by Lee Lipsenthal, MD Ed. Note: Lee Lipsenthal was a longtime IONS board member as well as a gifted integrative medicine physician, who dedicated his life to helping doctors and others find the source of healing within. He passed away on September 20, 2011, just weeks before his book was published. It is a fitting legacy to a man who touched the hearts of many. “Being fully alive has nothing to do with the presence or absence of disease.” —from Enjoy Every Sandwich In my journey over the last few years, the question of who I really am arose powerfully and profoundly. Am I the physical being I see in the mirror each morning? Am I a soul living in this body that will move from body to body over many lifetimes? Is this life just an illusion? Defining the self by bodily limits comes into question in a very simple experiment often performed in Psych 101 classes around the country. A person is asked to sit at a table with one hand above the table and one hand below it. On the table is a rubber hand, placed where the person’s real hand would have been. The subject’s hand under the table is stroked with a feather while the rubber hand above is being stroked. The subjects are confused about which hand is real. They feel the tickle of the feather in the rubber hand and sometimes try to pull it away, perceiving the rubber hand as the real hand. When the fingers of the rubber hand are bent backward, these individuals fear pain and withdraw the real hand. The substitution in the subject’s mind of the rubber hand for the real hand occurs because the brain creates an internal imaginary construct of what the body is and where its boundaries lie. To keep us from hurting ourselves, the brain needs to know where the body is at all times, and to do this, it relies especially on the senses of touch and vision. You need to know how far to extend your arm or withdraw it in any task or emergency, but this construct, created by the brain, can be fooled by a rubber hand. Our definition of the self can get recreated rapidly by the brain, so that even the brain doesn’t know who we are all the time. How can we define ourselves by our physical bodies when this definition is flexible even to our own brains? In addition, our bodies change over time. Our cells are being replaced constantly as new cells grow and old cells die off; none of the cells in your body are the exact same cells they were a few years ago. You can tell this by looking at an old photograph of yourself. You look different now than you did when you were younger, yet you would say that you are still you. We change, we grow, we gain weight, we lose weight, we get injured, we heal. Our bodies are in flux. Clearly, the body alone can’t define the self. Can we define ourselves by our thoughts and emotions? Ask yourself if you think about and see the world the same way you did twenty years ago. Have your perceptions changed? Have your beliefs changed? Have your motivations changed? Has your knowledge changed? Your thoughts, beliefs, and emotions change from moment to moment, year to year, and decade to decade, yet you are still you. We can’t therefore say that the true self is defined by our thoughts, beliefs, or emotions. I love the following exercise. Close your eyes and say the following to yourself, repeating each statement three times: I have a body, but I am not my body. I have feelings, but I am not my feelings. I have desires, but I am not my desires. I have thoughts, but I am not my thoughts. I am the self, the center of consciousness. When I am too wrapped up in a thought, an emotion, or a desire, I do this for about a minute, and it helps distance me from the thought or emotion. During my radiation treatment, I often repeat, “I have pain, but I am not my pain.” It is a simple yet effective way of lessening any experience of pain. There must be a broader definition of the self that transcends the body, emotions, and thoughts. I like to think of this as the spiritual self, the transpersonal self in psychological language, or the one self—a self somehow beyond the physical, beyond the body or mind. This one self is connected to our sense of spirituality, our sense of connection with others and the universe as a whole. It is to some degree selfless. You might get a sense of the one self while walking in nature, listening to music, praying, or meditating. In that moment, you lose your mundane definition of yourself. You may experience this as a connection with a higher power. You may even have a sense of this one self when feeling love toward another or holding your child in your arms. The usual boundaries drop away, and for a moment you become one, or as Bob Marley sang, “one love, one heart.” I believe that we evolve naturally toward this one self if we allow it to happen. We begin our lives vulnerable and depend on our parents to feed us, clean us, and comfort us. When we need these things, we cry to get our needs met. Survival is our primary concern; we are always surveying for danger and seeking safety as we age. In our early childhood we are also social beings. We learn that when we smile, our parents smile. This gives us a sense of protection and safety. Soon we learn to expand this interaction to others, and our community grows. We learn to adopt behaviors that we see in others, allowing us to fit in and feel safe within our community. This gives us a greater sense of safety and enhances