The Stressful Trip
The Stressful TripI was preparing for a trip with my wife for a job interview halfway across the country at a prestigious university-affiliated hospital. I received calls several times during the prior year from the hospital recruiter. He was interested in me because of my experience in psychiatry and holistic medicine and the fact that I had worked for one of the leading practitioners of holistic medicine. Because interest and demand for complementary and alternative medicine were at an all-time high, his hospital wanted to set up its own unique department. I was considered a good fit for their needs. They offered me a considerable salary with other perks to make it of interest and value to me. My wife and I were ready to change for growth and new experiences, and my son was finishing his college program, so the timing and offer seemed perfect for us. Of course, it depended on their hiring me for the highly valued position. My wife and I were anxious because it was a significant decision fraught with many unknowns, a move to a new city, and employment situations. If the job came through, there was also the need to uproot ourselves, sell our current home, close out my current practice, and make all the arrangements in the new city where we would live, such as buying and moving into a new home. It wasn't outlandish for us to make such a move to other parts of the country, as we had done it several times before. The first step was preparing for the trip and taking the needed essentials. Packing was easy, as I simply needed a change of casual clothes and attire for my interview. It became a little trickier to decide what I might need for the interview as information about myself and my background. I wasn't sure what they might expect of me as the person to qualify for their position. It was a journey into uncharted waters. We got things together and got to the airport without a hitch. To keep our minds off everything, my wife and I made small talk and humorous banter as two going on a vacation trip. All went smoothly until about an hour out from landing at the airport. My wife, maybe related to the stress or stuffed anxiety about the whole thing or from other unknowns, went into a rapid, irregular heart rhythm. She tried to remain calm but knew it might be atrial fibrillation, which she had when younger. As the compassionate and well-trained physician, I was, I put on my best calming demeanor and bedside manner, knowing that this could be a disaster for both the immediate situation and our plans. I remembered a saying on a poster, "People plan, and G-d laughs." The poster was a reminder not to overthink things or take them too seriously. The fates must have been with us, as Jan calmed some, and by the time the plane rolled into the airport, she was back in a normal heart rhythm. I guess, for now, we had forgotten about the upcoming event and my soon-to-be interview. It seemed to take a back seat to the present frightful experience and closer reality of the true nature of things, meanings, and priorities. Things seemed back in perspective when we got situated, and I got to the interview. I was so confident and laid back by the time of the meeting that the hospital team and organization representatives had to over-sell me about their needs and wish to place me in their open position. After consulting my wife, who was now calm and in a normal heart rhythm, we accepted the job in their lovely community. Of course, we would live near, and I would work at a hospital with one of the top cardiology departments in the country. So, we would be close to top services and specialists if she had any arrhythmia recurrence. I guess there are different levels of fear or anxiety: what we anticipate as the unknown or things that we can't control that might occur with the unfolding of future events. There is also the worry about an event that happens without warning. The unexpected might come with not knowing what will result or whether we can surmount the challenge. Forged identities and perspectives strongly influence emotional states, behaviors, sense of security, and well-being. A person's core beliefs and identity intertwine with a perceived self or the "who I am." Our acceptance of self and others, or their rejection with ensuing conflicts, are molded by our idea of self and personal identity. The more one embraces an identity, perspective, or position, the more likelihood of inflexibility, conflict, stress, or fear and anxiety as occurred on our stressful trip. The seductive teacher When I was younger, I became enamored with eastern philosophy and the liberating feeling of participating in yoga. I remember a charismatic yoga teacher, some called a guru. I attended a retreat with some of his group members in the mountains of a nearby state. I was captivated by the liberating feeling and euphoria of the group activities and yoga practices, so well taught by the teacher. I returned home to Baltimore, where I was in the third year of my psychiatry residency at the university hospital medical center. My wife was excited at the recounting of my adventures. We soon planned a trip for a more extended retreat at the