In today’s installment of my journey with chronic fatigue I want to tell you what I’ve been learning about the art of listening. Because it turns out to be a much more complicated task than we realize. And because, in unexpected and potent ways, it’s what has enabled me to find a pathway to healing. It’s been a slow journey and one that I am still working on and learning from each and every day. But there’s more to listening than we think.
Below I’ll tell you about barriers to listening, which stem from difficult experiences that change our brains rather than from “who we are” or because we are “too sensitive” or “willfully ignoring” ourselves. I’ll tell you why I’m calling it the art of listening rather than something that you can just figure out one time before throwing it into your tool kit. I’ll also give you a glimpse of what I’ve learned in developing the theories about the role of trauma in the origins of chronic illnesses of all kinds, including my chronic fatigue. Not because chronic fatigue or chronic illness is not real or because it’s “all in our minds.” But because trauma changes our nervous systems. I’ll then briefly introduce you to how the art of listening is a key to healing. I’ll close with a poem from Mary Oliver that captures the meaning of this Art of Listening.
Worsening of Fatigue
The onset of my chronic fatigue was very gradual and took place over a number of years (see my CFS story 1). My symptoms continued to slowly worsen even as I bought my first home and started to rest more, even as I reduced the stress in my life, slowed down to part-time work as a family doctor, simplified, starting taking regular walks, eating better and meditating.
In the year after actively implementing all of these changes into my life I was sometimes in bed by 8pm, even when I’d already taken two naps. I was dancing and skiing less because of my fatigue although there were times when I had no difficulty. But I was also beginning to have to back out of get-togethers with friends at the last minute.
I was still working 30 to 40 hours a week in addition to being on call for 36 to 72 hours at a time. I continued to think, at some barely conscious level, that I must simply be stressed or experiencing burn-out.
What I discovered in the space that all of these changes created and from the experiences I was having of feeling listened to in therapy, was how good it felt to truly listen to my patients (see my CFS story 3).
What I realized was that I wanted to help people heal their lives. Even as I was learning how to heal my own.
I also started wondering if medicine was the right fit for me.
The Art of Listening
In the last post about my cfs story I described how listening to my patients turned out to be an action – one that could heal, repair and support them in ways I hadn’t fully understood before. I discovered how the act of listening also fed my soul.
In today’s post I was going to focus on the act of learning to listen to my own voice.
In the first draft I found myself tying it all up in a tidy little package, all wrapped up in a bow. As though learning to listen to myself was a one-shot deal and finding a career that was a better fit for me was all I had to do in order to begin to heal. In reality, it was just one step. And a complex one at that.
Because listening turns out to be an Art. And it’s an art that I am still honing and refining even now, 20 years later. The art of listening is about learning to discern what to listen to amidst all the voices and advice and chatter that comes at us every day – from our thoughts and symptoms and impulses and feelings on the inside and the social, medical, cultural and religious input (and more) on the outside.
The art of listening is about finding one’s own voice amidst the babble. It’s about disentangling the helpful messages from the patterned ones that can lead us astray. It’s about recognizing the impulses that speak from the health of our systems – those places of deep knowing about what supports our growth and healing – from the ones that do not serve. From the ones that have been learned. Learned so that we don’t have to figure everything out from scratch. But also learned for survival and self-protection, for fitting in with cultural norms and beliefs, and for feeling safe when what we feel is insecure or alone or afraid.
What I’ve learned from living with a chronic illness is just how difficult it can be to listen to myself. I’ve learned that understanding what to listen to changes. Every day. That we don’t always hear what we want to hear. And that our decisions are influenced by pain and fear and hope. And struggle. That we have to experiment, try things out and learn through our mistakes and successes. To learn from our risks. To learn from the frustration, overwhelm or despair that comes with symptoms that don’t change. Or that get worse no matter what we do or how diligently we follow what feels right.
I’ve also been learning why it can be so difficult to hear our deepest truths. And what we can do to hone the art of listening. To make it easier to hear. And easier to follow our hearts.
The Doubts That Keep Us Immobilized
When I realized that I felt deeply conflicted about the practice of medicine I was dismayed. The connection I had with my patients and families and with the babies and mothers I assisted through birth was precious to me. A privilege. Wasn’t this what I had wanted since childhood? Wasn’t this what I was meant to do? How could I leave after all those years of training? How could I leave my patients, who I cared about so deeply? Was it just Fear speaking – fear of not knowing enough, of not being good enough, fear of causing harm, fear of … ? And if I didn’t face my fears now, I wondered, wouldn’t I just have to deal with them later?
I worried that I’d be running away if I left my career.
At a barely recognizable level I felt as though something was wrong with me if I wasn’t happy with the life I had worked so hard to attain. And that if I just tried a little harder I could make it work.
The fear and confusion that I was just running away made me want to “hibernate” – to curl up with a cozy blanket and sleep until these painful new awarenesses that threatened to upset the order in my life had passed. I wanted to bury my head – in my garden, in my books, in TV and in the movies …
As I continued to chew on this new wrinkle in my life I gradually realized that sometimes you can’t really tell if you are running away from something you fear or if you are running towards something you want. You can’t tell until you try.
Listening My Way Into My Truth
In the end, my doubts were met with unexpected counterpoints. The answers and supportive insights kept revealing themselves to me in a hundred different ways.
Sensations: It was in the sinking feeling I had on Sunday nights as my free time came to an end and I headed into my work week.
