My daughter took this photo while we were walking in the fresh spring air recently. "You should use this photo on your blog," she said. "It's how you really look everyday." And so here it is.

Today I came across a “Thought Challenge” from meditation teacher and writer Jack Kornfield, whose work I so admire. Kornfield talks about separating ourselves from our tightly gripped sense of our “self,” and seeing what happens.

Selflessness, Kornfield teaches, is not about seeing “how selfless I am.” It’s about stepping away from identifying everything as “me” or “mine.” Selflessness, he writes, “does not reject our experience in any way. We don’t get rid of anything. The experiences are the same…. All that’s changed is that we have stopped identifying with them….When identification with the small sense of self drops away, what remains is the spacious heart that is connected with all things. The Wise Heart.”

I am always in search of my Wiser Heart. So I was drawn to Kornfield’s suggestion to try this practice — to notice what happens when we stop identifying so tightly with our sense of self and me-ness. Here is his challenge: “Try today to study the sense of self. At regular intervals, pause to check in and notice how strong the sense of self is. At what times of day, in what roles or situations is it strongest? How does your body feel then? How do others respond to this? What might happen in the same situation without a strong identification with the self?”

So I did try it. I wanted to challenge myself to note in what situations (and, for me, with which people) my sense of self looms strongest. And the exercise proved so profound I felt I had to write about it here, and share what I found.

Trying this exercise helped me to have a difficult conversation with a person I often find to be trying in my life — and to handle that interaction with a wisdom and grace I had been unable to find within … until I tried Kornfield’s exercise.

The person with whom I was interacting has a good heart but also has what I like to call “Oppositional Conversational Disorder.” Have you ever met anyone like that? I’ve found that whatever I say, this person disagrees immediately, often before my whole sentence is out of my mouth. Call it conversing in a Culture of No. For instance, I say, “I was thinking…” and this person says, “Oh no, that’s not how it works…” And if I say, “That made me sad…” this person says, “Oh no, you shouldn’t feel sad.”  This person is wedded to “no” and “it isn’t” and “don’t” and “but” and “shouldn’t” and argues so reflexively it’s a habit of mind that has permeated their very nature.  But this person is also a good person, a really really good person, just not an easy person to have a meaningful conversation with, because “Oh no” or “Don’t” proceeds every sentence they say.

So I tried it. I tried letting go of my sense of me, my point of view, my being right, my… me-ness. As this person’s Oppositional Conversational Disorder reared its head and they said “Oh no it’s not because of…” I took note of how my jaw tightened. They said, “You didn’t” and my upper palette locked down on my tongue. I heard, “You shouldn’t” and a band tightened around my chest. “Don’t do it that way…” The muscles in my thigh tightened. I took a mindful breath. Look how tightly clenched my chest feels, my legs, my throat.

I replayed Kornfield’s question in my mind. “What might happen in the same situation without a strong identification with the self?”

I reminded my “self” that I am not my thoughts. Indeed, new research tells us that our feelings shift every 90 seconds.

I asked myself, Why am I identifying so closely with my sense of self, with having myself be heard and be right — when I don’t even really know what “self” is? When I know my thoughts shift every 90 seconds?

If I am not my thoughts, if I am not my ever-changing feelings, including this feeling of irritation and frustration and anger that now threatens to overwhelm me, what is my “self?” And why is my “self” reacting so strongly to what another person is saying that seems to be in judgement of “me” if that self is not real?

Gosh, I hope that makes sense.

By interjecting the question, I could step back.

This was such a freeing experience. I began to breathe. My jaw relaxed. The bands around my chest fell off. It felt so freeing. When I stepped back from that strong sense of self that I had been nursing as I heard “don’t” and “shouldn’t” I felt something else. A bubbling up of awareness. I am not my reactivity. My “self” is something much larger, much wiser. For a moment I had to hold back my sense of inner glee, and keep from laughing out loud – not at my conversational partner, who was still talking, but with the freedom I felt within.

