Mindful Acceptance

How to Listen

I’m not asking you to come down here

and clean out the muddy corners of my life.
I’m asking you
to be a forest where mud and leaves,

shadows and light, growth and decay

all have their unquestioned belonging.
I’m asking you to be an ocean
where even great storms

don’t trouble the depths

and each tear is welcomed as a homecoming.
I’m asking you to be as spacious

as the vast darkness behind the sky,
which will never be afraid

of what I do or don’t choose.
I’m not asking you to hold me together.

I’m asking you to open so wide
there’s room for all the ways I come apart.


James A Pearson

How do we open so wide to the pain of others and our own?
How do we create room when all we want to do is run away or hide under the covers?
How do we stay present and not turn away from all we see, and feel, and avoid numbing ourselves to all the suffering all around us.

Take, for instance, the study I read last week, Climate-driven depopulation and adaptation realities in America’s coastal ground zero published in the journal Nature Sustainability, which made headlines in its direct and unequivocal conclusion:

 “the window of opportunity to save the New Orleans area in the long run has probably closed, the next few decades will be decisive as to whether other population centres that are presently well landwards of the coast will be among the next to face their seawards fate.”

Succinctly put New Orleans cannot be saved, and to protect human lives, the migration, and all that entails, must begin now.

When I broached this new subject with several people, I was met with responses ranging from blank stares to a flagrant indignation. Since none of the people with whom I spoke lived in or knew anyone residing in Louisiana, the conversation stopped there.

I mention this article not as an invitation to debate the inevitabilities of climate change or the need to prepare for migrating to other locales, but to discuss a broader issue – mindful acceptance and the ways in which we respond to the world. Whether climate, political or health related, I wonder how we orient to unsettling, unpleasant or downright disturbing experiences. In saying, “I’m having a hard time accepting x, y or z,” or “I cannot accept this,” what specifically are we saying is difficult to accept? Is this lack of acceptance an argument over the validity of the facts or a staunch refusal to be present to all the uncomfortable and disturbing ways we come apart when confronted by those facts?

Acceptance is a way of orienting, a way of life, a way of engaging with ourselves and our experiences. As Paul Tournier once penned,

Acceptance of one’s life has nothing to do with resignation; it does not mean running away from the struggle. On the contrary, it means accepting it as it comes, with all the handicaps of heredity, of suffering, of psychological complexes and injustices.

Acceptance is acknowledging and embracing reality, or said in the inverse, not fighting reality. Acceptance has nothing to do with liking or disliking, finding something pleasant or unpleasant, or even agreeing or disagreeing with someone or some data. Acceptance nods knowingly at the reality of things, and says, Yep, that’s happening. I see / hear / feel you. And in the very next breath, acceptance asks, What now? How do I want to respond fully, thoughtfully, and mindfully? So how do we practice acceptance in our daily lives without covering our eyes and ears, without distracting or ignoring, without refusing to see what is happening?

I began my career in the HIV care in a time when receiving the diagnosis was typically accompanied by a 5-year prognosis, which fortunately has changed in the passing decades. Back then, naturopathic medicine offered many treatments for mitigating medication side effects, increasing medication efficacy, easing pain and discomfort as well as treating some opportunistic infections, but overall, it did not stop the progression of the disease.

Rather than attempting to fix or cure, which can be a way of avoiding our own discomfort, I attempted to practice, or so was my intent, providing room, space and acceptance. After the initial 10 - 15 minutes of medical updates (review of symptoms, medications and supplements changes or issues, etc.), my questions settled on a singular theme - How are you living with all of this? How are you orienting to and navigating your life? How are you showing up for your life every single day? Many with whom I spoke felt isolated, stigmatized and rejected – because, quite frankly, they were. Yes, some had supportive friends and family, yet others talked of being the sole surviving member of their formerly large friend circle. One man spoke about the museum his home had become, filled with the furniture, books, clothing and tokens of his departed friends. Each step from room to room was a reminder of all he had lost. For so many, a pervasive sense of unworthiness clung about them, accompanied by a constant refrain that no one will ever love them, hug them, touch them, or be close to them. They would never be intimate with another person ever again. Were they wrong? Did they need to be more positive, more optimistic, more hopeful? Did they need to reframe the rejection they experienced? Did they just need to regulate their nervous system so such experiences no longer disturbed them? Should they learn to be happy with the loss of their dreams and futures?

