“If the world is to be healed through human effort, I am convinced it will be by ordinary people, people whose love for life is even greater than their fear. People who can open to the web that called us into being.” Joanna Macy
From the top of our roofs we could see the fires crawling over the hills closer and closer towards us. In December 2017, Santa Barbara was stricken by the most significant fires on the West Coast of America. For about two weeks, our little town felt like a post-apocalyptic landscape, deserted, with shops closed and scattered people wearing facemasks and shawls, scurrying through the deserted streets. Thrown back and forth between terror of annihilation and detached numbness, many of us hunkered down at home glued to the TV screens or fled town.
The Santa Barbara fire followed closely on other catastrophic burns in California and hurricanes in other parts of the country, as well as environmental distress spreading throughout the world, from Puerto Rico and Mexico to Bangladesh. Our fire flared against the backdrop of a harrowing year in the political and social arena. Environmental protections had been stripped away as well as healthcare, respectful treatment of immigrants, quality education and human rights.
In the midst of the desolation of the fire crisis, when many of us felt contracted, lonely and shrunken, the yellow-clad Bodhisattvas had rolled in on their red chariots. Youthful strong firemen and women faced the inferno on all of our behalf. Their willingness to give, to risk it all for our towns-people, saved not only countless lives and houses but also momentarily restored trust in the goodness and generosity of life. One of the Bodhisattvas, a 31-year-old man, father of a young girl, tragically lost his life in the fire. His willingness to give all to save others softened our hearts.
Who would have dreamed that three weeks later, as we were beginning to heal from the fire, rains would come to devastate the fire zone with a mudslide? No one was prepared for this catastrophe. After the fire and before the flood there was a strangely surreal hiatus between tragedies. For a few days we were inspired by the compassion and courage of others and we tried to believe that all was normal again. It was surprising how we seemed to re-bound when the flames receded just days before the holidays. We took on the Christmas holidays with gusto; we shopped away and cooked up a storm while trying to forget the recent calamity. Yet, a strange sense of hollowness and un-reality remained. I found within myself a nagging sense of unease. Caring only for ourselves and our near and dear ones did not seem enough.
Right after New Year’s, when the rains descended, the mountain moved, and immense masses of rocks and mud slid down to decimate our town. A gargantuan rain and mudslide left a significant area destroyed, hundreds of houses demolished or damaged and over twenty people dead. Several victims have still not been found. Overwhelmed with emotions, many of us wondered if we were experiencing a preview of a nightmare future. We experienced ourselves as vulnerable little creatures, easy to get hurt and perish. And we felt the vulnerability of our broader world. While the immense rocks tumbled down the mountains, our hearts cracked wide open. With so many human lives lost, our community was devastated, and because so many were displaced, those of us remaining were brought together by our tears.
We were broken open to one another by amazing stories of human bravery and generosity. Curtis stayed behind intentionally, so he and his neighbor could help all the other people on his street out of their houses into safety. Connor, a 22-year-old friend of my kids from school, tried in vain to pull his dad out of the stream of mud. A young fire-fighter risked his own life to dislodge a family of five and their dog from their destroyed house: to lift them, one by one into a helicopter. The family, that had lost their father received generous donations from a go-fund-me collection; they gave the whole sum to an underprivileged immigrant family, a father and his 2-year-old son, who had lost their mom and siblings in the stream of sludge and boulders. Hearing about this and many other examples of selfless and compassionate action freed us from isolation, and, for a brief time, allowed us to know the web that called us into being to remember that we inter-are.
As much as I wished that this catastrophe had never happened, at the same time I appreciated what we were learning. I began to worry that our open hearts would close up again. I recognized that the events here were a microcosm of what is happening on a global level. We had been catapulted into what may well be all our future, a future foreshadowed by what is already happening in many other parts of our world. As humans we are pulled between closing up and self-protection on the one hand and openness towards others and generosity on the other. This is a fundamental dynamic for all of us as we face difficult times.
In his best seller, Why Buddhism is True, developmental biologist Robert Wright argues that over the millennia it may have been to our evolutionary advantage to be greedy, selfish and “delusional” in our perception of ourselves and reality. Boosting up our egos and grasping whatever we could for ourselves, may have advanced our family’s or tribe’s position. Now this kind of behavior is threatening not only to the survival of our eco-system but brings the gravest suffering to many parts of our world. Wright has a recommendation for us: as genetic evolution is too slow to save us now, we need to engage in cultural evolution, meaning we need to cultivate attitudes that help our societies to transform and our planet to survive and heal.
As I contemplate attitudes that might support us in holding our experience in a more caring and respectful way, I think of a phrase I heard recently from Joanna Macy: “mutual belonging.” She used this term in her explication of the ancient Buddhist Idea of dependent co-arising. The Buddha saw life as continuously emerging and then falling back into the stream of becoming. He showed us how everything co-arises in interaction. The reality we experience ascends from what we bring to it, our intention, effort, mood and awareness. Life is changing as we participate in it. Training in understanding of dependent co-arising helps us to cultivate attitudes of caring towards a widening circle of others. As our caring widens, our perceptions and behaviors change, allowing us to develop more compassionate ways of being with each other and our world.
The Buddha teaches that we suffer deeply when we stay imprisoned in a “delusion of separateness.” As we remain stuck in fear and alienation and as we cling to what by nature is transient, we become more and more entrapped. I see this with some of my psychotherapy clients. Those who have been so frightened by life that they have retreated into a shell of self-protection find themselves cut off from the stream of life. They often suffer the secondary trauma of isolation, quiet desolate anxiety and loneliness. By contrast, I have seen that it is possible to free ourselves by living our true nature, that of inter-being, joining the dynamic of life itself. Awareness of our interconnectedness as well as of the fact that we all affect each other in everything we do can then become the basis for a dynamic bridge-making between ethics and metaphysics. If we cultivate attitudes of being that help us abstain from violence, greed, and self-preoccupation and instead practice awareness, kindness, and caring for all life, then our own suffering and that of others will spontaneously decrease.