I highly recommend trying this. In the midst of your next difficult interaction, especially if it is with someone with Oppositional Conversational Disorder, let go of your tightly held sense of “self” in your conversation. See what happens.

Here’s what happened to me. The person I was talking to stopped. They breathed. My oppositional conversational partner just looked at me after ten more minutes of conversation or so and said, “Oh, okay.”  Two words they had never said to me before.

To let that strong ID with self go during that difficult interaction changed its outcome.

I have so much left to learn.

It was when my own physician, Dr. Anastasia Rowland-Seymour, at Johns Hopkins, said this to me that I began to understand how important my own inner dialogue was to my state of well-being

What is the direct relationship between letting our mind drift — ruminating about the past, worrying about the future, focusing on distressing thoughts, what’s going wrong, what isn’t fair, or what we’re afraid will happen next — and our cellular and physical well-being?

Although we can’t peer inside our cells in real time and see how mindful calm versus a racing mind have radically different health impacts, a new study published in the journal Health Psychology, sheds new light on the question. Researchers at U.C. Davis Center for the Study of Mind & Brain have conducted the first study which shows the direct relationship between using our mental resources to manage ruminating thoughts and stay with our immediate experience — and lowering our levels of the inflammatory stress hormone cortisol.

High levels of cortisol, a hormone produced by the adrenal gland, are, as we know, associated with physical or emotional stress. Prolonged release of the hormone contributes to wide-ranging, adverse effects — and are linked to every physical and mental disease imaginable.

Sometimes it helps me to remember what “stress” really is.  Stress is really a euphemism for our thoughts. Our racing, self-flagellating, ruminating, resentful, could-have, should-have, wish-I-had, wish-I-hadn’t thoughts that catch us in their trance. Or what I call, in The Last Best Cure, the “Pain Channel.”

All too often we can’t get out of the Pain Channel’s trance. We can’t turn the Pain Channel off. We keep tuning into what it has to say, and as we do, those thoughts help promote the production of stress hormones and cytokines that are, in turn, linked to higher rates of depression, heart disease, autoimmune disease, you name it.

Other research tells us that in the lab, the negative cellular impact of stress hormones look a lot like the negative impacts of the toxic chemicals I wrote about in The Autoimmune Epidemic.

So, here is my reminder equation.
Stressed State of Mind =  Pain Channel.
Pain Channel = damaging stress chemicals circulating in our body.
Damaging Stress Chemicals = what scientists call the “Negative Floating Brain.”
“Negative Floating Brain” = greater likelihood of emotional and physical health challenges.
Greater Health Challenges = more likelihood of being in a Stressed State.

This is not to say that our state of mind creates disease. That’s far too simplistic.There is so much at play — genetics, diet, environmental toxins.

But stress chemicals certainly add to our “barrel” of factors that work against physical and emotional healing. And even if moving away from the “Pain Channel” and the Negative Floating Brain doesn’t necessarily mean we overcome whatever physical challenge we face — turning down the “Pain Channel” volume can’t help but make us feel better, whatever chronic condition we’re up against. (For more on how I see that, see my OpEd for PBS’s online magazine, Next Avenue, called, “I’m Not Cured but I am Healed.”) (I really think the title should be, more accurately, “I’m not Cured, but I am Healing.”)

The practices that help us walk away from the Pain Channel and the Negative Floating Brain really do make a difference, and they are worth our time and our commitment.

For me, as a science writer, reminding myself of the science every day helps me remake the commitment to meditate, focus on mindful breathing, loving kindness, down dogging, laughter, nature walking…all of it. The science is my guide.

Post-doctoral researcher Tonya Jacobs PhD says that in the above study, researchers taught study participants attentional skills such as mindful breathing, observing mental events, and practicing cultivating benevolent mental states, including loving kindness, compassion, empathic joy and equanimity.

Individuals whose mindfulness scores increased showed a decrease in inflammatory disease-promoting levels of cortisol.