Paul revealed to me the urgency of learning to open wide and create room for all the ways a person can come apart. His medical history was extraordinarily complicated. In his late 30s, he was frail and walked slowly with the use of a cane, suffering with interminable fatigue. When he handed me his list of medications, I stifled the urge to gasp. A few years earlier, he had his first bout of CMV (cytomegalovirus) in his gut, for which he was prescribed a potent antiviral, foscarnet, that caused his kidneys to shut down, which, in turn, required him to take massive amounts of sodium bicarbonate, lest he experience seizures and a host of other symptoms. In addition, he was taking upwards of 50 other pills daily. Even if I had a desire to cure or fix, I had no clue what I could offer him since many supplement and herb might disrupt his acid-base metabolism and that was too risky.

While foscarnet kept his CMV from progressing, his eyes were not spared, and he was partially blind in both eyes. He was also taking three anti-HIV medications which kept his viral load below detectable levels and his CD4 cells count up. However, because of all these medications, his liver enzymes were exceedingly elevated, indicative of liver damage. Activities of daily living were a chore. Due to his partial blindness, he couldn’t engage in his previous pleasures like reading or working on crafts. Because walking was difficult and driving impossible, he was primarily homebound, unless his partner, who continued to maintain his tech job while simultaneously acting as full-time caregiver, shuttled him to his multitude of weekly appointments.

As part of his care, each week Paul checked in with his psychiatrist for sessions that lasted no more than ten minutes, at which time he asked Paul a few pointed questions and told him to maintain his course. Paul, looking at the ground, and in a quiet voice said, “I guess I am a bit depressed.” In an unedited and uncontrolled moment, I blurted out without thinking, “Why the hell wouldn’t you be depressed!” Before I could course correct, he lifted his head and looked me straight in the eyes and said, “Thank you! Thank you for saying that” and began to weep, his body shaking as it released all the grief and sadness he did his best to push away.

From that moment on, the tone of the visit changed, and Paul’s mood brightened. Although his reported intention was to discuss supplements, we did so minimally. Paul began to accept an aspect of himself, accept his feelings without needing to treat, remove, minimize or justify them. When he was able to embrace the fact that his depressed mood was present and an appropriate reaction given his circumstances, that his feelings were neither wrong nor pathological, that he was grieving – the loss of abilities, loss of meaning, loss of dreams - something new emerged. The appointment ended with Paul smiling, thanking me, and asking to see me again in the following weeks. We met several more times over the next two months, yet now we spent time opening to whatever was arising for him. Two months after that initial meeting, Paul developed acute pancreatitis, fell into a coma and died at home. All these years later, as I write these words, my heart continues to break open when recalling Paul’s story.

How comfortable are we at tolerating distress, not only our own personal distress but also the distress and discomfort that comes while sitting before another person, whether patient, colleague, friend, partner or spouse or parent or child? It is understandable that we long to do everything and anything in our power to ease their suffering, but what happens when it fails to bring relief? And moreover, if we rush to act, do we even know what we are trying to address? If we no longer want to fight with reality, if we value ease in the face of all the tumult around us, what must we practice daily to inch ever more closely to that vision?

Let me take moment and explain, as best I can, what acceptance is not:

•  Acceptance is not passivity or inaction, as anyone who has struggled with keeping their mind focused on the breath for 30 seconds without allowing it to wander can attest. Acceptance, and mindfulness, its prerequisite, takes practice. Acceptance doesn’t merely happen to us; we must cultivate the conditions to allow it to thrive.