our likelihood of survival. At some time in your life, you begin to realize that you are not made up of just the component parts of your personality. You also realize that you are not satisfied with the life that was prescribed for you by family and community. You realize that something else is needed to satisfy your soul; your one self is calling out to you for something more, something vague, something unknown, something different. You wake up to the feeling that this life may not be enough. I believe that this restlessness, this pressure to change, moves us to evolve naturally toward this one self if we allow it. Our human capacity to change and grow over time opens a new door of possibility: a more fluid definition of the self. Like a tree that can bend with the wind, we become more able to deal with life’s changes as they arise. As you continue to push and grow, you have more one -self or selfless experiences, connections with nature, with God, with a sense of spirituality, with unconditional love, compassion, and service. You can begin to move beyond simple survival. You are no longer attached to the you of the moment. You become open to all possibilities. For me, it is this one self that is not identified with cancer, pain, or fear. Cancer is just a physical event of the moment—it just is what it is. What Bucket List? An event that changed my view of so-called bucket lists occurred in the middle of my treatment. My friend Mark, his wife, Anna, and their family came to visit us from Pittsburgh on one of my chemo breaks. Knowing that my life might be shorter than expected and knowing my love of rock ’n’ roll, Mark asked me one day what band I would most like to see before I died. Laughing, I said The Beatles (I knew I might have to wait until after I died for that one!). When I was a seven-year-old sitting on the floor, two feet from a round, black-and-white TV, watching the Beatles on The Ed Sullivan Show, my life changed. The energy, vibrancy, and passion coming out of the tiny TV speaker resonated through my little body, creating a passion for rock ’n’ roll that still lives. Mark said, “Would you like to meet Paul McCartney?” I said, “Sure,” knowing that this was an impossible task for a guy who is not in the music industry and a difficult one even for those who are connected. He called me a month later to tell me that he was working on it and had a plan. He had gotten in touch with Paul’s pilot, whom he knew from Pittsburgh, and was trying to make it happen. I was laughing my head off with delight. Although meeting Sir Paul would have been on my bucket list, I had something better: a friend who would go well out of his way to do something to make me happy. Just knowing this was a huge petal in my pocket. I no longer have a bucket list. I have love in my life. This is far greater than seeing the Pyramids, climbing mountains, eating Thai food in Thailand, or any other physical activity that might be fun to experience. I am loved, and I have loved. My bucket list is complete. I believe we are all born with the capacity for gratitude, but many times we get in our own way. Two common examples of this are pessimism and perfectionism. Pessimists and perfectionists may have things to be grateful for in life, but they will rapidly find a reason why something is not right or perfect or how it could have been better. Their imaginal minds search for mistakes or flaws. In doing so, they immediately jump to the negative without enjoying even a brief moment of gratitude. “Yes, but . . .” is their language. They can’t enjoy a sandwich because it has too much mayonnaise or too little lettuce or the bread is too hard or too soft. On the other end of the spectrum are those who ignore difficulty until their lives fall apart. I often see this in people with significant spiritual lives and practices. They blind themselves to life’s realities by diving deeper into their practices: “If I just meditate and do my yoga, this will all go away.” I have seen many people who are not aware of themselves or the harm they do to others and use spiritual practice to avoid their real lives. My friend Nita and I refer to this as spiritual bypass. People use spiritual practices and beliefs to excuse the harmful things they do to others and avoid or bypass who they truly are. Gurus and priests do this unconsciously to avoid the dark aspects of their personalities. This is how child abuse and sexual affairs can occur among religious leaders. They have not dared to look at their shadows. They can enjoy their sandwiches, but while they eat, the ceiling falls down on them. Ignorance is not always bliss. Gratitude practice means facing reality and gaining awareness of the many aspects of yourself: your inner self, your one self, your subpersonalities, and those of the people around you. It means understanding and embracing your shadow. It means letting go of a need to control yourself and others, it means growing compassion for those who have hurt you, it means being aware of the difficult parts of your life and still being able to reach into your pocket on a dark, snowy night just before you leap from a bridge to find that small, innocent petal. Gratitude is the ultimate expression of hope. A healthy practice of gratitude is simple. You don’t need to whitewash the bad; just remind yourself of the good now and then. Remember, what you look for is what you find.