Practically speaking, how can we engage in Wright’s cultural evolution? How can we here in Santa Barbara remember Joanna Macy’s call to practice our radical interconnectedness with all of life? How can we cultivate attitudes that help our societies transform and our planet to survive and heal?
A little over a year ago, in response to feeling overwhelmed and despondent in the wake of the presidential election, my husband, physician and author Michael Kearney and I initiated monthly community meetings, called the “Solidarity and Compassion Project.” In each meeting we addressed a different theme and invited a panel of speakers, representing a range of spiritual, intellectual, scientific and psychological perspectives to join us for practice and discussion. Poets and musicians also joined us as we learned that joy is the much-needed antidote to despair and grief. Each meeting combined meditation with an exploration of sustainable ways to bring compassion and engagement to the many social, political, and environmental challenges we are confronting.
Serendipitously, in December, before the fire and mud, we had planned that the theme of our January gathering would be about grief. Meeting in the belly of an old church with richly colored windows allowed us to exhale after we had held our tension in so tightly during the weeks of fire, downpours, and rolling mountains of sludge. Guided meditations allowed us to be present with our inner feelings of rawness, dread, and alarm as well as with continuous feelings of uncertainty. Michael and I led participants in loving awareness and mindfulness phrases, “Let yourself settle into the sensations in your body, and notice whether there is tightness, ache or vibration. Feel breath arising with the inhale, letting go with the exhale, allowing the warm breath of life to breathe you.”
We also led the group in compassion practice, inviting all to extend caring to themselves and others in a gentle and relevant way. I suggested that those gathered quietly repeat the phrases I offered. I said, “May I treat myself with gentleness and understanding in this time of loss, May I meet my grief with tenderness and care,” and,” May I be compassionate and patient with myself especially when I feel afraid.” Widening the circle to include others in our care, I continued, “May those close to us be healthy and protected, may all those who were hurt in this crisis be safe well again,” and, “May those in this world, who experienced similar traumas to ours, find the support they need to heal.”
Finally, we began to relax. Together we were able to feel the feelings of our last week’s experiences. Images arose of burning mountains and memories of the alarming voices of TV announcers shouting their warnings. We remembered the dark grey air, the torn apart houses, the mud-covered areas that had been once streets; we remembered the faces of those dead or missing. Within the safety of community and practice we were also able to feel the sensations of our stressed nerves, so raw and fried. Feelings, thoughts, and image debris were released within the safety created by this practice of mindfulness meditation—all passing down a river of loving awareness.
When we feel afraid, lost and trapped within ourselves, practicing self-compassion can reaffirm our willingness to extend a hand towards our own traumatized inner selves. As we gradually make friends with ourselves, compassion for others will follow more easily. We extended warmth and understanding towards that in ourselves which was afraid and lost; we thawed out the cold spaces within and around our hearts. It felt as if the cores of our beings had contracted in the midst of so much agitation and panic. Like shy birds with their heads pulled in, we needed breath to breathe us into calm, warmth and tenderness. Then we sat together for a long time, sharing what we’d been through, remembering Curtis, Conner and the young fireman. Through love and developing equanimity, we began to learn to tolerate the rawness of our experiences. My husband Michael puts it like this, “The more connected we are, the more we care. The more we care, the more we long to do what we can to improve the well-being of others. And in that process, we heal.”
In recent weeks groups of volunteers of all ages and of all parts of the community, the “bucket brigades” emerged. These groups of community volunteers have gathered every weekend and moved “bucket by bucket” restoring damaged homes and landscapes. One young woman, Anahita, who lost a close friend in the mudslide, shared in one of our gatherings, “At first I felt more triggered than anticipated, by seeing all the mud and debris. It reminded me of our friend died, and I felt like I had more of a tangible visual and tactile feel for how she lost her life. But as I connected to the people and the mission of the bucket brigade, and as we picked up our shovels and started slowly chipping away, I felt a sense of healing in this. Tears welled up in my eyes, tears not only of grief but also of gratitude, for community healing in action.”
Catastrophic events challenge us to find new ways to re-integrate our psyches. I am grappling with unanswered questions: What do we learn from such events? Do we go back to “business as usual,” trying to forget as fast as we can? As research on groups of people threatened with annihilation suggests, will we close up, become more rigid, look for scapegoats and turn our grief into blame? Or can our hearts stay open and soft with increased compassion for others who suffer through similar plights?
A few weeks after our first gathering, I led a meditation In Montecito, in the area that had been most devastated by the mudslide. Huddled together in a yurt-like structure behind a store, in what is called the “Sacred Space,” fifty people came to meditate together, listen to stories of loss and trauma, of uncertainty, fear and hope. A man told us about the anxiety that still wakes him up every morning at 3 am. A woman talked about how she found gratitude for what is truly essential in her life after her house had been completely flushed away. There was a raw and open feeling in the room.
Recently, I heard that there are lawsuits looming in Santa Barbara, some devastated residents blaming others as culprits for nature’s disaster. What is happening in our little town is mirrored by the developments in our country, where we face daily choices between angry blame and proactive compassion. Experiencing the mudslide brought out a whole spectrum of responses. Some have found themselves retreating into understandable behaviors of self-protection while others have turned towards initiatives leading them to reach out in generosity. A grocery store and several restaurants at the edge of the disaster zone opened their doors to give free water and meals to survivors and first responders.
