The more I think about it and talk to thoughtful friends, the more I find uncertainty and lack of control at the foundation of the majority of stress and suffering I observe in our fellow humans.

In terms of health, more and more information from commercial blood tests and imaging can be known, but the utility and predictive value of all that extra information is still too often unclear. And so we spiral, worrying about the uncertain future and looking for more tests and the latest ‘hacks’ to ensure the outcomes we want. Capitalist Medicine, as I think of it, preys on our worries, offering test after test without regard to sensitivity, specificity, or predictive value. Too often there is zero clinical consultation before or after people fork over hundreds or thousands of dollars, with minimal explanations for the meaning of ‘green’ or ‘red’ range results. Overloaded and burned out physicians get inundated with messages from worried patients; precious time, energy, and resources are thus expended for unclear and sparse benefit. In time some of these tests, applied specifically and with strong evidence, may help a lot of people. What do we do in the meantime?

Follow Brad Stulberg for evidence-based and practical advice on cutting through hype and sticking to what works. Focus on the basics: Sleep, exercise, nutrition, stress management, and relationships. I emphasize relationships because it’s more complex than we want to admit, especially relationship with self, which is basically self-awareness and self-regulation.

What if we’re already great at sleep, exercise, nutrition, and self-regulation, and we’re still anxious, still ruminating more than is helpful on a future that we ultimately cannot control? How do we get to peace with what is, and stop over-worrying about what could be negative, revel more in what is and could be positive? For more and more of us, life feels VUCA: Volatile, Uncertain, Complex, and Ambiguous. Naturally then, we seek stability, certainty, simplicity, and clarity–we grasp at what comforts–even if it’s false. So how do we get to real, true peace with it all?

That’s the inner work, my friends. It’s different and unique for each of us. Whether it’s family of origin stuff (for so many of us), other trauma, or something else (many somethings!), our patterns of anxiety and compensatory attitude and behavior don’t come from nowhere. And we all learn to carry our anxiety, trauma, etc. in our own dys/functional ways. Look at us, getting through life, getting sh*t done, holding it together the best we can! Good on us, FFS!

My wish for us all is that at the end of our lives, whenever and however it happens, we can each feel vastly more peaceful than regretful. That in those last ten minutes, we can look back and feel satisfied that we lived according to our values, spent our time, energy, and resources on worthy causes and connections, and can leave this mortal life with serenity. I have written before that in order to die at peace, I need to live in peace. That means living as comfortably as possible with uncertainty and lack of control, because that is what life is. I don’t mean that we should never feel anxiety, never acknowledge adversity, lose a little hope sometimes, and rail at what enrages us. I want for us to embrace all of it, allow the intense and difficult feelings, move through them (or let them move through us), with the confidence that we can handle it all, get to the other side of anything, and even gain a little wisdom in the process. I think it’s this confidence and security in ourselves and our connections (because we all need help, whether we admit it or not) that helps us make relative peace with uncertainty and lack of control.

Talk therapy
Somatic psychotherapy
Meditation of any kind
Breathwork
Martial arts
Prayer
Spiritual discernment
Mindfulness practice
Medication
Music
Creativity
Bibliotherapy
Walkabout
What else?

I wrote to a patient recently, “I will continue to look for ways to ease your worry.” This is my work. Every conversation informs and educates me on new possibilities, other ways I can help. We go together, my patients, friends, and I, exploring and co-creating according to our values, goals, and aspirations. I do my best not to judge anyone’s anxiety and worry, even as I observe the suffering it causes.
We all have our own unique burdens to carry in this life. Whatever we can do to lighten one another’s loads, let’s find a way to do it, yes?