Likewise, when as patients we are confronted with illness, with the unexpected, and on the receiving end of powerful suggestions from health practitioners about our future, it is easy to turn away from ourselves, losing all sense of direction, no longer trusting our innate wisdom and navigational sensitivities. But if, in these moments, we learn to stop and be present, we have a chance to learn a lot. In these moments, no matter what our role, so much seems to be at stake, so much of our identity ripe for loss, uncertainty, or displacement. And so we often turn quietly away. This is our common habit. It is understandable, because none of us wishes to be hurt. Yet because this tendency is so pervasive, our intention, our continually renewing vow to practice being present to the full range of our unfolding lives, is an enormous resource. My own experience suggests that the willingness to stop and be present leads to seeing and relating to circumstances and events with more clarity and directness. Out of this directness seems to emerge deeper understanding or insight into the life unfolding within and before us. Such insight allows us the possibility of choosing the responses most called for by the situation, rather than those reactively driven by fear, habit, or long-standing training. By virtue of being human, each one of us is on intimate terms with not being present. Because of this, our intimacy with this felt absence is a powerful ally. This is the terrain of mindfulness practice. Each time we awaken to no longer being present to ourselves or to another person, it is, paradoxically, a moment of presence. If we are willing to see the whole of our lives as practice, our awareness of the moments when we are not present, coupled with our intention to awaken, brings us into the present. Given our penchant for absence, opportunities for practicing presence are abundant.

Meditation on the Awareness of Breathing

Meditation practice requires a disciplined, sustained effort. Yet at heart, mindfulness meditation is about care, about a willingness to come up close to our discomfort and pain without judgment, striving, manipulation, or pretense. This gentle, open, nonjudgmental approach is both merciful and relentless, asking of us more than we might ever have expected. To practice in such a way, awareness of the breath is an effective, ever-available means for cultivating presence. Find a comfortable place to sit down. Sitting on the floor or in a straight-backed chair is fine. If you are in a chair, see whether you can ease off the back of the chair and support yourself (unless you have back trouble), sitting upright yet at ease, placing your feet firmly on the floor, allowing the knees and feet to be about hip-width apart. Find a comfortable place for your hands, resting them in your lap. Try folding them together or turning the palms up or down. If you are on the floor, placing a cushion or two under your buttocks can be helpful. This will encourage your pelvis to tilt forward and your knees to touch the floor, thereby providing a strong, stable base of support. Again, find a comfortable place for your hands.

Now you’ve taken your seat.

Allow yourself to simply be with the feeling of sitting upright, solid, dignified, without pretense…settling into your seat, becoming aware of the flow of your breathing, sensing the rhythm of inhalation and exhalation, the feel of the breath coming into and leaving the body. Become aware of the rise and fall of the belly or the feeling of the breath at the tip of the nostrils or the sense of the whole breath coming in and going out. Rather than thinking about the breath, allow yourself to feel the breath—the actual physical sensations of breathing—as the breath comes in and goes out. There’s no place to get to, nothing to change. Simply be aware of the breath in the body, coming and going, in and out. Each time you notice that the mind has wandered away from the awareness of breathing, gently and firmly return to the feeling of breathing, to the tide of inhalation or exhalation. This wandering away might happen fifty times in the next five minutes. This is normal. Still, each time you notice that the mind has wandered, gently and firmly return to the feel of the breath. No need to scold yourself, no need to hold on to whatever enters the mind. Breathing. Riding the waves of inhalation and exhalation. Just this breath…and this breath…and this breath. Simply dwelling in the flow of the breath. Coming home, returning, through the awareness of the breath, to your wholeness, your completeness. Right here, right now. Try working with this practice for five to thirty minutes several times during the next week. If you’d like, try gradually increasing the length of time you devote to “formal” mindfulness practice.

Balancing the Heart-Mind

Sometimes people confuse mind in the word mindfulness as having to do with thinking about or confining attention to cognition, imagining that we are being asked to engage in some form of introspection, discursive self-analysis, or mental gymnastics. Simply put, mindfulness is bringing a fullness of attention to whatever is occurring, and attention is not the same as thinking. The Sufi teacher Hazrat Inayat Khan said, “The mind is the surface of the heart, the heart the depth of the mind.” Indeed, the language of many contemplative traditions suggests that the words for “mind” and “heart” are not different. Likewise, the artist and calligrapher Kazuaki Tanahashi describes the Japanese character for mindfulnessas being composed of two interactive figures. One represents mind and the other, heart. Heart and mind are not imagined as separate. From this perspective Tanahashi translates mindfulness as “bringing the heart-mind to this moment.” Whether giving or receiving care, maintaining this heart-mind balance is not easy. All too often we ride the extremes—either we become lost in sympathy and the suffering of another or we find ourselves coolly observing, at a distance, aloof and uninvolved. The qualities of the quiet mind are spaciousness and clarity, the source of our capacity for discerning wisdom. The open heart is tender, warm, and flowing. Together, these attributes allow us to feel deeply and to act wisely. Even when acting means doing nothing. Perhaps compassion, in the fullest sense, is the delicate balancing of a quiet mind and an open heart. There is abundant opportunity in the healing relationship for the cultivation of such a quality of presence. But what does “a quiet mind and an open heart” mean? What does this actually feel like? Even though I cannot know how this feels to you, my sense is that we have all tasted this way of being. It is elusive, yet it is not something we have to get; rather, it is something to be revealed. Something we can cultivate through paying attention. Something to be alert to, both in its presence and in its absence. For more, see Saki’s article Befriending Self