Feisty advice to patients: “Get down off your cross!”

~ Carolyn Thomas

by Carolyn Thomas  ♥ @HeartSisters

I’ve never met Debra Jarvis, but we’re practically neighbours, separated only by a few measly miles of Pacific Ocean coastline and an international border. She’s a writer, breast cancer survivor, hospital chaplain, and ordained United Church minister from Seattle – a city I can see from the shore here in Victoria. Oh, wait. That’s the city of Port Angeles, Washington. Still, I can see Seattle in the Sarah Palin sense of the word “see” . . .

I first encountered the “Irreverent Reverend” Jarvis watching her poignantly funny presentation at TEDMED 2014.  And like so much in life, when smart people tell good stories, their messages can be meaningful no matter what they’re talking about.    

One of my favourite Debra Jarvis stories was delivered to a Seattle church congregation one Sunday morning last spring (it starts at around the 4:10  minute mark on this podcast). Here’s how it goes:

Once upon a time, at the hospital where she was serving as chaplain, Rev. Jarvis was thrilled to run into a patient she hadn’t seen in over a year. This woman was accompanied by her two grown daughters for an annual follow-up appointment, and told Jarvis that she’d just received all of her medical test results back. Happily, every test had revealed what hospital staff describe as NED (“No Evidence of Disease” – (or as some zany health care staff sometimes interpret it: “Not Exactly Dead”). 

But despite this great news, within the first two minutes this patient began retelling the whole story of her past diagnosis, surgery, treatment and recovery (although as her chaplain, Jarvis had seen this woman every week for six months and so already knew every detail of her entire story). 

Yet the patient was telling her story as if it were happening to her right now, instead of 18 months earlier.

And the minute their mother started in on this story, her two daughters both stood up and said aloud:

“We’re going to go get coffee. . .”

After the two daughters had left, Rev. Jarvis looked at this woman, and offered to her this (surprising) advice:

“Get down off your cross!”

I should explain right about now that Jarvis embraces what she calls the “Three C’s” of the hospital chaplain’s code: 

  • to comfort
  • to clarify
  • to challenge

Part of the challenge part clearly includes that reference to crucifixion.

Every one of us, Jarvis observes, has likely felt crucified, which she defines as enduring any situation in life that we cannot control, or fix, or explain, or change, or maybe even understand. This could be anything that brings us undue pain including abandonment, betrayal, rejection, being misunderstood, loss, and even a life-threatening illness.

But, there are some people, she warns, who do not want to climb down from that cross.

Jarvis also wonders:

“Why do we keep identifying ourselves by our wounds?  Cancer survivor, combat survivor, rape survivor, Holocaust survivor, heart attack survivor. . . ” 

Is our emphasis on the wound, or on the survival? In the case of the woman in that Seattle hospital, Jarvis explains:

“Staying stuck in her story had served this woman. It had gotten her lots of attention. But now it wasn’t serving her at all. People kept leaving to go get coffee.

“There can be no ‘resurrection’ until we get down off those crosses and let our old selves die, do our own deep inner work and let our spirit heal us.

“Let the old story go – so that a new and truer story is born.

“Let that old self die, so a new and truer self is born.”

She’s quick to point out, by the way, that she is NOT talking about occasional venting or processing of difficult emotions, which each of us absolutely must do once in a while for the sake of our mental health.

Instead, she’s talking about not “feeding your emotions so you stay stuck”.

I can identify with that seductive appeal of stuck-ness. I admit that a number of times since my own heart attack, I too have enjoyed moments of that delicious “Poor Me” rumination. As Rev. Jarvis says, often this can actually feel like it’s serving some purpose at the time – even when it is not. See also: “Get Over Yourself: How To Stop Boring Others With Your Heart Attack Story”

I’ve written here previously about the work of psychologist Dr. Martin Seligman, the author of a book that I love called Learned Optimism. He, like Rev. Jarvis, suggests that staying stuck in complaining actually worsens physical and emotional symptoms by focusing our attention on them. and even adds that remaining stuck may also lower our resistance to illness, increase our chances of heart disease, and even shorten our lives.

Dr. Barbara Keddy agrees, writing on her excellent blog about women and fibromyalgia. Professor Emerita at Dalhousie University (and as of January 2013, also a heart attack survivor), she cites a support group of Toronto women who get together regularly, not to discuss their shared illness, but wellness only.  See also: Do You Think Too Much? How Ruminating Hurts Your Heart

Dr. Keddy, who has lived with the daily symptoms of fibromyalgia for over 40 years, explains:

“Reliving past injuries of a physical or emotional nature only reactivates the nervous system.

“Instead, it is more important to recognize our reactions rather than the specific events related to the trauma.”

To illustrate this seductive inclination to keep feeding emotional trauma (sort of like picking away at old scabs), Rev. Jarvis offers another non-health-related example:  a person who has been unjustifiably fired from her job. Every time this person retells the story of this unfairness, she becomes more resentful and more angry.