Emotions: It was in the despair and grief I experienced as I struggled with a sense that there was a better way to heal, to help, and to support people with their pain and symptoms and chronic illnesses.
Dreams: It was in my dreams of moving out of my parents’ house, even as one thing after another kept pulling me back. It was in a dream that stated, “Who says you can’t decide to shorten your skirt when you reach the age of 18? You don’t have to live forever with the arbitrary length you first chose when you knew nothing about skirts. It’s okay to change your mind once you’ve learned what you like.”
Thoughts: It was in my unconscious belief that hospitals represented a sense of safety and security, where everything could be made better. Except that when this belief came into the light and I was able to look at it more closely I found that I didn’t believe it. That it was a fill-in for the sense of safety and security and community that I craved but didn’t really experience in my day-to-day life.
Metaphors: It was in the insights I had when I sat in mindful meditation with my questions and listened with curiosity rather than judgment.
If you are a bumble bee you serve unexpected and vital functions by being fully who you are. When bees visit the flowers they are so drawn to, I saw, they also inadvertently pollinate them.
When you are a spider any of the spokes of your web eventually lead you to the center. There is no “right” thread to follow to get to where you are called to go. It’s okay to pick the thread you want.
Role Models: It was in the characters who inspired me in books, on TV and in the movies. The ones who stuck to what they believed in. Who followed their truth against all odds, even when it meant risking it all.
Responses: It was in the tremendous and immediate sense of RELIEF I experienced when I finally made the decision to leave.
Eventually, the pull of what I hungered for became stronger than the doubts and the fear of the unknown that had been keeping me immobilized.
What I’ve Learned About The Layers
What I’ve learned since leaving medicine and discovering research I’d never heard of when I was a doctor is that many of the difficulties in discerning one’s voice come from what has been learned.
While we all have to learn to differentiate our healthy impulses from the ones that can takes us down the darker paths, this is not always straightforward. For many of us, the wisdom gets obscured. By layers of protection. By disuse. By having to repeatedly ignore our own needs or wants or impulses. By fear. By overwhelming experiences that we could not overcome.
Even as I became increasingly clear about my desire to leave medicine, the feelings of intense self-doubt were intimidating. And often immobilizing.
Such feelings, even regarding as difficult a decision as leaving one’s career, are not an innate part of our personalities or genetic make-up. The doubt we have about following our longings and the whisperings of our hearts is something we learn. It is something we are taught. It becomes something we carry within us. An invisible and seemingly normal part of who we are.
The Art of Listening and Healing from Chronic Illness
The kind of self-doubt and fear that is immobilizing is actually an indication of a “freeze” response: the nervous system pattern that is the fallback position when fight and flight are not viable options for survival.
The freeze response is the one that makes us hunker down to wait for danger to pass. It’s the unconscious survival response that uses camouflage and invisibility as a means of self-protection rather than attack mode. And in time, it’s what makes it difficult to act, to simply change the things that aren’t working in our lives, and to be fully and freely who we are.
I’ve learned that this kind of pattern is not all in the mind. The freeze response comes from a change that has taken place in our brains. It can affect our bodies, our mind and emotions, and our behaviors. And over time, our physiologies. The freeze response, I have come to recognize, is a sign of past trauma. And it is a risk factor for the development of symptoms of all kinds. Including the very real altered physiology that can lead to chronic illness.
Learning to honor our truth is how we access the courage and strength and guidance to step into our own lives. And into our own beliefs. It is a pathway to healing and to living from a place of passion and joy. It is a pathway to feeling more secure and safe and connected.
This is not because it’s all in our minds.
It is not because following your heart will cure your chronic disease.
It is because learning to listen is how we begin to heal from trauma.
Just as our bodies are designed to do.
This is what I’ve been working on for the past 20 years in my new career. Learning about the role of freeze and trauma (often expressed very subtly as a perception of threat our cells experience even as we are not conscious of it) and how it changes our brains. Learning about how our brains and bodies and minds protect us through layers that try to bury the painful past. These changes in our brains arise from experiences such as subtle types of childhood trauma and overt forms of adverse childhood experiences (ACEs). They initially keep us safe in the face of overwhelm or terror or difficult times. But in time these very real changes in our brains confuse us. Immobilize us. And play a role in the development of chronic illness.
To reiterate, this is not because chronic illness is all in our heads. It’s not because chronic illness is “psychosomatic.” It’s because trauma and its effects on the brain alter us – they alter our bodies as well as our minds, our physiologies as well as our feelings, our thoughts as well as our beliefs and behaviors.
These states and threads and layers also show us how to come home to ourselves. And how to begin to heal.
That is the gift that comes from an understanding of trauma. And from understanding how the art of listening is not just about hearing words or participating in conversations with others. The art of listening involves attuning to ourselves through multiple channels – from the language of the body that is accessible through sensations and impulses, metaphors and dreams to attending to our emotions and thoughts, and beyond.
I look forward to sharing more about these discoveries in future posts in this series and on my blog.
Mary Oliver’s “The Journey”
One day you finally knew
what you had to do, and began,
though the voices around you
their bad advice–
though the whole house
began to tremble
and you felt the old tug
at your ankles.
‘Mend my life!’
each voice cried.
But you didn’t stop.
You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
It was already late
enough, and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do–
determined to save
the only life you could save.
You can learn more in my summary post about my story with chronic fatigue and 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.