Adaptation PracticeA doctor's anxiety
Laurence B – Doctors suffer from anxiety and depression just like anyone else.
‘Having continued practicing AP for more than 25 years now I have watched with interest as other psychological trends have come and gone.’
The good thing about approaching Clive Sherlock was that it was anonymous; there was no record that anyone in the National Health Service could find or read. And, more than this, he was offering training like Continuing Professional Development rather than a treatment or therapy. When I met him and was introduced to Adaptation practice I realised that, although his background was medicine and psychiatry, he was a teacher of an old highly respected traditional eastern practice in psychology and meditation.
I am a senior hospital consultant physician. I came to AP with serious doubts and worries about my position in a changing health service. These had led to anxiety and eventually to depression. I started taking antidepressants secretly, not daring to let my colleagues know anything was wrong. There was nowhere and no one I could turn to for help without jeopardising my career. I was struggling – really struggling.
Talking to a psychiatric colleague at a conference we discussed how depression so often accompanies medical conditions on the medical wards and, having talked about the complications of antidepressants and tranquillisers both on their own and especially when given at the same time as other medication, he told me about a new method he had heard of in Oxford called Adaptation Practice. He had started training in it himself and was clearly impressed by it saying it was a real breakthrough in psychology. He thought it would become the way forward in psychiatry and psychology for conditions like depression and anxiety. It did not involve drugs, but could be learned while still taking drugs. It did not involve psychological treatment or thinking. It was a matter of putting yourself, body and soul, into what you’re doing at any given moment no matter how you felt. “This”, he said, “was the difficulty and once you do it there’s already a big change in you”. “It’s why it’s called Adaptation practice: you adapt in this way, do something when you don’t want to do it”.
I had known him since medical school and had great respect for him as a scientist and a clear thinker. He was so enthusiastic about Adaptation Practice that I decided to look at it myself, which I did without his knowing. The good thing about approaching Clive Sherlock was that it was anonymous; there was no record that anyone in the National Health Service could find or read. And, more than this, he was offering training like Continuing Professional Development rather than a treatment or therapy. When I met him and was introduced to Adaptation practice I realised that, although his background was medicine and psychiatry, he was a teacher of an old highly respected traditional eastern practice in psychology and meditation.
I like to thoroughly understand what I am going to do before I embark on anything. I have to say that, although I understood the simple clear instructions I was given in how to do what in AP is called the Practice, I could not understand why I needed to do them. I could not see the connection between eating quietly or focusing on brushing my teeth and the worries and problems facing my colleagues and me in the NHS, let alone the anxiety and depression I had succumbed to. This not understanding what I was being asked to do would have put me off almost anything else I was about to do but the rationale and coherent argument Dr Sherlock used to explain AP was compelling in a way that I can only call intuitive.
I felt it was the right thing to do but I couldn’t say why. Everything I heard about The practice made complete sense but still there was a gap between doing ordinary tasks and how I felt. But the main point is, I did it. Almost immediately, as if by magic, I started to feel stronger and more confident. I say “as if by magic” because at the time I still couldn’t see how what I was doing could possibly change how I felt. But it did and I was encouraged by knowing that most of medicine has been discovered and practiced for centuries in this way. We know that something works but often not why or how it works.
I made AP my way of living. A number of its rules (Dr Sherlock likened the instructions to the rules of a game which you have to keep to if you want to play the game) were already part of my professional and personal lifestyle. Others I had to learn, break old habits and get used to new ones.
Having continued practicing AP for more than 25 years now I have watched with interest as other psychological trends have come and gone. But I only see Adaptation practice continuing steadily in the same way over the years. Its consistency has impressed me deeply. The practice is to engage with life, with whatever you are doing at the moment and not, I repeat, not to be like a fly on the wall acknowledging it or seeing it this way or that way. It is to put yourself into it as thoroughly as you would when you’re either running a race or running for your life. In other words it is physical, in the body and not mental, in the mind. Dr Sherlock puts it as “being a participant, not a spectator and not a commentator”.
Another point is that I aim at doing The practice all day wherever I am six days a week. It is full on. This has brought about a steady change to how I feel. I was a molecular biologist before I trained in medicine and as a scientist I was convinced that everything had to be understood by thinking clearly and objectively about it. I believed that what I thought was reality. Doing The practice I soon came to realise that this insistence on logical thinking was largely the cause of my having become depressed had made it worse and more difficult to get out of. I realised this because I was starting to become aware of emotions and feelings in a way I had not known before. Rather than observing them and letting them be I was being shown how to engage with them and to work with them. Dr Sherlock likened this to taming a wild horse. He only mentioned this when I was able to demonstrate to him that I had discovered emotion physically in the body – something I had not been able to envisage before doing The practice. Having been what I would call 100% in the mind, always thinking about everything, I was coming to be able to have a rest, a break, from the mind and from thinking and live the sensations and emotions in the body. When this first happened to me it was the most exciting and thrilling moment of my life. It was as if the lights had been switched on and suddenly I realised I had been living in the dark without knowing it.
Four weeks after starting Adaptation practice I was back at work firing on all four cylinders. The same people, the same politics, the same issues, the same doubts were all there but I had changed and was no longer phased by them. I could cope and I had become immeasurably stronger.
Now, all these years later, I would describe it like this: when upset it is to be upset but not to be overwhelmed by it; when annoyed or angry it is to be annoyed or angry but not to complain or lose our temper; when saddened or depressed it is to be sad and depressed but not to slow down, withdraw or collapse because of it; and when frightened or anxious it is to be frightened or anxious but not to try to hide or run away.
Adaptation practice is the opposite of passivity: it is at all times active and engaging. I am sure I have been a far better doctor, husband and father because of this and I can say so because my patients, colleagues, staff, wife and children all tell me so.
LB June 2009 London