JOY AS MEDICINE
Vol 6 #4
Caroline Giroux, MD, FRCPC
University of California Davis
After reading a first, 1500-word iteration of the article I believed I should be writing, I started feeling uneasy, bored, and worst of all, joyless. Since then, I have been haunted by the dilemma of writing the unnamable that needs to be told versus writing what I think others would like to hear. Even when I prepare lectures, I find myself crippled with self-doubt, knowing too well my bold style stemming from the overexcitement of recent revelations might shut certain people off. Would saying more about the intimate context of a particular topic one chooses to address make the statement less offensive? Context means the personal story behind it, the fertile ground for the intellectual nutrients. Even when the life details attached to the main topic seem too trivial, the message can still have value. Well, here are some meanderings that led me to make joy my daily life goal.
It might have started anywhere, for instance on a quiet walk in the woods or on the day on call in the ED when I fell in love with her salad. It is as if I was noticing kale for the first time. My dedicated intern, also very health-conscious, had probably no idea that her choice of lunch would cause such an imprint stipulating that not eating curly dark green at least once a week would mean missing out in banking some extra years of high-quality life expectancy. She also happens to be a very nice person, so chewing on kale gives me anti-oxidative joy because of the pleasant association. I started noticing that the experience of admiring someone fills me with gratitude to have crossed path with a being who could teach me how to lead a healthier, fuller life. While feeling often lonely in a world at odds with my meditative nature, I relish listing those founding moments. They elevate. As I have been keeping an inventory of my deep goals (peace, equality, spiritual growth etc), I began dreaming that our field would go out of business. Why not? After effectively preaching this new gospel, trauma will be more easily healed and prevented…
A free fall in absurdity can be interrupted. I can still shut the door of an appliance after I decide to refuse this recurrent metaphysical war with the family refrigerator that always seems frighteningly packed. No one forces me to keep my eyes open when I enter my kids’ rooms filled with a grotesque quantity of Legos, or the disaster of a garage saturated with tools or camping gear and where there is room for everything but a compact car. I can refuse to open junk mail. I don’t have to engage in a pointless battle of egos. Instead, I can always retreat in my calm, decluttered, refreshing room called joy, being in awe of how children think, catching their words inventing a whimsical, improbable, beautiful world.
Actively connecting with joy has enlightened me. Among other points of entry for my self-awareness is this realization that dwelling too low in some kind of white privilege guilt after spending a day hearing about underserved patients’ horror stories would not do society any good. My own privileged and fortunate children would not benefit from seeing an existentially depressed mom, and neither any of the other children of the world who are neglected, exploited or mistreated. Later on, a physician shared a paper that aimed to make the distinction between empathy and compassion . I finally understood that I was prone to empathy fatigue. Opting for compassion, on the other hand, could make me more effective in helping others without depleting me. This eventually led me to realize that after being ignited or recharged by mindfulness, joy is a battery, a power that gives current to compassion; therefore I ended up developing this lifelong contract with myself consisting of sheltering joys at all times and all costs, having those sweet treats for the soul protected by parentheses within the long sentence of low-grade misery of life to stay connected with my well of compassion.
When I feel a wave of despair sweeping over me, I know that an opportunity for joy is somewhere, waiting to be found. There are times when I get sick of playing yo-yo with my patients’ insomnia. I wish our field would stop seeing me like an EPIC* note-writer, a controlled substance-refiller, a Duo-mobile-app-clicker, a disability form-completer or an email threat-responder! So before I develop “in-basket fatigue” from a system playing Sisyphus’ myth with me, I pause, extirpate myself from this vortex of negativism and do yoga, hug someone, read a poem, write a letter on beautiful stationery for a faraway relative, eat chocolate, do crafts with the kids or sip a good wine. Without cultivation of joy, I would have lost my sanity long ago.
Mindfulness constitutes the coulisses (or behind-the-scenes) of my life that made me discover the joy going on stage all around me, and the astounding healing power of moving away from corporation-created types of illusory happiness. Everyone can heal themselves, and I am now prescribing formally JOY or hygge (a Danish word meaning comfort, coziness or simple pleasures such as a hot cup of tea, walking in a forest etc). Hygge (pronounced hue-gah) interestingly doesn’t have a perfect equivalent in English. The closest translation would be cocooning. A Danish concept, it is about celebrating life in all its enjoyable details, as it encompasses a feeling of cozy contentment and well-being through enjoying the simple things. I would like to think of boosting joy within our profession is a noble initiative (as long as the ultimate goal is not to increase productivity), but just one part of the solution. We will experience joy in the work once we can spread the word that joy is the medicine. Joy is the quintessential approach to life. It is shattering the walls built in some parts of my soul, as I sing “The Power of Love” convincingly since I have fallen in friendship with you.
