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with each other and with the disease and with our mortality, without succumbing to the need to fix or change any part of it.

Inspired by this family, I managed to do something I’ve never been able to do before. I hate to be confined or tied down, because it sends me careening into panic. For procedures like MRIs, I’ve always asked to be sedated. But last week I decided to try my next routine MRI—I must have them to check my back—without any medication to relax me.

An MRI machine is dark and confining—and extremely loud. I was put inside and the noise started up. Lying there in my thin hospital gown in the tube, my crooked spine pressed against the cold plastic pad, I felt fear slice through me. The banging was so loud it sounded like bombers were coming to deliver a blast, like the whole building might collapse in a heap of rubble. I thought I was going to scream and kick and have to be pulled out. But I said to myself, “The more noise I hear, the more relaxed I become.” And I did it. I made it for forty minutes in that machine without a pill. The ability to be still with my discomfort didn’t happen overnight. But as the years pass, I keep practicing.

This is how we release ourselves from the prison of avoidance—we let the feelings come. We let them move through us. And then we let them go.

KEYS TO FREE YOURSELF FROM AVOIDANCE

Feel so you can heal. Develop a daily practice of checking in on your feelings. Pick a neutral time—for example, when you’re sitting down to a meal, waiting in the checkout line at the grocery store, or brushing your teeth. Take a few deep breaths and ask yourself, “What am I feeling right now?” Scan your body for sensations like tightness, tingling, pleasure, or pain. See if you can identify a feeling and just name it, without judgment or trying to change it.

Everything is temporary. When observing your feelings at neutral times becomes a comfortable habit, next try tuning into your feelings when you are flooded by a strong emotion, positive or negative. If you can, step away from the situation or interaction that is provoking the feeling of joy, sorrow, anger, and so on. Sit in stillness for a moment and breathe—it might help to close your eyes or lightly rest your hands on your lap or abdomen. Start by naming your feeling. Then, see if you can locate the feeling in your body. Get curious about it. Is it hot or cold? Loose or tight? Does it burn or ache or throb? Finally, observe how the feeling changes or dissipates.

The opposite of depression is expression. Think of a recent conversation with a friend, partner, colleague, or family member when you avoided saying what you were feeling. It isn’t too late to take responsibility for your feelings and express your truth. Tell the person that you’ve been reflecting on the conversation and would like to follow up. Arrange a convenient time to speak, and say something like, “You know, I didn’t know how to express this at the time, but I realize I was feeling ____ when ____.”

Chapter 3

ALL OTHER RELATIONSHIPS WILL END

The Prison of Self-Neglect

One of our first fears is of abandonment. Thus we learn early how to get the A’s: attention, affection, approval. We figure out what to do and whom to become to get our needs met. The problem is not that we do these things—it’s that we keep doing them. We think we must in order to be loved.

It’s very dangerous to put your whole life into someone else’s hands. You are the only one you’re going to have for a lifetime. All other relationships will end. So how can you be the best loving, unconditional, no-nonsense caregiver to yourself?

In childhood, we receive all sorts of messages—spoken and unspoken—that shape our beliefs about how we matter and what we’re worth. And we can carry these messages into adulthood.

For example, Brian’s father abandoned the family when Brian was ten, and he became the man of the house, taking care of his mother, doing everything in his power to make life easier for her, to soothe her pain—and to make sure she wouldn’t leave, too. He brought this caretaker identity into adulthood and kept choosing relationships with needy women. He resented them for the constant sacrifice they demanded, and yet he had difficulty setting healthy boundaries. He thought that to be loved, he had to be needed.

Another patient, Matthew, was born to a mother who had not chosen to become pregnant with him. She felt burdened by motherhood and entered into it with no sense of anticipation or enthusiasm. When parents are stressed or disappointed or unfulfilled, their children pick up the tab, carrying the burden into their own lives. As an adult, Matthew still held a terrible fear of abandonment that manifested in rage. He was cruel to his girlfriends, and would go on rants in public, yelling at people, once even throwing a dog across a parking lot. He was so afraid of being left that he turned the fear into a self-fulfilling prophecy, behaving in such a way that people had no choice but to step away from him. Then he could say, “I knew it all along.” He became who he dreaded in an attempt to control his fear of abandonment.

Even if we didn’t experience a discernible event or trauma that forced us to fight to be loved or seen, most of us can remember times we protected others or performed for them in order to secure their approval. We may have come to believe that we’re loved for our achievements, or for the role we fill in the family, or because we take care of others.

Unfortunately, many families, in trying to motivate children to do well for themselves, create a culture of

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