How do we turn adversity into an opportunity to grow and love and heal? Holding this question, I was reminded of the well-known story American-Indian story “Which Wolf do we Feed?” This is the version told by Algonquin elder Wolf Wahpepah: “You probably heard the story of the Indian boy who went to his grandfather for wisdom.
His grandfather told him, “Inside of me there are two wolves, a selfish wolf and a compassionate wolf. And they fight all the time. The selfish wolf tells me to look out for myself, to feed my appetite. The compassionate wolf says 9 I should be concerned about the welfare of all and be concerned about their needs.” The grandson asked his grandfather, “Well grandfather, which one of the wolves wins?” Grandfather replies, “Whichever one we feed.”
This article is about practice, choice and about cultivating an attitude of compassion and caring. We need to develop structures that are based on an understanding of interdependence and inter-being, that recognize our mutual belonging and radical interconnectivity. Gradually, as we align ourselves one by one with these structures of mutual belonging, we create a culture of compassion and spontaneous caring.
What has happened in this tiny microcosm of Santa Barbara might have significance in a much broader context. As we get thrown about by increasingly intense environmental events, as resources for many are getting slimmer, and as our weapons of mass destruction become increasingly ominous, we in our broader world need to cultivate what we are learning in Santa Barbara. We need to teach ourselves to be generous, open-hearted and inclusive.
In November 2016, as I listened to speeches by the new administration, I felt a chill and sense of dread. Nightmares began to haunt me, awakening my genetic memories as a post-war German. I remembered stories I was told as a child by my relatives. In 1934 my grandfather lost his job as a history teacher after speaking out against the Nazi takeover and he ended up in a labor camp. My mother, a 22-year-old medic, joined the American liberation-force in 1945 to liberate Auschwitz. As I grew up, I grappled with these tales of horror.
Because of my history, I worried that I was overreacting to possible danger. As a psychologist, meditation teacher, author and mother of three, as well as a Buddhist practitioner of 38 years, I like to bring balance to my own reactivity. And, at the same time, I am committed to raising awareness and promoting compassionate action. One of my favorite teachers is the Dalai Lama. Every year in October I travel to Dharamshala to attend his talks. He inspires me enormously with both his balance of mind and his teachings on compassion. “Without Love and Compassion,” he says,” humanity cannot survive.”
Now we witness children, who had been cruelly separated from their parents on entry to the country, being housed in detention camps. And we watch groups of safety-seeking refugees being criminalized and incarcerated. These are horrors to be taken very seriously. Paul Krugman 2 from the NY Times puts it, “…the real crisis is [not immigration but] hatred- unceasing hatred that bears no relationship to anything the victims have done.”
The current administration suggests that circling our wagons and excluding others who are seen as a threat to our wealth and wellbeing makes us happier. As Trump said famously in his inaugural speech, “From this day forward, it’s going to be only America first. America first.” I find it repeatedly disturbing to hear Trump promote Americans over all others and isolation of our country from the rest of the world as ways to make ourselves be better-off. The evidence speaks otherwise: what we are seeing is a growing culture of hate, anxiety and meaninglessness, with a 30% rise in suicide rate, especially among the young. Just last week a 15-year-old high-schooler with a Spanish name was found dead on one of the beaches in my home-town, Santa Barbara, his school back-pack full of stones.
During this time of unease and confusion following Trump’s election, I have been waking up at 5 am with a sense of foreboding in my body and a pounding heart. I have noticed how my sense of alarm has been deepening as the days have gone by. One morning during meditation, I sensed my grandfather standing behind me. I knew that I had a choice: either I could allow myself to sink deeper into despondency, or I could try to do something. Along with my husband Michael, a palliative physician and like me a student of Joanna Macy’s engaged Buddhism, I organized an evening that offered a safe space for our townspeople to voice their fear, 3 frustration and grief. Each month on the first Tuesday we began to provide a protected, open-minded forum, where neighbors could reflect together on how to be compassionate and engaged in a time of uncertainty. We start each gathering with a compassion meditation, thus forging an inner refuge allowing us to keep our hearts open. Through the months we have set up panels with Jewish, Buddhist, Muslim, Hindu, Christian, and Native American leaders as well as psychologists, historians, musicians and poets, who inspire our neighbors with ways to go forward—to be courageously engaged.
As we have tried to find ways to be of help, we have felt helped. Our Solidarity and Compassion evenings have continued for the past eighteen months and I have noticed that, even though I continue to feel horrified and outraged by what is unfolding on a national level, I now feel a sense empowerment and belonging. My early morning anxiety has vanished.
My friend Ralph Manuel, a Chicano studies professor, told me on a long walk that he was beginning to feel increasingly numb and helpless. I encouraged him to become active by organizing support for those who are vulnerable. 500 people came to the vigil he organized last week, and he has confided in me that he has felt much less anxiety since he organized help for his students that are Dreamers.
Arno, an immigration lawyer, whose law firm defends those in danger of having to leave the country, used skills he had learned in a mindfulness training to teach meditation and self-care to his burnt-out colleagues.
Currently he is organizing a meditation group for his frightened immigrant clients, allowing them to find an inner sense of refuge as well as a way to respond rather than react to their many challenges. He reported that some of his own sense of overwhelm and foreboding has subsided and that he now feels even more passionate than before about his work.
I am reminded of the word Bodhicitta, which I learned on a trip to India in 2011 when I was visiting the Dalai Lama in Dharamshala. Bodhicitta is the wish for all beings to be well, to be happy, and to be free. Even our wish for own awakening is dedicated to the well-being of all. The Dalai Lama said, “Bodhicitta is the medicine which receives and gives life to every sentient being who even hears of it. When you fulfill the needs of others, your own needs are fulfilled as a byproduct.” When we act on our wish to share our riches such as knowledge, insight, happiness or wealth with others who are less fortunate, we are acting with the motivation of Bodhicitta. As we act with the intention to help others to be more at ease, healthy, or safe, we notice that we ourselves become happier and more confident in ourselves. At the same time, we notice a growing desire to continue working for the wellbeing of others. Our longing for connection, and to see others well and happy becomes intertwined with our own happiness, a sense of meaning, and purpose. I call this the “Bodhicitta Effect.”
