Understanding the importance of Living in the Here-and-Now
By Grant D. Nelson, PhD
Is the present always going to be less than for the ostamate (i.e., one who lives with an ostomy)? This seems to be one of the more difficult concepts for those of us with a chronic illness to understand and accept. Yet, in the same manner we can ask, why should it be easy to understand or natural to accept? Regardless of where one resides on this planet, the universal message varies little,“success and happiness are virtues that are there for the taking…all that is required of you is to stay busy through multitasking and to keep looking to the future where all your hopes and dreams will come to fruition”.
The problem with this axiom is that it keeps one very distant from knowing themselves. It leaves us feeling alone and it leaves us feeling anxious when we are alone. However, and this is important, life happens in the here-and-now. It is only in this present moment that we are able to embrace all that is good as well as to have the strength to fight all that ails us. When we long for those days when we were healthy (healthier?) and free of our ostomy; or when we get lost in the future waiting for a cure (or at the very least an improvement in our health, possibly even, with the hope that we may be reconnected), we become lost to this moment.
If we label the past or the future to be better, then we must ask ourselves, “Better than what?” In so doing, we must accept that we are giving-up, or running away from the present moment; and thus, the here-and-now becomes something less than. Loneliness sets in. Fear and anxiety take over. And either a sense of hope or hopelessness begins to govern your emotions. The direction or camp that you fall into generally depends on whether you are you a half-glass full or a half-glass empty type of person. Are you an optimistic and hopeful type of person, or are you filled with pessimism and hopelessness?
In a Brief Report taken from the journal, Health Psychology, Smith, Loewenstein, Jankovic and Ubel (2009) looked at whether or not a belief that an adversity, in this case, getting a temporary versus a permanent ostomy would influence how the individual would experience that adversity. That is, would the knowledge of this adversity take away their hope for a better life, or would it improve their mood and belief that their life was going to get better. The study looked at patients who had just received a colostomy or an ileostomy, divided them into two groups based on whether or not they were receiving a permanent or a temporary ostomy, and then followed them for a period of 6-months. From a perspective of general models of adaptation (Diener, Lucas & Scollon, 2006) one would assume that negative thoughts and reactions to a adverse event would decline over time. In essence, as time went on, an individual would become more comfortable with their ill fortune, and thus, their quality of life would improve.
Interestingly, their findings showed that those who had a permanent ostomy were quicker to accept the adversity and report an improvement in their quality of life at the end of the 6-months. This “…idea that hoping one’s circumstances will improve can impede adaptation suggests a paradox:
people who are objectively better off, because they have reason to believe their circumstances will improve, might be subjectively worse off, because this hope impedes their ability to adapt to their current circumstances” (italics in original, Smith, et. al, p. 788).
I would submit to you that the reason for such a paradox resides directly in my assertion that the very idea of hope removes you from the here-and-now. The word hope is, by its very nature, a futuristic concept. It implies an expectation for a desire to occur with a reasonable expectation that it will happen, at some point in the future. This raises an interesting question about the relationship between the idea of hope and the struggle with a [chronic] illness. Indeed, it challenges the general concept of hope, and how it influences the way we live our lives. It begs the question of whether or not these two can exist together, in harmony? That is, can one hope, and simultaneously live in the present moment?
Diener, E., Lucas, R. E., & Scollon, C. N. (2006). Beyond the hedonic treadmill: Revising the adaptation theory of well-being. American Psychologist, 61(4), 305–314.
Smith, D. M., Loewenstein, G., Jankovic, A. & Ubel, P. A. (2009). Brief report: Happily Hopeless: Adaptation to a Permanent, But Not to a Temporary, Disability. Health Psychology, 28(6), 787–791.