I and my patients were experiencing was to become a vital aspect of my own journey.
Reducing the stress in my life was critical to my healing, but it was not sufficient in and of itself. It was what emerged from the space that it created that enabled me to find my way. The act of listening is what started shaking up my world and turning it upside down. In the best possible way.
I’ve learned in the intervening years that the act of listening offers support where none may have existed before. It softens our hearts and supports our nervous systems. Listening enables our brains – and therefore our minds as well as our bodies – to feel safe, to feel secure and to experience love and connection. It therefore plays a critical role in repairing trauma wounds, especially in healing trauma that stems from our earliest relationships. It enables us to mobilize where previously we may have felt stuck, overwhelmed, or trapped. Listening is, in and of itself, an act of healing.
The act of listening has been the pathway to my own healing.
In today’s post I’ve shared how the act of listening to my patients showed me a different way of healing. In the next post in this series I’ll share how the act of listening enabled me to find the courage to leave medicine and to take the next steps in healing from my symptoms of chronic fatigue.
I’ve summarized my story with chronic fatigue in a single post about how understanding trauma helped me make sense of my symptoms and begin to heal. It’s how I came to an entirely new way of thinking about chronic illness.