Emphasizing the Buddhist principle of dependent co-arising, the Dalai Lama emphasizes that one’s own happiness is contingent on the happiness of others. In his powerful book, Ethics for a New Millennium, he says that 5 happiness comes from a deep and genuine concern for others. The Dalai Lama calls giving to others, “wise-selfish,” because in the end when we give we gain as well. I read that Mahatma Gandhi said, “The best way to find yourself is to lose yourself in the service to others.” Could we transform the idea of “self-help” from “me-help” into “we-help”?
Often, we are taught that in order to be happy, we need to give priority to taking care of ourselves and, perhaps, a very few near and dear ones. Even some Buddhist groups hold the belief that it is important to limit their efforts to personal practice. Such views can discourage practitioners from becoming engaged on behalf of those in need in the wider world. But in fact, as His Holiness continues to remind us, when we care for others, we will feel happier, less afraid, less alone, and more empowered.
Kelly, a woman, who has come for years to my meditation group, told me how she had begun to feel increasingly numb, disempowered and helpless when witnessing our national, international as well as environmental crises. She switched her TV off, blanked the news out and turned to knitting as her new hobby. Her women’s knitting group tried to stick to topics like grand- children, patterns for baby shoes and personal affairs. But Kelly has found that this only worked to some degree. Dreams of children behind fences and of angry mobs running down the streets of her town woke her up at night. An old friend recently told her about an initiative to become a “Big Sister” to a disadvantaged child. Somewhat reluctantly Kelly agreed to meet a 14-year old Latino girl, Claudia, whose parents had been deported and 6 who was now living with an aunt. Wednesday afternoons Kelly began to meet with Claudia. She had a wonderful idea: she would teach Claudia how to knit. As they sat together, Claudia told Kelly stories about her parents, and how she did not know when or if she will be able to see them again. This knitting tutorial became deeply important to both Claudia and Kelly. Kelly has come to realize that in addition to helping Claudia, she wants to find ways to help others like her. Kelly also noticed something else; she herself had changed. First, Kelly was not sure what this change was. Then she realized that the leaden depression she had been experiencing for the past year had softened into what she described as an open heart.
A central teaching of the Buddha is that the true nature of life is interdependence. Could it be that if we choose an activity with the intention of freeing another from suffering, that we are aligning ourselves with “the way things are”? We are aligning ourselves with the mutual co- arising of all things, and this brings us joy. Happiness emerges spontaneously and organically when we practice interdependence. The Bodhicitta Effect means that our happiness, confidence and sense of meaning are interwoven with our willingness and ability to share our knowledge, wisdom, and kindness with others. This effect is activated in every act of kindness that aims to relieve another’s suffering.
During the same trip to Dharamshala when I was introduced to the teachings on Bodhicitta, I met one of the Dalai Lama’s translators, Mr. Tsepag. He taught me the word “popba”, which in the Tibetan language can 7 be understood as courage, strength, gutsiness. Popba is a quality that comes straight from our hearts when we have the wish to assist another, especially when they are in distress. The positive action we extend in response to another’s sorrow comes back to us as self-esteem. We feel stronger as we act on the grounds of popba. There is one caveat. It is essential that the motivation for popba is genuine, that it does not come from guilt, from obligation or pressure from authorities, or from the desire to enhance one’s own ego-importance. Popba must come from an authentic feeling and a spontaneous wish to be of help to others. The best thing about popba is that popba leads to popba, which leads to more popba, snow-balling itself along. As our emphasis shifts towards giving, and we go beyond merely satisfying our own needs, we will experience popba again and again. Through an increased sense of self-worth, we can meet the world feeling more resilient, capable and free, and an expanding ability to serve others in need.
Rebecca, a social worker and mother of three, wakes up at 4 am, turns over and over in her bed, unable to fall back to sleep. Images of scared children peeking through the wire-fences of a detention camp arise in her mind. California’s Adelanto Detention Center is less than 100 miles away from Rebecca’s home where she and her family are living in a modest but comfortable house. Knowing the discrepancy between the safety and comfort of her home and the dangers of the detention camp, she is outraged, and at the same time, hopeless. Even though she feels strongly about the injustice of this situation, she experiences powerlessness to effect any change.
Steven, a young oncology resident feels outraged and hopeless about his 27-year-old patient Shawna, whose treatment of Stage IV Melanoma has been delayed because of health insurance complications. Steven wrote a letter on Shawna’s behalf, yet to no avail. The bureaucratic red tape is making it increasingly unlikely that Steven will be able to save Shawna’s young life.
Don, an environmental science teacher at a Midwestern high-school feels gloomy and disheartened when he learns that coal mines have been re-opened in his town. Requests to re- train the miners for alternate careers have been voted down by the city government. Don knows how badly his students’ fathers do need these jobs, yet he is at the same time all too 2 aware of the detrimental influence of fossil fuels on climate change. He feels paralyzed, unable to act.
Recently, I was asked to write about burn-out, secondary traumatization and Moral Distress disorder in a book on self-care for nurses and other health-care providers. When I read the invitation, the word Moral Distress jumped out at me, landing right on my heart. This syndrome is described in the nursing literature: “Moral Distress occurs when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action.”
I immediately recognized that this phenomenon, so clearly described in the medical literature, is naming an experience that is endemic to our culture. Liz Stokes, a professor of nursing from the University Kentucky writes:” …this conundrum, dubbed ‘Moral Distress,’ can make nurses feel powerless, anxious, and even depressed.”