“The more a person reported directing their cognitive resources to immediate sensory experience and the task at hand, the lower their resting cortisol,” Jacobs says. She adds that training the mind to focus on immediate experience may reduce the propensity to ruminate about the past or worry about the future, the thought processes that have been linked to cortisol release.

We are all walking around listening to the Pain Channel way too much of the time. And we know that the negative floating brain damages our immune system and our cellular health.

The question is, what are we going to do about it?

In hopes that they might prove helpful, here are two upcoming offerings.

The first is being offered by the phenomenal health advocate Elisa Rodriguez, who is launching one of the first The Last Best Cure Virtual Book Clubs to discuss and encourage us all on the journey … I’ll be joining in for a one hour discussion. I’ll also be sending signed bookplates to participants. To learn more, see Elisa’s video here. I’ve spoken with her several times now, and wow, she is just amazing. The beauty of The Last Best Cure Virtual Book Club is that you can join from wherever you are, and Elisa has found a way to make it easy and accessible to all.

The second is an upcoming retreat by my own beloved teacher, Trish Magyari, whose work I feature in The Last Best Cure. Magyari will be teaching a one day “Befriending Yourself” Mindfulness Retreat” on Saturday June 15 at Baltimore Yoga Village in Mount Washington (Baltimore, Maryland) from 1-5pm. Trish is a life-changing teacher. If you can take this opportunity to work with her, do.

I hope to hear from you about your own efforts to stay on the path.  What is working for you today?

I treasure meeting my readers — there is nothing, really, that I love more about what I do than that moment of connection when I meet readers face to face. You all humble me, in the way you meet your own challenges with such grace and dignity and humility and determination.

Yes, women with chronic conditions may be fatigued, but I find my readers to be an extraordinary force of nature.

Like many of you who have chronic conditions, lots of travel can be hard on my system. That, coupled with my keen desire to be fully present on the homefront with my teenagers as much as possible (my oldest leaves for college in the fall!) means I can’t plane hop as much as I’d like to to meet the wonderful groups of amazing women who are gathering to talk about The Last Best Cure from Albany to Chicago to Vancouver. But that doesn’t mean I don’t want to be there.

So, here’s my offer. If you are planning to read The Last Best Cure for your book club, and gather a group of say 10 women or more who are reading the book, I’ll “drop in” by Skype or speaker phone or whatever works best for you — and we can have that “small group chat.” I’d love to.

And since it’s nice to have signed books, I’ll send signed The Last Best Cure “Book Club Bookplates” to book clubs (like all bookplates, they adhere to the page) so you’ll have author signed copies.

Let me know what you think of my virtual book club tour idea! Any ideas to improve upon this concept? I’d love to hear.  If you reach out to me and let me know you’d like to schedule a date, we can follow up by email.

In hopes of helping more women who suffer from autoimmunity have even more resources in their toolbox, I’m partnering up with AutoimmuneMom.com, a website for moms struggling to manage their autoimmune conditions while raising kids. Autoimmune mom Katie Cleary founded the website as a resource for other mothers who are trying to sort out the challenges they face when coping with multiple autoimmune diseases. Katie is helping moms with autoimmune disease to find a “new normal” in as many areas of their lives as possible. I wish her site had been around when I faced my first diagnosis (and my kids were ages 4 and 1).

The website has just launched their Get Answers Giveaway Spring 2013 —an opportunity for those with autoimmune disease to ask and answer questions, and win a terrific prize collection, including the work of three of my esteemed colleagues, as well as my new book, The Last Best Cure.

To help facilitate more community sharing on the latest research, and support and insight on managing symptoms and flares while raising kids, betwee April 15 through May 14, 2013, any visitor who enters a question or answer on the site will be entered to win a pretty cool prize package of critically acclaimed autoimmunity books.

My fellow authors and I are helping to spread the word of the Get Answers Giveaway in the hopes that more moms will find the help they need.

Here’s more information about the four books in this one-of-a-kind giveawy. For more information, visit the contest landing page.

• The Last Best Cure, by Donna Jackson Nakazawa
  Hopefully you know all about my book by now!

