Jon Kabat-Zinn, Ph.D.
Over the course of fourteen years, more than six thousand people have attended the stress reduction program at the University of Massachusetts Medical Center. In doing so, they have embarked on a lifelong journey in an effort to regain control of their health and to attain at least some peace of mind. They come referred by their doctors for a wide range of medical problems ranging from headaches, high blood pressure, and back pain to heart disease, cancer, and AIDS. They are young and old and in-between. What they learn in the stress reduction clinic is the how of taking care of themselves, not as a replacement for their medical treatment but as a vitally important complement to it.
The stress clinic is not a rescue service in which people are passive recipients of support and therapeutic advice. Rather it is a vehicle for active learning, in which people can build on the strengths that they already have and come to do something for themselves to improve their own health and well-being.
In this learning process we assume from the start that as long as you are breathing, there is more right with you than there is wrong, no matter how ill or how hopeless you may feel. It will take conscious effort on your part to move in a direction of healing and inner peace, learning to work with the very stress and pain that is causing you to suffer.
The stress in our lives is now so great and so insidious that more and more people are making the deliberate decision to understand it better and to bring it under personal control. They realize the futility of waiting for someone else to make things better for them. Such a personal commitment is all the more important if you are suffering from a chronic illness or disability that imposes additional stress in your life on top of the usual pressures of living.
The problem of stress does not admit to simple minded solutions or quick fixes. At root, stress is a natural part of living from which there is no more escape than from the human condition itself. Yet some people try to avoid stress by walling themselves off from life experience; others attempt to anesthetize themselves one way or another to escape it. Of course, it is only sensible to avoid undergoing unnecessary pain and hardship. Certainly we all need to distance ourselves from our troubles now and again. But if escape and avoidance become our habitual ways of dealing with our problems, the problems just multiply. They don’t magically go away. What does go away, or get covered over when we tune out our problems or run away from them, is our power to grow and to change and to heal. When it comes right down to it, facing our problems is usually the only way to get past them.
“Facing our problems is usually the only way to get past them.”
There is an art to facing difficulties in ways that lead to effective solutions and to inner peace and harmony. When we are able to mobilize our inner resources to face our problems artfully, we find we are usually able to orient ourselves in such a way that we can use the pressure of the problem itself to propel us through it, just as a sailor can position a sail to make the best use of the pressure of the wind to propel the boat. You can’t sail straight into the wind, and if you only know how to sail with the wind at your back, you will only go where the wind blows you. But if you know how to use the wind energy and are patient, you can sometimes get where you want to go. You can still be in control.
If you hope to make use of the force of your own problems to propel you in this way, you will have to be tuned in, just as the sailor is tuned in to the feel of the boat, the water, the wind, and his or her course. You will have to learn how to handle yourself under all kinds of stressful conditions, not just when the weather is sunny and the wind blowing exactly the way you want it to.
We all accept that no one controls the weather. Good sailors learn to read it carefully and respect its power. They will avoid storms if possible, but when caught in one, they know when to take down the sails, batten down the hatches, drop anchor, and ride things out, controlling what is controllable and letting go of the rest. Training, practice, and a lot of firsthand experience in all sorts of weather are required to develop such skills so that they work for you when you need them. Developing skill in facing and effectively handling the various “weather conditions” in your life is what we mean by the art of conscious living.
The issue of control is central to coping with problems and with stress. There are many forces at work in the world that are totally beyond our control and others that we sometimes think are beyond our control but really aren’t. To a great extent, our ability to influence our circumstances depends on how we see things. Our beliefs about ourselves and about our own capabilities as well as how we see the world and the forces at play in it all affect what we will find possible. How we see things affects how much energy we have for doing things and our choices about where to channel what energy we do have.
For instance, at those times when you are feeling overwhelmed by the pressures in your life and you see your own efforts as ineffectual, in all likelihood you will wind up feeling depressed and helpless. Nothing will seem controllable or even worth trying to control. On the other hand, at those times when you are seeing the world as threatening but only potentially overwhelming, then feelings of insecurity rather than depression may predominate, causing you to worry incessantly about all the things you think threaten or might threaten your sense of control. These could be real or imagined; it hardly matters in terms of the stress you will feel and the effect it will have on your life.
Feeling threatened can easily lead to feelings of anger and hostility and from there to outright aggressive behavior, driven by deep instincts to protect your position and maintain your sense of things being under control. When things do feel “under control,” we might feel content for a moment. But when they go out of control again, or even seem to be getting out of control, our deepest insecurities can erupt. At such times we might even act in ways that are self-destructive and hurtful to others. And we will feel anything but content.
If you have a chronic illness like VHL, or a disability that prevents you from doing what you used to be able to do, whole areas of control may go up in smoke. And if your condition causes you physical pain that has not responded well to medical treatment, the distress you might be feeling can be compounded by emotional turmoil caused by knowing that your condition seems to be beyond even your doctor’s control.
