August 9, 2019

Medicine for Difficult Times

July 15, 2019

“How is Your Heart Today?”
Compassion at Angola Prison

Lara Naughton and I arrived at the Louisiana State Penitentiary (known as “Angola Prison”) around 8:15 a.m. anticipating a lengthy security check to enter. Fortunately, Lara’s colleague at Angola had arranged for a visitor pass and we sailed right through.

I understand the need for prisons, but I don’t like them. Three nights before we arrived, I had a nightmare of being stuck in Angola for life. Driving through the gates, however, the white wooden fences along the fields reminded me of horse farms in Massachusetts. I started to relax a bit.

Angola is a complicated place. It is one of the largest maximum-security prisons in the United States, covering more ground than Manhattan. The prison holds more than 5,000 incarcerated men, some of whom are on death row. It is named after a plantation that existed before the Civil War, and Angola is a country in Africa from which many of the slaves had come.

Still, it is a prison in which approximately 75% of the inmates are African-American and 70% are serving life sentences.

Lara and I waited about an hour for the 150 men who were scheduled to show up for my talk on self-compassion. Only 75 men eventually came due to transportation difficulties from the various “camps” that are scattered throughout the property. As we waited, I noticed clusters of men chatting amiably with one another, or just sitting quietly. No cell phones. Groups of men talking together seemed like a fond and distant memory to me and I felt strangely comforted by it. Lara went off to talk with some others in the room—all of the men in the room were graduates of the Compassion Cultivation Training (CCT) program she has taught at Angola over the past 3 years.

When we finally started our program, an hour late, Lara read a beautiful poem that spoke about common humanity and then invited everyone to pair up and ask one another, “How is your heart today?” She and several of the men developed this practice, and they use it at the beginning of every gathering. My plan was to visit Angola, deliver a talk on self-compassion, chat with some people, and then get back to the French Quarter in New Orleans in time for dinner.

It wasn’t the best talk of my life. Lara had told me that these men had already been introduced to some of the research on self-compassion, and have begun to develop both a learned and practiced sense of what self-compassion is and isn’t. Many of them had been practicing compassion for themselves and others for a couple years after taking the CCT course, and some were even CCT teaching assistants. Others had attended the Angola Bible College and were pastors and had their own congregations consisting of other incarcerated men. A few of the men just had their dreams of parole eligibility dashed by a court ruling that week; another had just been granted parole that morning and would be leaving Angola after being convicted as a juvenile more than 25 years ago—he had never been out of Angola his entire adult life. What could I possibly say to these guys as a married, upper middle class, white, PhD psychologist and author?

The men were genuinely interested, polite, and generously volunteered answers to my questions, such as “Is there a difference between how you treat yourself and how you treat others?” They definitely perked up when I mentioned the word “shame” and how self-compassion is an antidote to shame.

The CCT teaching assistants had lunch with Lara and me after the talk. Lara paid for it from her grant sponsored by the Compassion Institute and it was catered by men in the Re-entry Club—a group associated with Angola’s Re-entry program, which is run by mentors with life sentences who help other incarcerated men prepare for life outside Angola. Lara always orders a couple extra meals so she can invite additional people to join, or so men can take an extra back to their dorms and share it with their friends. At lunch and through the afternoon, the guys asked very personal questions, such as whether I think the mother of the person he killed could ever forgive him, or what to do about trauma flashbacks. I was blown away by the urgency of their questions, and their candor. A group of guys asked later on, “Do you ever swear?” I explained that I was from New Jersey and that we love to drop the F-bomb in every sentence, but I was controlling myself in public. We also had a lot of laughs together.

Lara said that she needs the 2 ½ hour drive home to New Orleans to digest what happens during the day at Angola. I realized what she meant when my new friends at Angola could not pass through the gates when we left, and maybe never in this lifetime. Lara has never gotten used to that. Lara also predicted that I would probably get more out of the day at Angola than I could give, which is also Lara’s experience even after 3 years.

Still, I felt a little nauseous over the subsequent days when I reflected on the pain those men experienced in their lives, including the pain they caused to others and are likely to relive every day. It could hear Helen Keller’s words in my head, “Although the world is full of suffering, it is full also of the alleviation of it.”

Where do we go from here?

The work that Lara and her assistants are doing at Angola is deeply inspiring and I’m drawn to support it. This fits well with the commitment by the CCT and MSC organizations to collaborate on projects to can bring more compassion into the world, especially to underserved populations. The self-compassion component seems to be particularly helpful for those living in a prison environment.

What originally brought me to Angola was a dear friend, Jenny Phillips, who was making a documentary on the compassion work at Angola. She is the same person who directed the amazing film on teaching mindfulness meditation at an Alabama prison, The Dhamma Brothers. Her passion was criminal justice reform and, sadly, she passed away last year in a swimming accident. I had the privilege of meeting several of the remarkable men who are featured in Jenny’s film. Her colleagues are determined to complete the film, so please stay tuned for that.

May 9, 2019

Unearthing Me:
A Psychologist’s Journey with Self-Compassion

by Dr. Jennifer Ayres

Psychologist and MSC Graduate

May 9, 2019

Several years ago, I hung a painting on the wall in my office. It is a picture of beautiful purple flowers that peek in and out of a white lattice trellis. A butterfly sits on one of the flowers. A family medicine intern painted it for me as a thank you gift. She followed me into my office after our weekly support group one day and bravely shared a painful experience, her doubts about her worthiness to be a doctor, her identity struggle from medical student to doctor, and her humanity. I helped her find self-compassion at a time she needed it.