• Acceptance in no way means we love, or even like, what is happening, to ourselves or the world at large. Acceptance is not about loving your cancer, the violence in your community, or the price of gasoline at the pump.  That is a practice of spiritual bypassing where we ignore, suppress or avoid our internal thoughts and feelings. Our goal is not to meditate or breathe away our fear, sadness, outrage, grief or despair. Those feelings are present, so we open wide to it all, as uncomfortable as it may be.

• Acceptance is not the same as condemning or condoning, agreeing or disagreeing with another’s behaviors or actions. We can get caught up in an endless mental spiral of fault finding, demanding we lay blame and shame. Blaming and shaming are not the same as addressing the cause, which tends to be multifactorial and never as simplistic as we would like it to be. We can identify and accept the cause(s) without sliding into a debate about worth and value, which, at its core, is the essence of shame. Remember, acceptance is not a passive act. We can still ask, or even demand justice, yet before that, we must accept the reality of the situation. In those moments, however, such as in imminent flooding or acute pancreatitis, fixating on blame does little to address our deep emotional devastation and prevents us from taking action to move out of harm’s way, should choose to do so. 

Acceptance begins with a declaration of intent, an act of commitment, each day - to show up for ourselves and to ourselves, to all aspects of ourselves, to our entirety, to our multitudes. We intentionally show up for what is happening all around us. It is easy to read the news or see images on our screens and detach, compartmentalize these events – these people, this famine, those bombs, that fire – are elsewhere and not happening to us. In that breath, we abandon any feelings that arise within, and for what purpose? So we can continue functioning as normal, to maintain the status quo, when all the while we are crying inside? What is normal? By failing to confront reality, are we, in essence, condoning it?

We show up for ourselves - compassionately, respectfully, nonjudgmentally. Acceptance does not ask us to be devoid of emotion, to be nonreactive to trauma and suffering. Mindful acceptance is asking us to embrace it all without being crushed by its weight. Yet we must build our capacity for this, which is why acceptance is a practice. On those days where we long to stay hidden under the covers or lie on the bathroom floor in tears, acknowledge this, nod to it, open to those feelings and thoughts, without shame or criticism, without pathologizing and labeling. And do not judge longing to run as far from these feelings as possible. Hold it all. The more we attend to ourselves, to our thoughts, feelings, and bodily sensations, to those around us, and to the world, the more space we have within to withstand suffering.

When we see clearly, open to it all, we do notice that while pain and heartache is present, so, too, are a myriad of other simultaneous experiences. As we gain skills at mindful clarity, we can choose where we would like to rest our attention. As we grieve, we can find ease in the trees and birds outside our window, the cat resting on our lap, the friend talking beside us, the meal we are eating, the book we are reading or videos of kittens and puppies that bring a smile to our hearts. This is not a dismissive, bypassing approach to gratitude; it is more inclusive that that. It is living in the AND. Fear is present AND so too is love, appreciation, calm.  Anger is present AND so too is compassion and understanding.

When we truly open to what is around us, we realize we are not alone in our suffering. Blame and shame separates us; acceptance brings us closer together. During our intense moments of struggle, accompanied by our own internal sense of shame, we isolate, hide, retreat. Afraid of the impending judgment, we not only distance ourselves from our sense of shame, but we also distance ourselves from others. We see those around us as adversaries thus we are thrown back on that never-ending wheel of motion, constantly playing defense, unable to rest.

Acceptance isn’t easy. It begins with honoring ourselves and life itself. Whether confronting a climate crisis (such as receiving a terminal diagnosis for your city), adjusting to the loss (and death) of a job, or navigating a serious health condition, commit to showing up for ourselves, if not others. Crises are inevitable. Everything changes. What would happen, I wonder, if we were to make mindful acceptance a constant companion? What will take place when we accept what lies before us - all our striving, longing, and discomfort, all the pain and sufferings of those we love and those we do not know, and of the planet? What might we discover?