yoga master's retreat center. When we arrived, we both had a similar experience to my first visit to his center. Our feeling of connectedness to the group, support, and loving relativeness made us feel fantastic. It moved us beyond our limited self-preoccupations and interests and tightly held identities and perspectives. The master yogi was very caring and seemed interested in our welfare. He invited me for a personal session and conversation in his home office. I felt this was an extraordinary and high honor. I felt so euphoric I remember my head spinning (probably from excitement and some hyperventilation) during my visit and when I left to walk down the path to rejoin my wife. While talking with the impressive teacher and leader of ardent followers, he inquired about my work as a doctor. As he developed a yoga and Ayurvedic medicine program, he asked if I'd drop out of my psychiatry residency program and work with him. He would allow my wife and me to move onto his large mountain property to study and work for him if I would provide service to his program. I was at first honored and felt special that he offered this opportunity. When I returned to my wife and we walked, she was the first to speak and say this is crazy that I would drop out and move here. After further discussion, I realized the complete craziness of the prospect. I was only a year away from completing my training for my specialty degree. I learned the cult-like nature of this program: With further experience, I felt that some cult-like groups and organizations had positive aspects if you were aware and avoided getting caught up in the group identity and groupthink orchestrated by the charismatic leader. I understood the need to maintain flexibility of mind, awareness, and identity and not to be intimidated by the identity needs and perspectives of another. The misunderstanding of a sage's teaching I remembered an incident when I studied Advaita Vedanta philosophy at a yoga retreat. An animated, youthful woman I was talking with told me she had visited the Ashram of Ramana Maharshi. He instructed her in a mantra meditation technique, where she continually repeated with full awareness, "I am" or some variation. She said that after repeating the exercise as much as possible in the ensuing week and months, her sanity began to slip, and she was frightened and stopped. I thought about this after the weekend retreat and was trying to grasp the meaning of this practice. I learned that the exercise's likely reason and intention was to bring awareness to the "I" expression and over-identification with one's limiting beliefs and biases. Both Maharshi and Nisargadatta seemed to appreciate the similarities of the philosophies of non-dualism, western monotheism, and psychology. All appear concerned with getting extremely narrow or restricted in the belief of an independent individuality with entrapment in a false sense of who one is. Embracing a rigid identity, as separate from all that we are, intertwined and interdependent, would be against the actual reality of nature and destructive. Failing to appreciate our interdependence could lead to alienation and fear of all defined as "not I," other, or outside." 1,2 A person may believe that things conceived in their mind are separate or distinct from perceived outside individuals or things. The alternative view would be that we are all a part of a greater whole or a small part of an infinite universe, the ground of all being that is all-inclusive. As people search for meaning, existential questions arise: where are we going and why? Who is taking the journey, or "who am I?" Seeking the answers to these provocative questions is a doorway to an expansive and enlightening dialogue that opens the mind to a broader perspective, growth, and learning on the path to wisdom. According to the Advaita Vedanta school of the east, the individual self is a false construct. The true self is the Atman, the eternal, unchanging, and immortal soul that is one with the universe and all its parts. By meditating on this knowledge, was the belief that one could transcend the limitations of the individual ego and experience the true nature of reality and being. The power of identity and the transpersonal Throughout the ages, spiritual writings have alluded to people's limiting perception that they exist as a separate independent I. The belief was that the authentic self or I was the inner source of knowledge and power, always available through meditation, awareness, and realization of our interdependence and connectedness. There was always the possibility of transcending self-imposed limitations of one's limited beliefs to experience a higher state of awareness and connection—the transpersonal. Openness to the transpersonal recreates balance and connectedness for well-being and fulfillment. By getting unstuck from your restrictive thoughts and ideas, the inflow of new possibilities and alternatives happens with the unlocking of creativity and imagination. What, who, or where is the transpersonal? The mystic, sage, or philosopher would probably say it is nowhere. It is not a thing, and no exact words describe it. The transpersonal is