Clearly, it is not only nurses who feel morally troubled when they can’t give the care they know is right because of institutional constraints. Like Rebecca, Steven and Don, many millions of us feel disheartened when the vulnerable among us and at our borders are treated without compassion and respect, and big institutions or the current government seem to make it impossible for us to take right action.
The term Moral Distress names an often-unrecognized source of demoralization and paralysis in our society. Our feeling of powerlessness leaves us riddled with self-doubt, and without a sense of agency. Symptoms of Moral Distress, as described in the medical literature, include anxiety and depression as well as gastrointestinal problems, insomnia, headaches and 3 nightmares. As I reflect on Moral Distress, I remember accounts from friends about how they feel nauseous when listening to the news, how they wake up at night worried that our democracy is crumbling, leaving countless people un-safe and un-cared for. As a psychologist, I work with my clients’ nightmares about trying to escape from detention camps, from autocratic armies or environmental catastrophes. A psychiatrist friend told me, “Most of my clients can deal with life, but the unpredictability and lack of safety in the social situation feels like a bad flu that does not go away.”
Stokes’ recommendations for nurses grappling with Moral Distress can be beneficial for the broader community. “Once nurses identify Moral Distress,” Stokes writes,” they’re better equipped to overcome it.” Many of us are not aware of the degree of our upset and moral angst over what is happening to the vulnerable in our country. While nightmares and physical symptoms sometimes express how we feel inside, we push our upset away, distract ourselves and deny our feelings. I have come to see that simply acknowledging how we really feel, as Stokes suggests, allows us to find ground under our feet again. Rebecca felt less atypical and eccentric in her feelings about the children in detention camps, when she knew what she was experiencing: Moral Distress.
Stokes writes: “Coping with moral distress includes cultivating both moral courage and resilience.” The cultivation of moral courage that is recommended to nurses involves developing the strength to speak up despite the fear of repercussions. Moral resilience is the internal capacity that nurses have to learn in order to restore and sustain their personal integrity in response to Moral Distress.
Imagine, if a majority of us would stand up and voice exactly what we feel, without fear of being criticized, excluded, or of being impolite or uncool. What if we truly allowed ourselves to feel what we feel? Imagine, if Rebecca allowed herself to feel true pain and outrage when she got to know about the fate of the children in the detention camp nearby as well as about her own powerlessness and inability to help. Imagine, if she could have calmly driven to the Adelante Detention Center and would have found the courage to speak out on the behalf of those incarcerated children. Who knows? Possibly some officers might have responded with understanding and allowed her and others to come in to support those children in finding appropriate care and in reconnecting with their parents. If all of us were able to act in accordance with our inner integrity in response to what feels wrong, I believe our world would be a very different place.
Stokes tells us further: “When nurses experience Moral Distress, it’s important that they feel supported. They have to be able to address the issue in a safe and nonjudgmental space.” As I see it, we need safe public spaces where we can reflect, think and feel together, spaces that allow us to feel a sense of belonging instead of isolation, of respect instead of ridicule. I am reminded of my grandparents and parents in Hitler’s Germany, where it was unsafe to share one’s feelings with each other, and where people were hiding timidly and scared in their homes. We are not in Hitler’s Germany, but so many of us do not feel comfortable and free enough to voice our sentiments openly. Imagine if people in health- care settings and in our various communities were encouraged to speak out on behalf of those vulnerable. Imagine an environment where such acts of bravery would be rewarded 5 and respected?
Stokes proposes what she calls “Four A’s” to those in healthcare settings. Like nurses, we all can be helped by these four A’s. The first A is Ask: We ask ourselves, “Am I feeling distressed or am I showing signs of suffering?” This is an important issue, as at times we feel sadness and grief about the information and images of pain that come towards us, such as a stranded orca or a child hit by a car. Our suffering becomes distress when we feel powerless about sorrow and anguish that we would love to have prevented. Don, the environmental science teacher from the Mid-west, was asked by his primary care doctor at his last yearly visit, if “he was OK.” The doctor worried about Don’s haggard look. Don confided in him his great worries about climate change, about the future of his own children and his students. He revealed that he was suffering from bad dreams and that he found it hard to eat. “I don’t know what I can do,” he told his doctor, I feel completely powerless.” So, a first step is recognizing one’s own distress.
The second A is to Affirm our experience: You may say to yourself, “Yes, I’m feeling this distress and I’m going to make a commitment to address it.” Imagine Hitler’s Germany. What would have happened if the majority of the adult population would have made a commitment to act on their outrage about injustice and violence happening in their midst. Or if in our time, thousands would demonstrate in front of detention centers, refusing to leave until the last child was released to her family.
The third A is Assess: “Assess your ability to make a change. Ask yourself, ‘What can I do personally? How can I contribute to my organization to try to mitigate moral distress?’ Do a 6 deep dive to understand the root causes of the distress.” I find the last sentence of this recommendation especially important. Yes, let’s find the root-causes of our unease. Let’s understand deeply the range of social and spiritual causes that contribute to our moral distress. The rules and regulations and social forces that allow greedy individuals to harm others? The I, me, mine culture that shapes us to think of ourselves first and foremost before considering the welfare of others? Our own inability to ponder our meaning and purpose in life, and our lack of connection to a wider perspective?