• Anti-Inflammation Diet & Recipe Book, by Jessica K. Black, N.D.  The connection between inflammation and chronic ailments has become increasingly clear. Food allergies and poor dietary choices over-stimulate the immune system and cause inflammatory responses that erode the body’s wellness. Jessica Black shares a complete program for how to eat and cook to minimize and even prevent inflammation and its consequences.

• Living Well with Autoimmune Disease, by Mary Shomon   A complete guide to understanding the mysterious and often difficult-to-pinpoint disorders of the immune system—and finding the keys to diagnosis, treatment, and recovery including natural and alternative therapies.

• The Autoimmune Connection, by Rita Baron-Faust and Jill Buyon, M.D.  From determining which tests you need to finding the right doctor to living with autoimmune in different stages of life, this book is a complete resource.

Readers can visit http://www.autoimmunemom.com/questions, to enter a question or an answer, and be automatically entered to win.

Good luck!

The piece will focus on what friends need from their friends when they are facing a chronic condition — whether it’s lupus, fibro, RA, Lyme, MS, you name it — or a more acute situation, such as cancer. My hope is to give women who are ill a voice to talk openly about what serves them best when they are sick, and how friends can say and do the most supportive things. And to also help all of us who have a friend who is ill to be the best friend we can.

We all know this is tricky territory. It’s hard, when someone is ill, to know what to do and say without saying or doing the wrong thing. Who among us who has faced chronic illness hasn’t seen both sides — the friend who was there, making our kids grilled cheese sandwiches without our asking them to, or the one who came and got our kids dressed and drove them to school every day without ever once talking about her own busy schedule? Or who simply sat by our bed and asked, “Hey, what kind of day is it for you today?” And we have seen the opposite, too. The well-meaning friends who said insensitive things. Maybe we’ve learned a lot about who our friends really are by how they behaved when we were really ill.

It’s not easy to know what to say and do when someone we love is sick or seriously ill, and when we are sick it’s hard to know how to ask for what we need. As s a society we’re just not all that comfy having conversations about illness openly.

We also know, and studies show, that having warm, caring friendships is good for our immune systems. It helps us both physically and emotionally to have strong ties.

This piece will explore all this and more.

So, in order to make the piece as rich and honest as it can be, I’m looking to interview some of my amazing female readers who fit MORE’s age demographic (between the ages of 40 and 60) who are also facing chronic or even quite serious chronic conditions. If you are interested, and are between 40 and 60, reply below just to let me know a bit about what you’re facing physically (a sentence or two will do), and whether this topic is something that’s been on your mind, and why. I’ll reach out to you to discuss more.

Thanks readers! Oh, and you can read my previous two part feature on how illness impacts the lives of mid-life women here: “Ill in a Day’s Work” and “How a Marriage Survives When One Partner Gets Sick.”

I so hope you’ll check it out, and that you enjoy. Links below!

I’m Not Cured, but I Am Healed

After years of pain and chronic illness, an author finds relief through breakthrough research on how the brain affects the body

The way we manage our thoughts right here, today, determines how we'll feel -- and whether we'll suffer from depression and anxiety -- ten years from now. The best way to stay on a healthy path? Redirect your negative emotions today by learning to mindfully manage your thoughts.

The way we manage our emotional responses to the stresses we meet in day-to-day life  — to what is happening right now, right here, in our life — predicts whether we’ll suffer from depression and anxiety ten years from now, says a new study in today’s Psychological Science.

Researchers examined the relationship between how we handle daily stress and our mental well-being ten years later. They found that our longterm emotional health has less to do with what happens to us than with how we react to what happens to us.

The better we are at managing our emotional responses and thoughts today — to whatever problem we’re facing at work or at home or with our kids — the better mental health we’ll enjoy ten years from today. The better brain we’ll own.

When we respond with a lot of negativity and reactivity to our day-to-day stressors we’re more likely to be clinically depressed ten years later and experience feelings of “worthlessness, hopelessness, nervousness and anxiety.” We take those negative emotions with us, wherever we go.