And people around her keep leaving to go get coffee…

Finally, some quotable quotes I love from Rev. Debra Jarvis:

  • “Claim your experience. Don’t let it claim you.” 

  • “It’s never too late to become someone besides simply a survivor.”

  • “I am really glad that we are on this bus together, and this is my stop.” *

* PS: I’d like to modify this one to use on certain people even when I am not on a bus

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Q:  Have you experienced a time in your life when you didn’t want to get down from that cross?

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See also:

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Published by Carolyn Thomas

35 thoughts on “Feisty advice to patients: “Get down off your cross!””

  1. From my very own near death experience, I feel strongly that people need to think before they speak. When one is in prolonged critical condition, please filter your quick fix words. Years later, some things may be appropriate to say, but now is definitely not the time. Everyone’s experience is their own to process in peace, please.

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    1. I agree with you, Roz. None of Rev. Jarvis’ words apply at all to the person in mid-crisis, as she explains (certainly not the time for ANY ‘quick fix’ responses) but to the person months or even years later who is “feeding emotions so they stay stuck”. I believe she’s addressing not the fact that we’re processing in peace (let’s face it, we all need to do that, especially at the beginning) but the continuing need to process out loud over a long time. It’s when we can’t shut that off that it becomes unhelpful and even damaging (see, for example, Do you think too much? How ruminating hurts your heart).

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  2. Pingback: Carolyn Hax

  3. Dear Carolyn:
    I have recently returned from the west coast celebrating Thanksgiving (Canadian- for our friends from other countries) and not attended to your website. During the process of giving ‘heart-filled’ thanks I will always feel gratitude for the help I have received from your blogs. They have sustained me in my darkest hours. My hope is that we will meet face to face someday.

    But, as I scanned back to this post I was appalled by the vehemence and nasty comments I read by four commentators who wrote such negative personal diatribes about both you and Debra Jarvis.

    The professional, in-depth information that you have presented in your blogs have required attention to detail and research that is beyond any I have read in any other blogs. Your insights and knowledge about heart disease in general and specifically women and heart disease is unlike any other websites about these issues.

    I was appalled by the lack of consideration and gratitude shown by these comments. Presenting negative comments which are hurtful is honourable on your part. You have responded to them with dignity. I am sorry you had that experience.

    I was led to the work of Debra Jarvis last evening and found her to be a breath of fresh air. She is herself a breast cancer survivor with a great sense of humour and intensely compassionate. I am impressed with her intelligence and positive approach to life.

    She told this story to her congregation and presumably did not offend anyone there or else would not have repeated it on TEDMED 2014. So how can we know the context of how she presented this to the woman who had just received great news but wanted to ruminate over and over again about the past?

    She had told Debra this same story every week for 6 months! Then 12 months later, meeting her again, reiterated the same old refrain in spite of good news.

    Language is a powerful tool. Had she said “snap out of it”, “give it a rest”, “be grateful for the good news” , “get a life”, or my favourite “suck it up” would the message, coming from a minister, have been any more powerful?

    It stands to reason she would have used the analogy of the crucifixion. She had given her ‘comfort’ in the past, now in one sentence she was ‘clarifying’ and ‘challenging’ and about time! She had just received great news!

    I don’t mean to suggest that in our darkest moments we ‘survivors’ don’t have periods of deep anxiety, fear and depression (I know I do), but to burden others who have spent as much time with her as Debra has and not instead share joy, is not compassionate about others, such as her daughters, who themselves feel anxious about her future every moment of their own lives. I know my own kids do. As much as I am tempted to, I can’t burden them every waking moment.

    I am not religious, do not have a minister, priest or rabbi to whom I confess or ask for guidance. But, if I did I would want someone like Debra Jarvis to shake me up!

    I hope that woman was brought into awareness after that encounter. I am daily telling myself to work with these negative thoughts and to be mindful and meditate with them. Not an easy task. In fact, my own greatest challenge. My own husband tells me to “let it go” and that, in essence, is what Debra was doing. That is what you were presenting and was not in the least bit offensive.

    Keep on with the great research and expert writing that keep many of us afloat!
    Regards,
    Barbara

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  6. I am shocked and appalled that you would laud a comment like that out of someone who hadn’t seen the patient in a year. She might have been depressed, having a bout of PTSD, etc. I find the comment cruel and lacking in compassion, not at all “feisty.” If the patient is still troubled, I don’t understand how flippant, snotty remarks are helpful. Perhaps a recommendation to a real counselor would have been more appropriate.

    I repeat: I am shocked and appalled. I actually considered not returning to this blog. That’s way too Komen for my tastes.