The last A encourages us to Act. Stokes urges nurses to take personal responsibility and try to implement the changes that they desire. When more people act, then acting becomes the normal thing to do. Then our culture becomes one that is alive, caring and creative. Then we feel good to live in our own skin. Imagine if oncology resident Steven had continued to write letters on behalf of Shawna to the higher echelons of power in the healthcare system. It is possible this could have been effective, helping her receive immediate treatment, and may have allowed her to continue her life being healthy and productive. Regardless of her treatment outcome, Steven would have felt confident within himself, and he would have continued his career with a sense of agency and hope. This might have encouraged him to stand up for of his patients in the future and may have led to him becoming an important agent of justice, compassion and change.
Building on Stokes’ four A’s, I suggest we meet our moral distress with the power of Bodhicitta, a term from Buddhist teachings. Bodhicitta is the wish for all beings to be well, to be happy, and to be free. The Dalai Lama has said, “Bodhicitta is the medicine which receives and gives life to every sentient being who even hears of it. When you fulfill the needs of others, 7 your own needs are fulfilled as a byproduct.” When we act on our wish to share our riches such as knowledge, insight, happiness or wealth with others who are less fortunate, we are acting with the motivation of Bodhicitta. Bodhicitta allows us to have an attitude that is bigger than our self-doubt, more powerful than our hate or our wish for revenge and deeper than our despondency and depression.
Bodhicitta is a term that has become highly relevant to me in my frequent travels to attend teachings of the Dalai Lama in Dharamshala, a community of Tibetan refuges in Northern India. How do the Dalai Lama and these exiled people manage to live with such equanimity and kindness in the wake of immense trauma and Moral Distress, having experienced and witnessed capture and torture by Chinese officials while being powerless to help and intervene on behalf of friends and relatives?
Day after day, the Dalai Lama listens with a caring ear to the horrific stories of countless refugees confiding in him. I am guessing that it is Bodhicitta that allows him to maintain an attitude of engagement, open-heartedness and presence with each person who approaches him. The Dalai Lama has explained, “I trust in the sincerity of my heart’s intention.”
One vehicle for cultivating an attitude of Bodhicitta as well as for healing Moral Distress is the practice of mindfulness and compassion. Mindful Awareness, can be understood as “Being aware with acceptance and caring intent, on purpose, with compassionate judgement, in the present moment” (Integral Mindfulness, Witt, Keith, Integral Publishers, 2014). When we practice mindfulness, our minds calm and our hearts open, allowing us to 8 recognize the quiet voice of Bodhicitta within us. Compassion is the movement of our hearts and the caring that arises when we witness the suffering of others. Compassion practice allows us to grow our ability to respond to others with a sense of caring and gentleness, spontaneity and relevance. Mindfulness and Compassion together allow us to be present with our own or another’s Moral Distress in a tender and loving way.
After the 2016 election, my husband Michael and I started a monthly town-hall meeting at a local church where we present and promote reflection and discussion about common areas of suffering and concern in our Santa Barbara community. After a beginning mindfulness and compassion meditation, a panel of speakers reflects together with the audience. Themes of such evenings have been: “Compassion as Refuge and as Response,” “Connecting to Love in a Time of Fear,” “How Bodhicitta can help us be Engaged in Uncertain Times,” and “Responding to Moral Distress.” These evenings have helped Michael and I feel a greater sense of agency and meaning. Our fear, even though still present, is more manageable now.
Recently, Patricia, a local therapist, spearheaded teaching mindfulness and compassion in a local High School. After a traumatic winter when two students committed suicide, discouragement and general anxiety were running rampant. Patricia grieved deeply over the loss of the two boys. The Moral Distress she experienced by being a helpless bystander in the face of those boys’ and so many of their school mates’ misery gave way to her being more able to feel her own deep distress. From that experience grew moral resilience and courage which in turn made it possible for her to organize a Mindfulness and Compassion 9 school program. This new project allowed her to experience herself as having a greater sense of agency and to act as a force for health in our community.
Lynne, a local accountant, felt helpless and exhausted when witnessing our community devastated by fires and mudslides. In the company of a few close friends, she allowed herself to feel her sorrow. Then she began to experience the energy and courage to lift herself out of her paralysis. She made a commitment to act, and with a small group of peers she started a non-profit through which courses on health, wellness and resilience are now affordable to everyone who needs them.
How is Bodhicitta a response to Moral Distress?
As we hold an intention that is greater than our own comfort and concerns, we learn to surrender even our sense of outrage to a greater vision, the welfare of all. This does not mean that we become inactive and compliant; instead it might mean that we speak out from the basis of a wider foundation than our own. We speak out as ourselves and as emissaries of all humankind and of universal goodness. Bodhicitta springs from the insight that we are all interdependent and interconnected. If we deeply understand what Zen Master Thich Nhat Hanh calls our interbeing, then compassion and acting on behalf of each other is the natural next step.
As we act with the intention to help others to be more at ease, healthy, or safe, we notice that we ourselves become happier. Then we feel a greater sense of belonging, we feel more confident in ourselves and our symptoms of Moral Distress recede. Our longing for 10 connection, and our desire to see others well and happy become intertwined with our own happiness, meaning and purpose. We may continue to know that we cannot easily change the system. However, we can feel part of something life-giving, and we can act with kindness, hoping that this will relieve some suffering, bring comfort, and inspire others to discover their courage to act.
In these unpredictable and perilous times many of us look aghast at the Trumpian world and right-wing movements across the globe and experience feelings of heightened anxiety, fear and even dread. As we continue to feel bombarded by news of chaos, aggression and danger, it is difficult to maintain an attitude of presence and caring. It seems all too easy to either despair, tune out, or become numb to feelings of concern for others and our world.