These findings, based on a study of 711 men and women between 25 and 74, show that mental health outcomes aren’t only affected by major life events — they are also affected by the “chronic nature of our negative emotions in response to daily stressors.”

We know there are so many ways to manage our thoughts and get off the distress highway — and stay on the path. Mindfulness, lovingkindness meditation, noting our moment to moment habits of mind, breath work, yoga, seeking out acupuncture.

In The Last Best Cure I spent an entire year learning from the best experts on the planet how to redirect my thoughts, calm my mind and quiet my stress response. And every day I continue to learn. Reading studies like these helps me to re-commit to these practices everyday.

Because that’s what it takes. It’s not instant. It takes work. Discipline. But it’s also fun. It’s a relief to step away from our daily wear-and-tear stress-reactions and ruminations. A half-hour spent mindfully breathing or in walking meditation or yoga sure beats a half hour spent ruminating and rehashing the should haves and what ifs that are worrying me today, and it will pay off long into my future.

Don’t we owe ourselves that small but priceless investment in who we are, and in who we hope to become?

My son, in the woods on a family walk. The Japanese call it Forest Bathing. It's so good for our cells.

This past Easter weekend, we spent many afternoons in the woods, walking trails, going on photo expeditions. My husband, son and daughter and I are great lovers of what I call “green music” — the music of the rustling trees. We all enjoy the hum of how nature nurtures.

I think for most of us that’s true. Research tells us that our cellular responses in nature are very different from those we have when we are in urban settings.

We used to live in Japan, where physicians sometimes prescribe 20 minutes of Shinrin-yoku, or “forest bathing” – for patients facing chronic conditions. In the United States, when many of our first hospitals were built, they included a sunroom or “solarium” where patients could view nature. The instincts of both Japanese physicians and early architects of American hospitals were spot on. Patients who enjoy a view of nature and trees heal more quickly, spend less time in hospitals, need fewer pain killers, and have less post-op complications than those in an urban setting. In our day-to-day lives, when we seek out “nearby nature” we tend to be healthier overall, and feel greater life contentment and satisfaction.

It makes sense. Immunologic studies show us that a walk through a forest pumps up our parasympathetic nervous system and suppresses the sympathetic nervous — or stress-now system — for hours and even days. We do better on memory and attention tests after walking through nature. Immersing ourselves in nature results in lowered levels of inflammatory markers linked to virtually every disease from depression to back pain to autoimmune conditions to cancer.

A crocus, a Vinca vine flower we found on the path.

I often take walks during my writing day, and today, I felt the first fingertips of spring playing across the daffodils and crocuses outside my window, as if it were touching my cells. I called the dogs and headed out the door. I felt a lot of the worry and stress I’ve been carrying around with me (book tour is very fun, but also stressful) fall away.

I’ve been catching my thoughts a lot lately: my worry about whether I’ve been doing enough promoting, social media, and book readings to spread the word about The Last Best Cure (I love doing book readings, but am not that great at social media!).  Worry about getting going on researching the next book (it’s a critical topic… stay tuned!). Worry over my stamina between book tour and organizing Easter (this year, we had an unusual Easter egg hunt for all of the grandparents — those aged 75 and up got to play! Now that was fun, watching the grandparents hunt for eggs in the garden on Easter morning, laughing like children with baskets in hand!). Worrying if my kids were getting short-shrift as I travel around.  And thinking about the reality of college next year, and what it will be like to have my son be so far away.

A carpet of yellow and green..

I did a walking meditation under the budding trees. I listened, really listened, to the green music. I felt the life rising beneath my feet. Something very different began to fill me as I gazed out at the green ground cover and flowers starting to sweep the hills and fields like a carpet, leaping over the rocks and lichen and between the Jack in the Pulpit and beneath the fallen trees.

I thought of something my son used to say when he was seven or eight, after seeing a show on PBS about string theory. “Mom, at the very center of things, in the middle of every atom of every tree and every rock and every star and even you and me we are all just strings — masses and masses of beautiful, vibrating strings.”