—✦—

I work in a primary care clinic, and last month my clinic moved across town. Although I had several months of notice, I remained in denial and avoidant. This move would result in many changes for me. A longer commute. Less flexibility with scheduling patients. Way less personal space.

It was easy to handle the “top layer” stuff. The stuff that I grab on a regular basis to help patients gain insight or family medicine residents gain a broader understanding of human behavior. The books I read to center myself after a particularly challenging encounter. These items would join me in the next chapter. They were packed in boxes with my name and the new office number.

The “middle layer” stuff was more challenging. What do I do with things that I don’t need or use often but reference occasionally or might need in the future? Notes from old conferences, programs I developed but don’t do currently, artwork from patients I no longer see, notes and cards from ex-residents. I evaluated those emotionally, then objectively, then ultimately discarded, photographed or packed in “not sure what do with this yet” boxes.

The “bottom layer” stuff was the most challenging. Some of it was part of my very first therapy office when I started a postdoctoral fellowship in 2000. Bottom-layer stuff evokes a sense of flipping through a high school yearbook or a childhood treasure box. The items themselves serve very little practical purpose to current life except to remind us who we were before we became who we are. I smiled once I got to the bottom layer stuff.

Two highlights of the bottom layer. One was the Candy Land game that I pulled from the filing cabinet. Nine-year-old Ben (not his real name), one of my first therapy patients, gave it to me — the only Hanukkah present I have ever received. Ben had Asperger’s syndrome, which impaired his ability to communicate and connect with people, including me. One day he and his mother were shopping. He pointed to the Candy Land and said “Dr. Ayres doesn’t have that game. She would like it. I think we should get it for her for Hanukkah.”

It was the first time he indicated thinking about anyone else outside of the structured social skills development exercises we did in session. And he was correct. I didn’t have the game and I did like it. So did he. We played it every week until I left that job three years later. By the time I was ready to move to Austin for my current job four years later, the box lid was crumpled by use. I taped it up and moved it across the country. As the box continued to disintegrate, I purchased a newer version to use in therapy sessions and my Hanukkah gift became a treasured museum piece.

I spent a lot of time looking at that box and the replacement version that never became a velveteen rabbit. I put it aside until I had a solution. It was a visual, tactile reminder of a special connection with Ben, and who I was when I was new to the field. I ultimately removed the cards and board from Ben’s game, put them in the 2008 version, and cut the “Candy Land!” box edge from my Hanukkah present. The game pieces and cards are in the new office, waiting for an enthusiastic child to select that activity.

I also found my journal from the intern support groups I led during my first four years. We started every support group with a 10-minute journaling exercise to gently transition from one task to another. I started reading the early entries. I was struck by the simultaneous familiarity of my voice from a decade ago and the foreignness of it.

Neither of us could have predicted how successful she would become over her three years of training, that she would be known for her depths of compassion and honored with a leadership award at her graduation.

As I Iooked at the painting, I reflected on how much more I knew about self-compassion now than I did that day I talked to her. I hadn’t had training in Mindful Self-Compassion. My guidance was more reflective of a therapist’s understanding of the interconnectedness of thoughts, feelings and behaviors than self-kindness, common humanity and mindfulness. But yet, it was the basic tenets of self-compassion that I pulled into that conversation as I helped her consider an alternative perspective to her critical self-talk. I thought about how natural it felt to guide others, particularly vulnerable new doctors, to self-compassionate self-talk and how difficult it is to direct those same reflective questions to myself when I need them the most.

These were the guidelines:

▸ I will make space for whatever feeling arises.
▸ My feelings will take as long as they need.
▸ I will search for common humanity when I feel isolated.
▸ I will remember that others hold a safety net underneath me. If I fall, they will catch me.
▸ I will not choose to carry this burden alone. I will accept help and support by sharing my feelings instead of guarding them.

—✦—

Fast forward to present day, four weeks later. I did make space for the gamut of emotions. I cried a lot and worried a lot.

I worked through guilt about self-compassionate schedule changes and boundary setting. I was kind to myself during the process and pushed back when the internal critic arose to offer well-intended, but emotionally minimizing, commentary. I attended our Tuesday night CDP meetings and talked about how hard it is to have a self-compassion practice when it is desperately needed.

A colleague asked me last week how long she can play the “my clinic just moved and I’m still adjusting” card. I told her I don’t think adjustment cards have an expiration date. They simply disappear when they are no longer needed. I had several adjustment cards about this move but now I’m down to one – the “not sure what to do with this yet” boxes are still in my living room and on my dining room table. My children, our dog and I navigate around them as I await the “now I know what to do.”

I trust the wisdom of Rainer Maria Rilke in Letters to a Young Poet when he told a young poet to live the questions and trust that the answers will be revealed when they are ready to be lived.

—✦—

The intern’s painting hangs in the shared office. I look at it often on the two days I inhabit the new space. It is a visual reminder to find self-compassionate grace for the person I am now while I’m developing into the person I am not yet.