A 2018 study reports that teen-age suicide has risen over 30% over last few years.We have an existential crisis in our country, in which meaning and purpose are put into question.What values do we offer the young people amongst us, which make it meaningful and enticing to be part of our culture and communities?The philosopher Frederic Nietzsche told us:“He who has a why to live can bear almost any how.” Questions about meaning voiced by my young clients include: “What is the purpose and significance of my life?”“What is meaningful and valuable nowadays?”“What am I here for?” Sarah, who is 21, told me: “It seems that I am pushed to achieve more and more, just so I can buy stuff in the end.” Jose, a Dreamer, who came to the States at age four with his mother, told me: “It seems nobody wants me or my relatives here, there is no place or purpose for me.”
Sarah and Jose are experiencing a crisis of meaning. Jose feels left out and unsupported, and Sarah sees her efforts and contributions as not making sense. Another client,Tony, agonizes about the ever-increasing threat of climate change: “Why should I go to college and work, when big parts of our world may be uninhabitable in a decade or two? This is no place to have a future.” (Tony had been referred to me by his school counselor because of excess marijuana and alcohol use.) Maya, who is 24, says: “I do not want to live in a world where people don’t care for each other, where everybody is out for their own advantage.”
Meaning in life is established when we have a valuable, purposeful place in a world in which we belong and with which we are interconnected.Victor Frankl, the psychiatrist who survived the Nazi death camps, pointed out that having meaning in life allows us to fare better in times of great stress. Therefore, I ask how we can promote attitudes that help us to embrace current reality with sensitivity and aliveness, while maintaining the will to make our world a better place?
I have been looking for examples from our philosophical and spiritual past, searching for those who found a way to stay engaged in the face of adversity. Sisyphus, the Greek hero, who was condemned by the Gods to do an arduous task for eternity, came to mind almost immediately. Each day he struggled to roll a huge stone to the top of a mountain only to watch it roll back down on its own weight. Some see Sisyphus as the quintessential sufferer, condemned to repeating hopeless and meaningless toil.
Like the mythic Sisyphus, many of us harbor suspicions that the stones we push up the mountain are bound to roll to the bottom once again. Many of us worry that our acts of engagement may be in vain. Several of my socially or politically inclined friends worry that canvasing, participating in protests, and working in activist groups will be futile.They find that with each polarizing and mean- spirited executive order, with each new law favoring the rich and powerful, they are left feeling more powerless and defeated.
One of the most well-known writers to interpret the myth of Sisyphus is the existentialist Albert Camus. Camus wrote for post-WWII Europe when there was a different yet comparable existential crisis playing itself out. People in Europe were demoralized after the devastating war and many young people were appalled by the rising economic consumerism and re-militarization. Just a few decades after the war had ended, this flight into superficiality took over. There was hardly any cultural awareness of what had happened just a few years earlier and why and how new value in life could be found.
Today we see a rise of nationalism, an intolerance toward immigrants and refugees, and an indifference towards those in our society who are the most vulnerable. Polarization splits our society, pitting one group against the other. While consumption is offered as a substitute for meaning, the problems of our feuding society can feel like huge boulder which we don’t know how to handle. Are we to be defeated by this huge boulder, which we have to roll up the mountain over and over again, or is there another way to respond to this conundrum?
Camus proposes an alternate and inspiring view of Sisyphus and his task. In The Myth of Sisyphus he sees the absurd hero as the one who defies the gods because they have abused their power. Sisyphus’ punishment for speaking out against injustice is to muscle the stone up the steep mountain over and over again, forever. In Camus’ interpretation, Sisyphus is well aware of his situation, including what led up to it as well as what his future will be. According to Camus, Sisyphus pushes his stone forward with an attitude of knowing, dignity and even joy, choosing to be present to his task. Knowing that he has no choice other than to shove the stone up the tall and steep mountain again and again, he makes the mental choice remaining to him to replace sorrow with joy.
I see Sisyphus as deeply present with what is.What he chooses to do is not arbitrary or accidental, but a life affirming response to suffering.
In a holographic reality, the whole is detected within the part, as the part lives within the whole.
Sisyphus realizes that in tending to the immediate situation (perhaps his hurting back or his aching thighs), he is in fact tending to the part that helps to make up the whole. Camus writes: “…each atom of that stone, each mineral flake of that night-filled mountain, in itself forms a world.” Thus, he argues that separateness is an illusion, and that all is interconnected. This truth can be sensed in mystical experiencing. In engaging with his challenge with an expended awareness, Sisyphus moves toward an attitude of kindness and increased presence, engaging in his task (a version of which is shared by all of us) in a new way.
In the face of the tension and confusion that I detect within myself, my clients, my students, and society as a whole, I feel myself drawn to reflect on the stone and Sisyphus’ relationship to it. I keep coming back to what I hear from many people, that taking care of their own life is the best they can do. But we can and must go beyond that. We can do both, engage with the troubles of this world, and take responsibility for our individual worlds. The awareness that all is radically interconnected, that everything “inter-is,” makes a difference to how we engage. We might envision this as a feedback loop, in which an act of kindness gives us meaning, and where meaning in turn gives us the strength to engage.
I think of the many people I know, who, in the face of seemingly insurmountable obstacles, give their all to work in some small way to help the world. My friend Manny Jesus, a retired professor of psychology, ceaselessly tries to promote the wellbeing and protection of Mexican American youths as he engages in battles with city authorities. Pete, a mathematician, has developed an instrument for the early detection of habitats threatened by drought, particularly those upon which poorer populations are dependent.And there is Nancy – in anguish about the fate of future generations, she and seven other mothers get together while their children are in school to write letters to congressmen about healthcare, education and the environment.These actions provide meaning and perseverance.
