Wednesday, February 16, 2011

Question of Control

On Wednesday afternoons I volunteer for a program called Cooking Matters that offers cooking and nutrition classes for low-income communities. This month I've been teaching the nutrition component of a class for Spanish-speaking adults, many of whom have diabetes. The participants are curious and motivated and ask so many questions I'm never quite sure if I teach the lesson I planned but somehow this class is always the highlight of my week. Today we reviewed many of the lessons we've learned together and when it was over I walked out with one of the members of the class. She expressed how sad she was that our class would be ending soon. She had learned so much and her blood sugar, which had been in the 500-600 range, had dropped week after week, as she changed her diet and prepared the meals we'd covered in class. This morning, she said, she didn't know whether to laugh or cry or thank God when she tested her fasting blood glucose and it was 84. She left me with these words: "my life changed when we were talking in class and I heard the words 'you have control over your body.' That was it for me. I cleaned out my fridge and stopped my snacking. My blood sugar came down, I lost inches and I feel better." Teaching personal responsibility can be a very empowering tool to help people get over the obstacles that prevent them from taking steps toward improving their quality of life. I have seen it and experienced it myself. And yet, when I got home today I read this powerful piece by a rabbi of mine in Seattle who wrote very convincingly that surrendering complete control is a spiritual practice necessary toward improving one's quality of life. So which is it?

As anyone who has ever tried to change his/her diet knows, the belief that the consumer/eater/dieter is in the position to make and uphold such decisions is of the utmost importance. Believing oneself in control enables a change in behavior and the commitment to maintain it. At the same time, in the cosmic sense, the need for control will constrain and restrict one's ability to fully engage with others, to be vulnerable and, perhaps most importantly, to cope when things don't turn out the way we hoped, wanted, expected. So are we in control or not?

First it's worth distinguishing between losing control and letting go of control. Losing control assumes that we once had it, that we are in control of our lives, our fate, our destiny while letting go of control is a choice to cede the need to know, to dictate, to approve, to higher powers and to instead determine how to flow with what unfolds before us. Letting go is not a passive state of simply allowing life to happen - I think of it more like the (perhaps dated) video game Tetris. We can't choose what pieces fall, but we can determine how to make them fit correctly. We have the power to shift the pieces around and move them to the right place. In this sense, then, we can exercise a degree of control and are active agents in our lives.

Eating right and exercising are all within our control. This is a message I hope to convey to patients for years to come. And yet, it does not insure that we will not develop cancer or get struck by a car or fall victim to an unfair outcome. But surrendering to that which is beyond our control while living by the ideals that are within it creates a liminal space where this tricky balance of life can dissolve into a graceful dance, a deceptively seamless routine that appears rehearsed, as though it were meant to be.

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