You Want Me to Accept This #*$%? By Heather Clague, MD on 3/13/20 - 1:10 PM

“Acceptance is such an irritating word! What the hell? One is supposed to ‘be okay’ with all the crap that happens?”

I am sitting with my patient who pounds his fist with frustration on his thigh. He works long hours, has a terrible commute, is a single parent, and to top it off, his autoimmune disorder is flaring up and his joints ache. He’s in the middle of a ferocious divorce. In the evenings he is exhausted. The sink is piled high with dishes. Instead of cooking, he orders takeout, which he and his kids eat in front of the TV. He feels terrible. He consoles himself with Instagram and ice cream. Too much ice cream. He’s gaining weight. He wants my help in changing this habit.

“I should be able to get the dishes done. I should be able to cook a meal for my kids! And I shouldn’t be eating like this!” He drops his head. “I can tell myself that I need to change my habits, but it won’t happen. I won’t do it.” He puts his hands over his face. “It shouldn’t be this hard.”

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Acceptance means to be okay, even when things are really crappy. Not just to be okay, but to be okay with the crappiness. To lay aside that powerful word “should” and stop demanding ourselves, or the universe, to be different than we are. My patient and I both know in our heads that something positive lies in this direction, and we are both feeling rather mutinous about it. My resistance to acceptance has been that it implies approval, like getting accepted into college. It feels almost offensive to be asked to send a thick welcome envelope to some craptastic aspect of life.

But what if we ease into it? Might that not be a little easier? One dimension of acceptance is to see things clearly, accurately, as they are. We could make that a first step, and call it “acknowledgement.”

A dear mentor, George Haas, founder of Mettagroup in LA, turned me onto one of those wonderful Buddhist lists. This one breaks suffering into three categories:

Type 1: We grow old, get sick and die. The same is true for everyone we care about.
Type 2: We don’t get what we want, we have to put up with what we don’t want, and when we get what we want, it doesn’t last.
Type 3: The subtle, constant, ongoing irritation that nothing is exactly the way you want.

My patient is experiencing a solid dose of all three types of suffering. Oddly, when I share this with him, we both start to laugh.

“Right. I’ve got a chronic illness and I’m tired and in pain when I come home. I have a demanding job with a hard commute. I’m in the middle of a hellish divorce. And I always get to the end of the bowl of ice cream.”

He relaxes and starts to cry. After a bit, he wipes his tears.

“And I really, really like ice cream. I guess it’s kind of silly to say this shouldn’t be hard.”

Maybe we are ready for step 2: “appreciation.” Appreciation is defined as “full understanding, recognition of worth.” Nothing is perfectly good. Is it not also true that nothing is perfectly bad? Can he gain a more balanced awareness of his experience?

He starts to give it a try, and immediately wrinkles his nose. “Eww.”

I nod. “Mmm, yeah. Not quite there yet, huh?”

“No. My life looks pretty dingy compared to the glow of the better life I could be having.”

We just sit and breath together for a few moments. He leans forward.

“But I know that life is imaginary. And for all of its glory, that perfect life casts harsh and inescapable shadows. And compared to many people in the world, I have it pretty good.” He closes his eyes gently this time, reflecting on his life as it is.

“I’m tired, and this is hard. The reports at work that no one reads. The grim faces on BART [Bay Area Rapid Transit]. My aching elbow and the way my skin feels rashy.” He takes another breath. “I got a seat on BART today.” Another pause. “I listened to a podcast about megalodon sharks. My middle daughter will get a kick out of that. I really, really love my kids. If I didn’t feel tired, I’d probably be trying to get them to do something ‘educational’ instead of just hanging out with them. We are having fun watching Star Trek together.”

He looks up at me, and smiles.

“Maybe I’ll improve my habits. I hear dark chocolate is pretty tasty. And I could get a plastic bin for the sink so at least the crap on the dishes can soak while I’m not doing them. I can be okay with that.”
 


File under: Musings and Reflections