Sleep

 

William Dement, a sleep researcher at Stanford, convinced me with this book of the importance of light hygiene. I do not sleep well if there's any light in the room. The modern world is full of light sources: clocks, power strips, computers -- even when they're supposedly off, our myriad electronics have little LEDs glowing, red or green or yellow, little eyes in the dark. Real darkness is not a matter of turning off the lights. It's a matter of blacking out your windows and covering up all those little eyes. Dement demonstrated in the lab that even these little increments of light disturb people's sleep: although they're unaware of why, they sleep less soundly and wake more easily in the presence of even very little light.

Sleep gets its own entry in my "whupping the food thing" series for two reasons. First: sleep is the great restorer of oomph, and everything about whupping the food thing rests on oomph. To eat right I need to plan ahead, to not always take the easy way, to throw myself into the fight with some vigor and enthusiasm: above all, to keep out of temptation's way, and to occasionally resist temptation if my planning fails. All those things require oomph, and if I start the day with a meager supply, chances are there won't be enough when my trough times come. If I'm exhausted, grieved, discouraged, and out of oomph by mid-afternoon, the odds that I'll be gorging on ice cream and potato chips before the end of the day skyrocket. I can't afford not to get a good night's sleep.

The other thing sleep does is relieve persistent pain. I'm not sure if it does this by actually encouraging the repair of tissue, or more subtly by somehow resetting the brain's pain responses, but the effect is striking. Most people my age or older are navigating their exercise around some pain or other, their "bad knee" or their "tweaked back" or something: we're working the trade-offs between the benefits of exercise and aggravating some pain or other. The catch-22 here, of course, is that to really get a good night's sleep, you have to exercise. I have clients in whom this has spiraled down to an almost sleepless and completely pain-filled life, getting around by motor-chair because they can't walk on their excruciating knees, unable to drive because they fall asleep at the wheel, unable to sleep because their body is desperate for exercise, and unable to exercise because everything, everything hurts. Trust me: you really, really don't want to go there. And the simplest intervention in this vicious cycle is a remarkably easy one. Block every single damn light source, block it completely. If you want to get fancy, it also helps to quit using televisions and computers for an hour or two before bed. Those are both powerful light sources, and you stare straight into them. I've never managed to do that: I'm too fond of dinking around on my computer in the evening. For me, it's enough to make it dark dark dark. Blackout curtains, clock hidden under the bed, duct tape on the power strip light. Really dark.

What does avoiding pain have to do with whupping the food thing? Well, exercise turns out to be critical for a normal metabolism. Whatever goes wrong with modern metabolism, and disposes us so disastrously to type II diabetes, cardiovascular deterioration, and cancer, study after study shows that exercise militates powerfully against it. I believe there's much more to it than the simple fact that exercise burns calories: the human body is designed for activity, and a whole slew of things begin to go wrong when it's sedentary, a cascade of ill-effects and metabolic abnormalities. My guess is that almost nobody with disordered eating regulation is going to really fix it without becoming active: and that almost nobody sedentary is going to become active if it's painful. So we come back to sleep. Protect it, cultivate it, defend it fiercely. Sleep is your friend.

Other posts on Whupping the Food Thing

Sotto Voce

What it comes to I guess is a sense that something is very close, yet escaping. And that the everyday misery of life is in the balance.

That I could – what? Translate the Buddha into touch therapy?

My mind darts at once in two opposite directions – one, that this is the same stupid arrogance that culminates in the AMA, and two, that sense in the Vajrayana that a skillful tap can shatter a glass slab that otherwise will take a thousand years to grind through. And people do report these breakthroughs.

Are they telling the truth?

Well, probably not. It's mostly impossible to tell the truth, especially about breaking free.

But still, telling the stories. Telling the stories is crucial. Not because the stories have not yet been told – to yourself. They have. But because they have not yet been externalized. Before they have been told to someone else, or to paper, or to a recorder, their power is absolute. Because you don't know them as stories, you know them as The Truth. The only way to escape the tyranny of your stories is to tell them.

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For a year I worked on Z's shoulder and got nowhere. He gets surgery, and the whole complex of trigger points and pain dissolves. Now, I don't believe in this surgery; I don't believe the pain was mechanical. But Z believed in it. He believed there was a family curse, a malformed shoulder, and surgery would fix it. Perhaps he was right. But I suspect that if the surgeon had simply closed the skin incision without doing another thing, the results would have been the same. No one will ever know. No controls on this experiment.