more of an experience, as when one feels elation, joy, rapture, awe, and wonderment; beyond usual thinking, defining, or knowing logic. To some, it represents a beyond-the-body, mind formulation or interpretation, a spiritual awakening, or a feeling of love, expansion, vastness, or interconnection with all we usually label as other or outside of our personal space. It can be in the moment as a walk in nature, a profound awareness, an overwhelming appreciation, or seeing the sun come up over a vast ocean. Lost in words but in the silence and the infinite source, all beauty and potentiality exist. The neuroscientist might locate its presence in the right hemisphere area of the brain that processes all incoming perceptions and aids in relationships, empathy, and context development. These processes work hand in hand with the left brain's more detailed, organizing and accomplishing day-to-day activity and projects and abstracting incoming data allowing focus and ability to complete tasks. When both hemispheres and areas of the brain are optimally working together, we have optimal functioning.3 The transpersonal experience releases and heals an overly stressed nervous system. Imbalances and inflexibility of thinking lead to exhaustion, mental functioning breakdown, conflict, and deterioration. The excess taxing, detailed, self-preoccupation, rigid thinking, and conceptualizing mental activity can cause a loss of optimal functioning and connection with the environment. The sense of relationships, empathy and contextual interpretation of experience and information gets lost.4 Inflexible and fixed individual identities entrap a person in biased reasoning and perspectives. Limited mental thinking and ideas develop from root causes such as early life learning, trauma experience, or upbringing with narrow cultural, tribal, or group beliefs. A narrowed identification and living without fully appreciating context and perspective can lead to suffering and despair. Doing yoga, meditation, mindfulness, and other awareness practices could help one rise above the limitations of the mind and narrow thinking to a transpersonal perspective. The potential would be to experience beyond the limited thinking and perceived personal identity to pure awareness, free of limiting perceptions, associations, and memories. A therapeutic and insightful breakthrough can facilitate emotional and mental well-being. Many types of transforming experiences can bring the release from containment in a narrow mindset of beliefs and attitudes. Martin Buber, a Jewish theologian and philosopher, also wrote about the individual "I" and the eternal other referred to as the "Thou." Buber believed the true self is a union between the individual and the Thou. When in a genuine relationship with the "Thou," one is in the presence of a higher form of knowledge, understanding, and love. His profound writings flowered from his studies and roots in the studies of Jewish mysticism, also known as Kabbalah. Buber wrote extensively on the possibility of transcending the individual self to find a deeper understanding of our shared humanity and connectedness to all beyond our self, identities, limiting beliefs, and perceived boundaries. To some, the undefinable, or the spiritual dimension, means the connectedness to the divine, G-d, the "I am that I am," or, as in Eastern thought, the Supreme Being, or primordial source of all existence.5 Buber was particularly interested in the relationship between the individual and collective self and the power of personal and transcended relationships to bring about personal and societal transformation. He believed that relationships, characterized by mutual respect and understanding, lead to a greater sense of identity and a better understanding of the world. Any authentic identity must be grounded in relationships with others and the transpersonal. An individual's relationships with others provide a unique opportunity to experience a transcendent unity with the collective self. The study of Kabbalah in the last century has a growing interest in the historical and cultural context of this mystical tradition within Judaism. Scholars use various methods, including close readings of Kabbalistic texts, historical analysis of the social and political context in which Kabbalah emerged, and comparative studies with other mystical traditions. In the 20th century, Kabbalistic learning and practice reappeared within Jewish communities, particularly in Israel and the United States. The relevance of Kabbalah to psychology and philosophy and its influence on art, literature, and popular culture is now of interest. The study of Kabbalah continues to grow, with fresh approaches and perspectives emerging as scholars from various disciplines engage with this rich and complex tradition. Kabbalah emphasizes the importance of spiritual growth and a deep connection with the universal or transpersonal, the spiritual essence or divine, of all that lies beyond personal limitations of knowledge, perception, and experience. By connecting or acknowledging all beyond our personal beliefs and concrete ideas about truth and reality, one can transcend the individual