I felt those strings vibrating inside me, inside the plants and trees. Vibrating in all things. For a second I thought of that oft-quoted moment from the Thorton Wilder play, Our Town. That moment when Emily asks, “Do any human beings ever realize life while they live it? – every, every minute?”

It’s so hard to do that, isn’t it?  Realize life? Green music is a portal of sorts that helps me to realize life while I live it. What works for you? What helps you to realize life while you live it? I would really like to know.

Lee J et al. Effect of forest bathing on physiological and psychological responses in young Japanese male subjects. Public Health. 2011 Feb;125(2):93-100.  Maller, C. Healthy nature healthy people: ‘contact with nature’ as an upstream health promotion intervention for populations. Health Promot. Int. 2006 March 21 (1): 45-54. Ulrich RS. View through a window may influence recovery from surgery. Science. 1984 Apr 27;224(4647):420-1. Rachel Kaplan and Stephen Kaplan, The Experience of Nature: A Psychological Perspective. (New York: Cambridge University Press 1989). Maller, C. Healthy nature healthy people: ‘contact with nature’ as an upstream health promotion intervention for populations. Health Promot. Int. 2006 March 21 (1): 45-54.  

This has been a busy week. it started with a conversation with Montel Williams on Joy Behar’s (of The View) show Say Anything, which we taped in New York. Montel is working hard to bring research funding and awareness to autoimmune disease and chronic illness, giving it his all given his own experiences with MS. We had a great chat both off camera and on. Here’s a small snippet from the show:

A photo taken after my conversation with Montel Williams on Say Anything about stress and chronic illness. Williams is doing a great deal behind the scenes to help fund research for autoimmune disease.

http://current.com/shows/joy-behar/videos/author-donna-jackson-nakazawa-describes-how-to-step-away-from-stress/

Later in the week Baltimore Yoga Village and The Ivy Bookshop combined forces for a truly special evening — a Last Best Cure Wellness Event. Several of the teachers who were integral to my journey in The Last Best Cure, Trish Magyari and Mria Tessman (if you are reading the book you know who these amazing women are) along with Anjali Sunita, treated the crowd to meditation, mindfulness, mindful movement and breath work demonstrations. Afterwards I read a few excerpts from The Last Best Cure. To present with those who’ve taught me was a profoundly gratifying experience, and I’m grateful to the many, many readers who came out and asked such meaningful questions afterwards. You make me feel so fortunate to be able to connect with you through my writing.  Here are a few photos from the book signing we held afterwards:

Signing books with The Ivy Bookshop at Baltimore Yoga Village

Anjali Sunita, Trish Magyari, myself, and Mira Tessman, last Tuesday night at our Last Best Cure Wellness Event at Baltimore Yoga Village

My writing companions, (rescue pups) Ashlie and Winnie, hope you win my Double Book Giveaway Contest! Post a review of The Last Best Cure on Amazon by April 13th for a chance to win BOTH books -- signed copies will be sent straight to our winner's mailbox!

Are you ready? Today I’m announcing my Double Book Giveaway contest!

This time, 1 lucky winner will receive A Double Giveaway Book Set: one signed copy of my new book, THE LAST BEST CURE, and one signed, first-printing hardcover copy of the award-winning THE AUTOIMMUNE EPIDEMIC. Both books!

Here’s how to enter. Post a review of THE LAST BEST CURE on Amazon. It’s easy. Just click on the Create Your Own Review icon. It will just take a few minutes to post your review and that’s it! You’ve entered!

I’ll announce our BIG WINNER and send out my Double Book Giveaway Set on Saturday, April 13th. If you haven’t read THE LAST BEST CURE yet, that gives you plenty of time to read and post a few sentences about what you thought on Amazon.

Here are some of the early comments that have been coming in via my blog and email the past two weeks http://bit.ly/Y5FwWi — so grateful to you all — if you post your responses on Amazon too you’ll be entered in the contest!