The Flow of Diabetes (Annica)

 – Sam Tullman, MPH

So, perhaps we can say that, at least for the moment, we’ve come to terms with Diabetes sucking. Then there’s the next moment, how are we that time? Then there’s the next moment after that, then tomorrow, each packing a punch that could potentially take our emotional and psychological breath away. Taking a larger perspective on the incessantly changing nature of our lives can be scary at first glance — especially if our hope is to make it stop.

Last month, I wrote a little bit about the discomfort that’s inherent in being a living being, especially one with Diabetes. This month, I’m writing about the constancy of change, which we so often see as an enemy in our lives with Diabetes. I’m here to say, from the start, that it is just as much a friend as it is an enemy. But perhaps more useful than seeing it as either enemy or friend, we can realize it’s our reality, both in life with Diabetes and life at large. Realizing this, we are a little more free to align ourselves with this stream of constant change, to flow with it. Of course, it’s much easier to be in a boat skillfully maneuvering a river than it is to stand in the middle of it and try to stop its flow. But pretty metaphors aside, what does this really look like in our day-to-day life?

See if this sounds familiar in some way shape or form: last week, after a stressful, long day, I decided to work out a little bit to blow off some steam. My blood sugar had been slightly high for the last few hours, and likely because I hadn’t moved around much, insulin didn’t seem to be having much of an impact. I started warming up for the workout. I felt a shift in my body. A coolness. A subtle weakness. I proceeded to start to workout vigorously, with the little energy I had. Profuse sweat. Lack of energy. I look at my CGM — double arrows down, around 100. Five minutes into working out, the workout was over. Body healthy in one moment, and in need of an urgent intervention moments later; promising plan in one moment, confusing mess in the next.

Though we often hear people talk about “choosing” a positive mindset about what happens to us, it doesn’t quite illustrate my experience to say I had a choice between feeling even more defeated than I did before my workout or feeling neutral about it. It certainly would be silly and naive to try to think of reasons to be grateful for this difficult experience, unless I were grateful it was giving me a practice opportunity. So, what was my honest reaction? I was mildly disappointed, walked home frowning, drank some juice, showered, and continued with my evening. I think I watched some Disney Plus or did something else to de-stress a little bit. No big deal. This day, there was no larger story this glommed onto, no idea about defeat or how my life sucks or is unfair. I felt my honest feelings and took the next best action.

Santideva, a 5th-century CE scholar and meditator, says it perfectly: “Where would there be leather enough to cover the entire world? With just the leather of my sandals, it is as if the whole world were covered. Likewise, I am unable to control what happens outside, but I shall shepherd what happens in my own mind. Then, what need is there to control anything else?” Who is more in need of these kinds of “sandals of the mind” than us? While we can’t always control what happens in our bodies, Santideva reminds us we can learn to gently orient the flow of our minds.

This is very difficult to do without a foundation of calm and clarity, and a strong practice in letting go. So, how do we do it? Fundamentally, what we need to train our minds to do is to notice changes happening without intervening, without adding our ideas or thoughts to them. This, like much of the practice of meditation, is simple but not easy.

There are countless ways to train our minds in this direction. The best way to start, perhaps, is to pick one sense or focal point during a meditation practice — breath is a classic one (paying attention either to the rise and fall of chest or belly, or the flow of air around the nose). Another option that works well for just noticing changes is sound. Whatever you choose to center on, paying attention as well as you can only to this object for a few minutes will begin to let the mind settle — this can require a little bit of effort, but being gentle or at least neutral in this effort, (rather than harsh and self-critical) expecting distraction, is of huge benefit. Just choose one thing to pay attention to, in one way. As we start to feel (yes, feel— it’s palpable when the mind begins to quiet down) we’re settling, we may endeavor to widen the scope of what’s openly noticed; if we’re noticing our breath, for example, we might continue to pay attention to the breath in this one way, but choose to notice changes in the sounds of the room or area we’re in. If we’re just listening to a sound (it could be the sound of rain falling, for example, coming from an audio track), we might notice what’s happening in our body. In this noticing, with the distance of a calmer mind, we may notice that we can feel feelings or hear sounds just pass in and out of our awareness, with less reaction. When we notice ourselves reacting, no big deal — we can just notice that reaction, or, if we feel it’s really sucked us in, we can go back to concentrating more intently on just one thing.

This helps later in day-to-day life when not doing a “formal” (usually seated) meditation practice. We can take brief moments throughout the day to notice what’s happening, and to notice the fact that’s changing. In a workout, we might feel what our hands or feet are doing, or what it feels like to have a heart beating faster. Washing dishes we can feel water flow over our hands, muscles working to hold dishes up and put some elbow grease into the dirtier ones. Going for a walk, we can hear cars coming and going, or if we’re lucky, of birds chirping.

How often do we see a blood sugar in good range, but rising, with some annoyance or dread? We try to avert the high with insulin, only to see a little while later that now, still in a good range, our BG is dropping, and we get nervous about how low it will go? With practice we can learn not with our heads, but with our bodies and the deeper, subconscious layers of our mind that change is not only OK, it’s normal. The kinds of practices above can help us learn this over time, and in an acute moment when we’re faced with change, help us see things with a little more sober, sane mind. When we don’t get as emotionally wrapped up in the changes that are happening all the time in our bodies, we can make better decisions, and perhaps more importantly, be a little more at peace with the conditions of our lives as people with Diabetes.

sam tullmanAbout Sam Tullman, MPH
Sam Tullman, MPH, is one of the facilitators and co-founders of DiabetesSangha. He was diagnosed with T1D at eight years old, and has been on a long arc of trying to understand the human experience and learn how to support meaningful and helpful experiences ever since, through the lenses of both science and meditative practice. He is a dedicated student of Rinzai Zen, but draws heavily in his practice from other Buddhist traditions, as well as modern Western psychology and Neuroscience. In his professional life, he is a researcher and consultant working primarily in the topics of emergence (“spiritual” or “altered” experiences) and contemplation, with a focus on EEG (electrical activity of the brain) and other brain-computer interfaces.