And now? Now the shoulder pain has been replaced by an equally mysterious and equally debilitating “sciatica,” and I can't say I'm surprised. I'm just watching this pain develop. Trying to treat it, of course, but it's eerie to me how it has exactly replaced the shoulder pain, in the narrative of his life – all the fears about the shoulder have transferred to the “sciatic” with ridiculous ease. This one, like that, is a harbinger of a hundred deadly diseases and conditions – it's diabetes, it's nerve degeneration, it's who knows what. And it will only get worse. And, like the shoulder, it has blossomed into a whole network of mutually reinforcing trigger points and pain. Spookiest of all is that he no longer remembers the shoulder pain. “Remember how debilitating that was, how you thought it would never go away, how it dominated your life?” He looks at me as if I was making it all up. “The shoulder? That was never much of a problem,” says the look.

My interest in treating the sciatica dwindles. It will go away or it won't, but as long as this story holds sway, I have the horrible feeling that Z will never be free of pain. What we really have to do is break the story.

The next time I see him, I will ask, when was the last time you were without pain? What was that like? Can you see it in your mind's eye, feel it in your mind's body? It's a longshot, but I have to try something. I want to back up to before the pain, and then see if I can elicit the story of how the pain came, and why it stays.

But maybe I already know. Always, always, there's the unhappiness with work, the unhappiness with love. This life is killing you, Z. There must be more to life, you keep saying. There is. But I don't know how to help you find it.

---

Well, sure, I could recommend meditation. People know I meditate, they even sort of fish for me to advise them to meditate. I don't, because I know what they'd do. They'd sit once, for five minutes. Or maybe twice. They'd find their mind full of jumpy obsessive thoughts. Then they'd conclude that they can't meditate.

Or else they'd sort of doze and fantasize and they'd love it and advertise themselves as the next thing to enlightened. Christ.

I do think that meditation is probably the single best way to change your life. But it's horribly difficult and usually it takes months, or years, before you start seeing the differences. What American is going to sit still (so to speak) for that?

I hate it when I see meditation advertised as a solution to stress. Well, yes, sort of. Meditate seriously and you'll realize that everything you know is wrong and that you have to change your life, and get out of your marriage, and quit your job, and scrape a living as a woodcarver, or as a mendicant monk. And when you've done all those (extremely stressful) things, yes, your stress levels will probably drop a notch. But the idea that you can beat stress just by adding meditation to your life is stupid. No. At first it's yet another stress, trying to find that much time, and it's hard as hell. And when meditation does lower stress, it does it by violently upending your life. Don't try it. It's not safe.

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Though really, you know, that's nonsense too. Jon Kabat-Zinn got some good results with meditation for chronic pain. So it can be done. I just can't provide that kind of framework for it.

---

A band of brightness behind the trees: muffled gray sky above. Birds shift places on a distant telephone wire, like one of those old bead puzzles. If they get it just right, the sky will unlock, and we'll all go fluttering up to the Sun. They say it's still up there somewhere.

On the Soapbox

Massage careers are typically short -- three to four years, on average. There are two reasons for this. One is that it doesn't pay well, particularly if you're working for someone else; and the sort of people who are drawn to massage therapy are often not good business people, so that a lot of them -- who are perfectly good therapists -- simply can't get and keep a business going on their own. Keeping books, networking, and advertising; paying office rent and quarterly taxes; reckoning expenses and setting prices, are not in their skill set. They end up working at spas for fifteen bucks an hour, with no benefits, doing half a dozen massages a day. Which is hard physical labor, and not something many people are up to doing for long. And not what they had wanted to do in the first place.

Which brings us to the second reason most massage careers are short: people wear their bodies out. The most important thing I learned in massage school was nothing to do with massage techniques per se: it was simply learning how to do physical work without hurting myself. How to stand, how to let my shoulders settle, how to apply pressure with my weight, smoothly, from my center of gravity, rather than by pushing and jerking. I typically don't feel at all tired after a two hour massage: on the contrary, I feel light and energized and joyful. I'm grateful to East-West College for drumming body mechanics into me. It wasn't something they talked about every once in a while: it was something they emphasized in every class, every practical demonstration. All my instructors had been therapists for fifteen or twenty years -- three or four times the average career length -- so they all knew how important it was.

