How To Be Sick . . . Again!

Toni Bernhard has just published a second edition of her classic How To Be Sick, or as I like to call it: The Book That Will Make You A Better Human. I have relied on How To Be Sick since it was published in 2010, and I am pleased to tell you that the second edition is even better.

To be fair, I should say that Toni is one of my closest and most beloved friends. I am honored to appear in the new edition twice. I’m not necessarily an impartial reviewer, but I genuinely believe that this is a wonderful book.

Toni did a lot of rewriting and expanding of the original How To Be Sick for this second edition. She writes that she “had no idea that what began as a collection of notes to myself about how to make the best of living with chronic illness would turn into a book with a worldwide following.” One of the amazing things about Toni is that she has engaged with her ever expanding audience on a daily basis, listening to concerns and answering questions. She has also continued to learn from her own experiences, which unfortunately included breast cancer in 2014.

The new edition reflects many of the things Toni has learned. She has also expanded material for caregivers, and uses language that is more inclusive of people with mental health issues. Toni explains many concepts in greater detail, and uses fewer Buddhist terms, in order to make the book more accessible to a general audience.

One of the most significant upgrades in the new book is the addition of nine new practices: Disidentify from Your Inner Critic, and Crafting Phrases that Directly Address Your Suffering (chapter 8); Giving In Instead of Giving Up, It’s okay if . . , and Try Mind (chapter 9); Take a Break from Discursive Thinking, and Three-Breath Practice (chapter 13); and Doing Nothing, and Pacing (chapter 14). She has rewritten and expanded many more. With all the new material, it’s impossible for me to discuss all the changes.

How To Be Sick is one of my reference books, and I have turned to it many times. Yet when I read this new edition, I was struck by a powerful realization: This book is an antidote to the ways we increase our own suffering by desiring something different from what we have or are at this moment.

Here is what I mean by increasing our own suffering. My internal soundtrack goes something like this: “I don’t want to be in pain. I should not eat that. I should call So-and-So, even though I just want to nap. This house is too cluttered. What are we going to do about health insurance? I want to go for a walk!” Each of those statements is an aversion (to pain), a self-criticism (food, obligation, clutter), a worry (about insurance), or a desire (to go for a walk). And by running that soundtrack on an endless loop, I am increasing my suffering at every moment. I can’t force my pain to go away, or magic myself into enough wellness to go for a walk. I can take steps to address worry or self-criticism, but I can’t will health insurance or clean clothes to appear out of thin air. How To Be Sick is not a magic cure, either. Yet I found that several of the new practices can help lessen my self-imposed suffering.

First, there is my inner critic. I have gifted her with a megaphone and spotlight, and I usually accept her running commentary without question. Toni points out that, “You’ll recognize that the critic is present because you’ll hear the words should and shouldn’t, and you’ll realize that you are directing blame at yourself.” Toni suggests that one way to Disidentify from Your Inner Critic (pages 65-66) is to imagine the Critic standing on stage as she speaks. Hoo boy, when I did that I wanted to storm out of the imaginary theater! I have found that changing my thinking patterns sometimes requires just a quick image or check-in to remind me to shift my outlook. Now that I occasionally check what the Critic is shouting from the stage, it is much easier to tell her to change her monologue (or just shut up already).

Another quick check-in is the Three-Breath Practice (pages 128-129). It is super short and super easy: focus on the physical feeling of three in-breaths and three out-breaths. This is grounding, and it breaks the cycle of whatever soundtrack is playing in your head. I especially like Toni’s suggestion of using it to help with Pacing (pages 142-144). Toni points out, “The reason that some of us tend to ignore pacing . . . is because being active distracts us from our symptoms; it keeps us from tuning in to how our bodies feel.” I don’t know if she had me in mind when she wrote that, but it describes me perfectly. Three-Breath Practice helps me check in with my body, good or bad, and also gives me a little detachment to make a more conscious choice about activity and rest.

There are so many gems in How To Be Sick. My favorite in this new edition is what Toni calls “Try Mind” (page 95). As we try new practices or ideas, or as we try to navigate chronic illness with equanimity, Try Mind says, “I tried to do this today, but I couldn’t. That’s ok. I will try again tomorrow.” This does not let us off the hook at all because we still have to try. But Try Mind gives us room to experiment, to evaluate how well an idea fits us, and to stumble as we move through life.

This forgiving approach to our personal difficulties is so typical of Toni. As her daughter Mara wrote, “If you think she sounds like a person you would want to be friends with when you read her writing—it’s because it’s true.” I have written about Toni’s work multiple times over the years, and something I wrote in 2013 is also true about the new edition of How To Be Sick: “Toni’s writing feels like a friend reaching across the table to pat your hand and offer advice. There is no preaching or judgment here.”

You don’t need to be sick, or a caregiver, or a Buddhist in order to learn from this book. Most (if not all) of us will be sick or a caregiver at some point. We all face change and loss and suffering. We all go through times when we wish for something different or criticize ourselves. When that happens, How To Be Sick can help.

Toni’s compassion and gentle wisdom, and her practical approach to easing our own suffering, is indispensable. Yes, she is my dear friend, but I would say the same thing even if she were not. If I could, I would buy copies of this book for everyone. I highly recommend How To Be Sick as a tool to help you be better.