ego or narrow self-held beliefs and experience a sense of unity, peacefulness, and clarity with the entirety of existence. The Kabbalistic concept of the "Ein Sof" (the infinite) represents the ultimate reality and true nature of all things beyond our reasoning, knowledge, physical, and psychological limitations. In this context, personal identity exists as fluid and developing, as the individual continually strives to align their consciousness with something much more significant than their ego, identification, and perceptions.6 Teachers and philosophers from ancient to modern times have sought a more holistic view of existence, knowledge, and truth, which always seemed to be developing and changing. The idea of the soul was the concept of a divine living entity, the true self, not bound by physical boundaries with a timeless and formless nature, and the ultimate source of knowledge. Transcendence and contemplation became a way to get beyond the restraints of ego and static personal knowledge. Early roots of the term transpersonal7 were in the human potential movement of the 1960s and the works of pioneering psychologists and philosophers. Prominent figures and contributions to transpersonal and humanistic psychology included William James's philosophy, Roberto Assagioli's psychosynthesis, and Carl Jung's work. A pioneer in transpersonal psychology, Stanislav Grof,8defined transpersonal states of awareness as when "consciousness expanded beyond the usual ego boundaries and the limitations of time and space." The Transpersonal experience is also called peak experience, altered states of consciousness, and spiritual experiences.9 Transpersonal therapy studies show the benefits of transpersonal states of consciousness as pathways for growth and healing. Psychedelic plants and chemicals, such as LSD and ketamine, are of interest for their beneficial use in healing and therapy work. Plant medicine has been used for centuries by shamans in ceremonial rituals for healing and spiritual awakening.10 Know Thyself As a significant influence in our daily life and activities, understanding of self has taken a considerable place in philosophical and psychological discourse and studies as far back as recorded history. The words at the Temple of Apollo in Delphi entrance were an admonition to know yourself, or so to speak, where you are coming from and your biases, before entering any meaningful discussion or relationship. Being open daily to discovering and allowing your held beliefs, knowledge, and opinions to grow and change is essential for healthy development and relationships. What is static and inflexible is more likely to lead to conflict with others and problems.11 Warning signs of mental stress or danger Our mind's more surface thinking activity is easily accessible by our awareness of our thoughts and moment-to-moment mental activity. Observing our thinking might reveal anything from racing thoughts, excessive worry, fears, overthinking, obsessions, or ruminations. Ruminations are the experience of persistent, excessive, overwhelming, and distracting thoughts that are difficult to stop, if at all. When excessive mental activity becomes apparent, especially if causing emotional distress and interfering with life's activity, productivity, and personal relationship, reaching out for help would be advised.12 Underlying and treatable problems such as obsessive-compulsive disorder (OCD), Post Traumatic Stress Disorder (PTSD), depression, anxiety, panic disorder, or cooccurring medical or pain disorder may be present and can benefit from help or intervention. Contact local or professional mental health resources, such as community mental resources, providers, or your healthcare provider. Tips and Points to Ponder: Many challenges and circumstances can affect your mental health and well-being, relationships, success, failure, or survival in life. Do your best to learn and develop your resources, knowledge, and wisdom for self-care and knowing where to reach out for trusted and dependable resources when needed. Our origins are as herd animals, so recognize our interdependency on each other. Recognize your struggles and difficulties and get help when needed; if you don't care for yourself, who will? As the often quoted saying from Rabbi Hillel, recorded in the Talmud's Pirkei Avot 1:14 ("Ethics of the Ancestors"), "If I am not for myself, who is for me? When I am for myself, what am I? If not now, when?".13 Study history when you can for the profound lessons it provides. Learn from your own experience, as I have certainly from mine. Also, embrace the teacher of history, philosophy, and wisdom from the past for their invaluable teachings. Seek to know about the ideas and the identity you hold as to their influence on you positively or in ways that may bring problems or adversity. Master holistic approaches to wellness and well-being, including exercise programs that enhance mental and physical health, awareness, and transpersonal experience. Yoga, meditation, mindfulness, swimming, and walking type of activities are favorites of mine. Your faith tradition may provide valuable and similar support for emotional and mental health.