It has nothing to do with how big and muscled you are. I have clients who picked me because I'm big burly guy, and they imagine I'll give a strong massage. That's lucky for me, but it's nonsense, as anyone who's had a massage from one of those tiny, ancient Thai masseuses can testify: what matters is not your weight and muscle, but knowing how to use it. If I find myself straining, using my muscles hard, I know that I'm doing something wrong. It should all be easy. And the benefit runs both ways: a massage from someone who's working too hard doesn't feel right. It jolts and jerks. It doesn't feel safe.

The things I learned in school spill over into everyday life, of course. I sit differently than I used to. I don't use the backs of chairs much: I tend to sit on the edges of chairs now, with my belly thrust forward and my shoulders back, so my spine can have its natural curve. I noticed the other day that in the morning when I get up out of my bed, which is down on the floor, I no longer push myself up flat-handed, which is murder on the wrist. I use my knuckles, like any sensible ape, so that my wrist is straight. A straight wrist can bear a couple hundred pounds' force easily. A bent one can be injured by twenty.

---

The other piece of body maintenance is the trigger-point self-treatment, which I mostly learned on my own, first from Clair Davies' wonderful distillation, and then from Travell & Simon's wonderful book, his source. This has been a godsend. The general knowledge about what musculoskeletal pain is and how to fix it is abysmal, both among the public and among the medical community. Every day people tell me about how they've been diagnosed with ligament injuries, tendonitis, arthritis, carpal tunnel, and bone spurs. I can't legally object to these diagnoses -- that's not within my scope of practice, as a massage therapist -- but secretly I know that seventy-five percent of them are crap. Some of these people are in tremendous pain, and they've been told that nothing but general analgesics or dubiously effective surgery will help. Mostly they just have trigger points in the muscles, from bad sitting habits or muscle overuse or trauma. It all has nothing to do with deformations of bone, or connective tissue injuries. It's just muscle injury, and muscles, which are richly supplied with blood and designed to recover quickly from damage, heal up remarkably quickly, if they're given the chance.

What people don't want to hear is this: you have to let injured muscles heal, and you have to stop re-injuring them. It's mostly as simple as that. You can't sit stock still at a desk for ten hours a day, with your shoulders hunched and your back slumped and and your elbows unsupported, and expect your muscles to just take it. They won't. It's not because you're getting old, and it's not because you're fat, and it's not because you're stressed. It's because you're abusing your muscles. Muscles need to move often and freely.

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I don't think anyone should work at a desk for a full workday. If you have to, then you must take care of yourself, by doing, at a minimum, this:

1) Take all of the breaks legally allowed you, and get the hell away from the desk. Stand up and walk away. Don't, for God's sake, spend your breaktime sitting. Walk, run, dance, do gymnastics, stand on your head. Lie down, if at all possible. Do anything but sit.

2) Make excuses to get up during your worktime. When I'm doing data entry at the Foundation, every fifteen or twenty minutes I need to print out a report of the commited data. Every time I hop up and walk the thirty feet to the printer to fetch the print-out. It's not efficient. I could let them pile up and fetch them all at once, and save myself five or ten minutes a day. I do it deliberately, though, to force myself out of the chair. I believe that the better blood flow probably makes me a smarter and more efficient worker anyway, so that it's worth it even in work terms, but whether it does or not, I'm going to keep doing it.

3) Pay attention to the ergonomics of your workplace, and experiment with changing it. Periodically bring your awareness to how your body feels when you sit this way or that way, try adjusting your chair higher or lower, try having your elbows supported, try having your keyboard and monitor in different places, at different heights. Try sticking a paperback book under one buttock or the other, & see if your spine likes that better.

If you're doing a full day of desk work, be aware that you're undertaking something that's very difficult for the human body. If you were digging ditches all day, or cutting down trees, or scything a wheatfield, you'd know that, and no one would find it remarkable that you wanted to lie down and rest, do something different, when you got a break. Desk work is supposed to be easy. We don't think of it as something that strains our physical abilities to their utmost. But it does. To do it and remain uninjured, over the long haul, requires a lot of attention and a lot of effort. It won't just happen. What will just happen is back pain, neck pain, spasms, cramps, searing pain in the wrists (elbows, knees, hips), aching eyes, and headaches.