When I think of the enormous problems that we are facing, I believe we have to consider and respect our “human condition.”When I reflect on us as human beings, I think about the first homo sapiens living in the Savannahs deep inside Africa. I imagine small groups of people attempting to survive a hostile environment full of disease and death. If one in the small crowd was vulnerable or cast out for some reason, this person would surely be rapidly devoured by predators.This is ultimately why primal anxiety leaves us humans with a terrifying fear of being excluded, criticized, or otherwise cast out. No wonder we want to attach to family, group, country, or ideology.Yet, attachment easily brings suffering, especially if, as the Buddha teaches, wholesome connectedness contorts into grasping, clinging, or rejecting.There is an inherent underlying suffering at the core of human nature, which is released to the surface when we do not feel safe, loved, and/or protected.
Such reflection may help us to understand why so many who resort to nationalism or “America first” reject those who are different. Unknowingly, they may be experiencing a great fear of sudden change. They may be left feeling un-rooted, while rapid globalization is likely to have caused many to fear a loss of place, value, and tradition. Speedy cultural changes in our society can erode a sense of tradition and of predictability. Unconscious fear leads to the development of “Terror Management Processes.”
Social psychologists Solomon, Greenberg, and Pysczynski propose that we, in order to buffer ourselves from the unbearable awareness of our finite nature (an awareness heightened by the visible dangers to life posed by climate change) instinctively build individual fortresses of wealth, power, and identity. Feeling ourselves as part of this “symbolic immortality” gives us a sense of protection from this fear.When something comes along that undermines this feeling of security and threatens us with an unconscious fear of annihilation, we try to find external solutions, such as circling our wagons or attacking a minority group. Looking down on the “other” gives many the unconscious hope that this will make them more secure, worthy, and important. However, events set in motion by this anxiety may make things worse by escalating the spiral of disconnection and fear.
That is why we need awareness and compassion for ourselves and others to heal this basic human dilemma. Awareness of it allows us to understand and to empathize with what it means to be human.
How would it be if we saw Sisyphus’s stone in a fresh way? Not as the burden of one Sisyphus pushing his or her personal stone up the hill, but as the common burden belonging to all of humankind, the rough and heavy boulder of our common humanity?
How would it be if we could, with eyes wide open, embrace this human condition, deciding to carry this stone for the sake of all of us? As we begin to regard the boulder as our stone, as a common burden that we all face, we could join with a spirit of solidarity and compassion. We could see ourselves as making the choice to push this load up the steep hill so that one day, even for a moment, it might stand in the sun. Seeing each small act as one of solidarity and compassion, we could add meaning to our lives.
I recommend three “medicines” that can help us in this current dilemma. The first medicine is the understanding of our interconnectedness with all life-forms. This insight stands opposite to the I, me, mine culture, in which our individual well-being, wealth, and success counts most.The notion of interconnectedness is embodied by the Bodhisattva, an enlightened being, who chooses to forgo entry into Nirvana, so she can stay with all others, until the last suffering being is healed. The Bodhisattva understands that everything in life is interconnected and constantly interactive. And with that insight she knows that she is not isolated but held in a web of mutual belonging.
The second medicine is to find the foundation for our security inside of ourselves, instead of frantically seeking to find safety in the three AAAs, (affluence, achievement, and appearance.) Yes, we need a sense of healthy belonging to our family and friends, but when we have an internal refuge and sense of connectedness, we feel secure and supported.Then we can give and be generous to others. Research suggests that meditation, which fosters compassionate awareness, allows us to be less afraid and defensive, and therefore much less likely to dismiss or cast out members of groups that we have no affiliation with.
When I think of someone embodying this ideal, I think of His Holiness the Dalai Lama, whom the Tibetans regard as a Bodhisattwa of Compassion. Every morning at 3:00 am he gets up to meditate, affirming his inner refuge and the experience of his interconnectedness with all of life within what he calls the “greater field of benevolence.” When asked how he handles the tumultuous and dangerous situation between Tibetans and the Chinese, he says: “Foremost, I trust in the sincerity of my heart’s intention.” Spiritual practice gives the Dalai Lama a place to live from. That inner wealth and security allows him to live from a place of Bodhicitta, meaning that he can live with an attitude of generosity and care for the wellbeing of all.The Bodhicitta-effect can empower all of us, just as giving to others makes us happy. And the Bodhisattva does what he does out of love and without regard for immediate outcome. I have come to see Sisyphus as a Bodhisattva.The insight that we are all connected, that we are all relatives, gives rise to his deep loving care.
The third medicine is the choice of being light-hearted and trusting. Camus’ Sisyphus is joyful. He is filled with gladness as he takes his fate into his own hands and decides to participate out of his own choice. Camus says: “The absurd man says yes, and his effort will henceforth be unceasing.” What happens when Sisyphus walks down the hill, aware of his feet sensing the earth, before he chooses to pick up the stone once again? As my Sisyphus meanders down again, following gravity, he is in the flow. This moment gives him respite and a relaxed being with what is, now with lightness and joy. Irish poet John Moriarty tells us: ”The best way to experience grace is to surrender to gravity.”
I propose that each-of-us-as-Sisyphus choose to bring grace and gladness back into our world, despite the burden of our human condition. As we give to others with love, we begin to transcend loneliness, separation, and fear. Contemplating Sisyphus helps me to experience my various projects in the world as propelled forward by my own choice and by a growing tenderness for others.
In these unpredictable and possibly perilous times, many of us experience feelings of heightened anxiety, fear, and even dread.
When I contemplate the committed people I know working for the well-being of the planet, for healthcare, the environment, and immigrant rights, I think of Sisyphus. The Greek hero was condemned by the Gods to do a task for eternity. Each day he struggled to roll a huge stone to the top of a mountain only to watch it roll back down on its own weight. Some see Sisyphus as the quintessential sufferer, condemned to repeating hopeless and meaningless toil.
Like the mythic Sisyphus, many of us harbor suspicions that the stones we push up the mountain are just about to roll to the bottom once again. Many of us worry that our acts of engagement may be futile.