“If you know how to use the wind energy and are patient, you can sometimes get where you want to go. You can still be in control.”
What is more, our worries about control are hardly limited to major life problems. Some of our biggest stresses actually come from our reactions to the smallest, most insignificant events when they threaten our sense of control in one way or another, from the car breaking down just when you have someplace important to go, to your children not listening to you for the tenth time in as many minutes, to the lines being “too long” at the supermarket checkout or at the bank.
It is not easy to find a word or phrase that really captures the broad range of experiences in life that cause us distress and pain and that promote in us an underlying sense of fear, insecurity, and loss of control. If we were to make a list, it would certainly include our own vulnerability and mortality. It might also include our collective capacity for cruelty and violence, as well as the colossal levels of ignorance and greed, delusion and deception, that seem to drive us and the world much of the time.
What could we possibly call the sum total of our vulnerabilities and inadequacies, our limitations and weaknesses as people, the illnesses and injuries and disabilities we may have to live with, the personal defeats and failures we have felt or fear in the future, the injustices and exploitations we suffer or fear, the losses of people we love and of our own bodies sooner or later? It would have to be a metaphor that would not be maudlin, something that would also convey the understanding that it is not a disaster to be alive just because we feel fear and we suffer; it would have to convey the understanding that there is joy as well as suffering, hope as well as despair, calm as well as agitation, love as well as hatred, health as well as illness.
In groping to describe the aspect of the human condition that the patients in the stress clinic and, in fact, most of us, at one time or another, need to come to terms with and in some way transcend, I keep coming back to one line from the movie of Nikos Kazantzakis’s novel Zorba the Greek. Zorba’s young companion turns to him at a certain point and inquires, “Zorba, have you ever been married?” to which Zorba replies (paraphrasing somewhat) “Am I not a man? Of course I’ve been married. Wife, house, kids, everything . . . the full catastrophe!”
“You are the world expert on your life, your body, and your mind, or at least you are in the best position to become that expert if you observe carefully.”
It was not meant to be a lament, nor does it mean that being married or having children is a catastrophe. Zorba’s response embodies a supreme appreciation for the richness of life and the inevitability of all its dilemmas, sorrows, tragedies, and ironies. His way is to “dance” in the gale of the full catastrophe, to celebrate life, to laugh with it and at himself, even in the face of personal failure and defeat. In doing so, he is never weighed down for long, never ultimately defeated either by the world or by his own considerable folly.
Anybody who knows the book can imagine that living with Zorba must in itself have been quite the “full catastrophe” for his wife and children. As is so often the case, the public hero that others admire can leave quite a trail of private hurt in his wake. Yet ever since I first heard it, I have felt that the phrase “the full catastrophe” captures something positive about the human spirit’s ability to come to grips with what is most difficult in life and to find within it room to grow in strength and wisdom. For me, facing the full catastrophe means finding and coming to terms with what is most human in ourselves. There is not one person on the planet who does not have his or her own version of the full catastrophe.
Catastrophe here does not mean disaster. Rather it means the poignant enormity of our life experience. It includes the crises and disaster but also all the little things that go wrong and that add up. The phrase reminds us that life is always in flux, that everything we think is permanent is actually only temporary and constantly changing. This includes our ideas, our opinions, our relationships, our jobs, our possessions, our creations, our bodies, everything.
In the Stress Reduction Clinic we learn and practice the art of embracing the full catastrophe. We do this so that rather than destroying us or robbing us of our power and our hope, the storms of life will strengthen us as they teach us about living, growing, and healing in a world of flux and change and sometimes great pain. This art involves learning to see ourselves and the world in new ways, learning to work in new ways with our bodies and our thoughts and feelings and perceptions, and learning to laugh at things a little more, including ourselves, as we practice finding and maintaining our balance as best we can.
As you embark on your own journey of self-development and discovery of your inner resources for healing and for working with the full catastrophe, what you learn will come primarily from inside you, from your own experience as your life unfolds from moment to moment rather than from some external authority or teacher or belief system. Our philosophy is that you are the world expert on your life, your body, and your mind, or at least you are in the best position to become that expert if you observe carefully. Part of the adventure is to use yourself as a laboratory to find out who you are and what you are capable of doing. As Yogi Berra once said, “You can observe a lot by just watching.”
At the time this was written, Dr. Jon Kabat-Zinn was Director of the Stress Reduction Clinic at the University of Massachusetts Medical Center, Worcester, Massachusetts. His work was recently featured in the PBS Television series Healing and the Mind with Bill Moyers. This article is an excerpt from Dr. Kabat-Zinn’s book, Full Catastrophe Living, a self-teaching guide based on his course at the Stress Reduction Clinic.
Visit Jon Kabat-Zinn’s website at UMASS.