Experiencing “Heart”

Notice the idioms we use  related to the heart. Soft-hearted. Open hearted. Closed-hearted. Tender hearted. Heartache. Heart felt. Stone hearted. Warm hearted. Cold hearted. Light hearted. Heavy hearted. Broken hearted. Change of heart. Heart to heart. From the heart. From the bottom of my heart…and many others.

These terms approximate what the body experiences – the “felt experience.” As an example, sadness causes a sense of heaviness in my shoulders and chest and a full sensation in my eyes. Consistent with my felt experience, we use the term “heavy-hearted” for sadness. I feel anger as warmth in my face, tight fists (even when they are open) and a closed off feeling in my chest. Matching my feeling of warmth in the face we employ the idiom of “hot headed” to describe anger and getting something “off my chest” as letting go of anger.

In contrast, I experience love as warm expansiveness in the chest. I sense compassion as similar to love but with a dimension of spreading outward and forward beyond my chest. Love, compassion and gratitude entail a sense of tender softening in the pectoral muscles while anger and dislike trigger a tight, closed sensation in the chest. In other words, the idioms of “warm hearted,” “open hearted” and “close hearted” match my felt experiences.

How does “felt experience” relate to the work of healthcare?

Most of us spent years training for our work. We acquired expertise in various areas including reading comprehension, medical terminology, math, science, analysis, process improvement, and specific motor skills. This “head” training is vital for providing healthcare workers with the ability to reduce suffering. Yet, despite the fact that our work entails supporting individuals who are suffering, most of our training failed to include practices to improve our skills of “heart.”

Tuning into “felt experience” represents a foundational “heart” skill for our work. We necessarily focus our thinking to be successful in our daily work. What is my next task? What is the cause of this patient’s symptoms? What do I need to say in the next meeting? What is the point of this email? As we stay in our “head” it is easy to get lost in thought and ignore felt experiences of compassion, love, gratitude, anger or sadness. However, when we ignore our felt experience we not only lose the satisfaction of feeling compassion and gratitude we also become less effective in applying our “head” skills. We may end up reacting out of anger or irritability when we fail to recognize these felt experiences or we may short change a healing relationship when we remain closed to our feelings of empathy and compassion.

For me, the first step to improve my “heart skills” is to recognize the felt sensation of “open” compared to “closed.” I sense openness as a spacious, tender softening in my chest. When I feel open, I let in experiences of the present and I stand in patient readiness to receive the gifts of the moment. In contrast, “closed” feels like a nagging tightening in my chest muscles accompanied by either a subtle leaning forward if I am anticipating what is next or a slight leaning back if I want to protect myself. As an example, if my wife and I are going out to dinner without reservations at a popular restaurant, I feel tightness and a slight leaning forward to get to the restaurant before a line forms. This causes me to suffer a bit and of course annoys my wife. Interestingly, the idioms of soft heart, closed heart, open heart, tender heart and hard heart capture these felt experiences.

Recognizing whether my felt experience is open or closed enables additional “heart practices.” If I sense a closed sensation, I pause, take a few slow deep breaths from the lower abdomen, feel my feet on the ground and gently and tenderly soften my chest muscles. If I already feel open I invite the felt experiences of gratitude, compassion and spaciousness.

Please use “comments” to respond to some of the following questions: What is your felt experience of gratitude, compassion or love? How do you experience openness compared to feeling closed? What practices do you use to improve your “heart” skills? How do you open your heart to suffering?

Time

I retired a year ago after attending 19 years of school and working for 38. I feel grateful for these years and have no regrets. However, sometimes I reflect on what I would have done differently had I known then what I know now.

These 57 years involved a specific structure related to time. Every weekday I arose to the sound of an alarm clock and went to school or work where I focused on accomplishing tasks. During the weekends and vacations that punctuated this weekday routine, I pressured myself to relax while simultaneously squeezing in the other parts of my life – exercise, “me time,” family, friends, etc. On weekends and vacations I fretted about school or work, and on weekdays I imagined weekends and vacations.

While engaged in one task, I churned about other items on my “to do” list and hurried the present activity in order to move on to the next. As an example, while seeing a morning patient, I might think about an upcoming patient scheduled for that afternoon, and while seeing the afternoon patient, I would ruminate about the morning patient. Consequently, while seeing one patient I would often be thinking about another.

I became fueled by the illusion that by moving fast enough I could outrun the clock and aging. As a result, I felt I was constantly swimming upstream in time. Occasionally, I glimpsed the possibility of a different relationship with time. In 2012, as my wife recovered from cancer surgery I blogged the following passage:

My wife’s recent stay in the hospital brought back the sense of  “patient time.” Watching her rhythmic breathing as she slept in a cloud of medications, I felt a rare burning clarity about what was important at that moment – to be at her bedside together with close friends and family. During her two days in the hospital, my endless task list disappeared into the background of the non-urgent. I felt still as time gently ebbed and flowed around me. Conversations, punctuated by comfortable quiet, seemed unrushed and important. I was present.

Work and school revolve around scheduled activities and tasks to be accomplished on time. But after my transient ischemic attack (TIA, or “mini-stroke”) in 2013, I learned I had a choice about my relationship with time as I performed these necessary activities. I found I could “float in stillness” in the midst of urgency.

If I knew during my many years of school and work what I know now after the TIA and retirement, I would have more intentionally cultivated curiosity about my relationship with time. As I planned and accomplished tasks, I would have practiced floating in time rather than struggling to swim upstream. I would have invited stillness and spaciousness into my days filled with movement and urgency, and opened my heart to gratitude.

We need urgency to fulfill the “head” aspects of improving health and well-being. Stillness is required for the “heart” of our work when we when apply our compassion and empathy to patients, members and colleagues.

What is your relationship with time?  How do you combine urgency with stillness?