Joy makes anger and other self-destructive emotions shrink. Laughter boosts the immune system. And I am sure humor is part of what helps people heal in the group therapy I co-facilitate for survivors of trauma. Joy is free, contagious and eco-friendly, such as when my youngest son hugs me as he exclaims that I smell like cookies (while others in my household usually complain about the fragrance of my vegan, body lotion bars). It is right there waiting to be harvested: in the luminous smile and colorful bravery of my trainees who dare to be themselves in a system field that has cooki-cutter expectations of their path. It is an unlimited resource, unlike happiness which, in its constitutionally sacred pursuit and when associated with an egocentrically corrupted notion, tends to create competition and to divide people: the haves and have-nots, the famous and the low-profile, the privileged and the stigmatized. Joy is an expression of our freedom, something directly connected to one’s essence and that no one can take away from us. Joy allows us to touch eternity, wrote Frédéric Lenoir . Not surprisingly, joy helps us access a form of spirituality.
When we are not in the moment, oscillating between ruminations over the past and obsessions over a future that is not even there or guaranteed, we are at risk of missing out on the hummingbird of joy that creates a sense of awe towards nature and life. Being a joy-pollinator in the garden of the world helps us find the real happiness, the one not occurring in isolation from others but the one that is driven by compassion and sharing.
The active process of letting go of control (mindfulness) opens up a space to welcome good stuff. And once you truly experience joy, the instant seems bigger or eternal. It seems like nothing else matters. The preoccupations pertaining to the ego and falling into the category of what Johann Hari calls “junk values”  (such as fame, money, control) dissolve in its presence. It is also a shield to toxicity. A safe addiction, it keeps the destructive ones at bay. I have patients going through draining challenges: alienating relationships, corrosive breakups, workplace abuse (I am very disturbed to see that there seems to be more of that!!! Is the self-centered quest for the corrupted concept of happiness at the root of such corporate brutality?) etc. When they are currently stuck in unescapable circumstances, I ask them to tell me what gives them the most joy, and then invite them to preserve those moments. Just like we need to wear sunglasses to protect our retinas from UV rays, seatbelts in a car, or a helmet when we bike, we must protect our ability to experience joy.
For instance, if you anticipate a painful discussion with someone, make sure you have your special self-preservation moment of joy that day, and make it untouchable and non-negotiable (chatting with a friend, doing yoga, hugging your child at bedtime, reading a captivating book). Then, focus on that moment to come and anticipate the bliss. While in it, notice the pleasant experience and stretch it. Something shifted in me when I started approaching life that way. If everyone could practice this, my clinic hours at work would suddenly become available for other things, like creative endeavors, for the sake of bringing more of my authenticity to the world. Patients would no longer need to ask for a pill to cope with their moods or insomnia. The world would be a much better and more sustainable place because people would all be empowered from knowing about their sacred haven. Once they gain that insight, they can access compassion, this infinite source of connection and positive energy between all people.
Maybe my current mission as a psychiatrist is about questioning the usefulness of this very field I embarked on decades ago and inviting others to unlearn. It is now a compass serving to point possible sources of healing to people we encounter, to remind them that they already possess the key to their problems, inside. After all, if one assumes that the goal of existence is evolution of consciousness, and if my specialty doesn’t work in that direction, who will? Once we are out of business, I will see this as a sign that this transformation took place, inviting my trajectory to adapt to this positive turn of events, looking for new challenges that are even more aligned with my authentic self. This will mean extra time to savor the joy of creativity and while leaning on this pillar of truth, maybe even touch eternity.
*EPIC: electronic health records used at my institution
- Ricard, Matthieu. From Empathy to Compassion in a Neuroscience Laboratory. From: “Altruism: The Power of Compassion to Change Yourself and the World”, Little, Brown and Company, 2015.
- Lenoir F. La puissance de la joie. Fayard; 2015 Oct 14.