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      1. I totally agree with Just Suze about this blog and don’t understand your flippant reply. You seem to like anyone who agrees with you, but have no time for other viewpoints. As far as I can see this is a blog site for the public and therefore you must expect differing comments. A wee bit more humility on your part would go a long way. What I don’t understand is why you take what this Minister says as right and proper, how could she have not seen this woman for a year but know exactly what is going right or wrong in her life? It just doesn’t add up to me, but then I don’t listen to Ministers on TV or the Internet.

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        1. Mag, I do in fact have time for differing viewpoints on what I write here. If I didn’t, differing viewpoints wouldn’t ever be approved for publication in the first place – I could have merely deleted reader comments before they see the light of day here. On the other hand, you seem to be having trouble accepting that my viewpoint remains clearly different from yours – without feeling the need for you to resort to personal attacks (a tactic, by the way, that rarely leads to agreement). The reality is that, based on results, I could completely relate to the Debra Jarvis story (and also to the corroborative comments on this topic from both Drs. Keddy and Seligman). You did not. We disagree. And that’s okay.

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      2. It was my understanding that the Susan Komen Foundation people have little compassion for those who develop metastatic disease and for those who are not grateful.

        I am 12 years out from a heart attack and still sometimes get depressed. Does that minister think that’s weak and self-pitying? I think she lacks empathy. Today, as yesterday, I find her cruel.

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        1. Suze, making sweeping and irrelevant comparisons between my blog and “the Komen people” is simply unwarranted. It seems that your focus sits squarely on Rev. Jarvis, and not on the other quotations I’ve also included here from both Drs. Seligman and Keddy, or from a number of other blog readers’ comments – who are saying essentially the same thing. Meanwhile, you have a perfect right not to agree with any of these people, or with any opinion of mine as well.

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  7. Wow, thank you for clarifying the newly minted cancer patient, who had just learned she was NED and was probably on an escstatic roller coaster of emotions…because this was all about her new lease on an extended future, something she’d endured hell to gain…..

    Had been seeing the hospital minister for an extended period already. Because she was in the hospital where she had endured all that with zero guarantee she would survive it, I’m going with the ‘story’ that it triggered an emotional landslide…and there was no way this particluar woman could just calmly squelch it at that moment in time. (Perseverating is classic ptsd).

    At no point in time am I going to agree it was appropriate for a minister to speak to a patient in that manner in a hospital setting. Never. Ever. She should have excused herself and politely gone elsewhere. “Get off your cross” was a projection, not wise counsel at that particular moment. Never ever in a hospital setting. Only in a counseling setting elsewhere. Patients are allowed to feel incredibly vulnerable, conflicted, overwhelmed and elated at the same time..in their hospital. There is a time to challenge and that wasn’t remotely the place.

    A female hospital minister came into my hospital room on day 6, my first day out of the Intensive Care after my first night of real sleep. I looked like I’d been beaten up and felt like it too from the injuries sustained before, during and after heart attack. I now know I also had a subdural hematoma from concussion at the time. Lady minister came clikety clacking in my room saying, “Feeling sorry for yourself?” Unable to eat solids still, I’d only had juice the previous 2 days, and it took me a long time to arrange a thought at that time, much less speak. I just looked at her, stunned and confused. She was a total stranger and I don’t have a minister. Maybe because I was just 41, she thought it appropriate to come at me with a ‘suck it up’ attitude? Thank goodness my friends were now free to come flooding in and I felt for the first time, I could survive. Not one of them said to me; “Feeling sorry for yourself little lady?” They were just as stunned as I was that I’d had a heart attack at ‘your young age’.

    Same hospital, major surgery years later to relieve heart attack burden, I had arrived via taxi in the wee hours and the nurse was going over paperwork as she prepped me for surgery when a large bellicose older woman came stomping into my private room, loudly interrupting our personal medical tasks and announced she was a minister and how are things going so far….Mrs.X. She again had the wrong name, wrong patient. I’d been in a calm meditative state, everything was going along just fine until this loud stranger burst in at 5:30am. She looked stunned when she realized her mistake..but would not leave!!!!!! The nurse finally told her we needed some privacy now. Unbelievably, this same female minister came barreling loudly into my room 2 nights later, just as I’d been wheeled in from ICU. Again, she called me yet another strange name. The nurses asked her to leave. It was 2 am and I was still on a dilaudid pump. Loud is never appropriate in a hospital room. I’d signed multiple HIPPA forms to keep my medical experiences private.

    To the uninvited hospital ministers who insert themselves into the most intimate personal moments in the lives of total strangers: (the story says she ran into this NED lady right?)

    “Get down off your cross”. You are not in a grocery store. You are in a place of sacred healing to the patient. If the family is ‘compassion-fatigued’ it is up to them to find ways to deal with it.

    Being a Zen lady, I have long practised the disciplines of not getting stuck in the water wheel of repeated miseries. I have a retinue of distractions and ways to switch my brain state since everything I deal with is chronic and forever. Challenge is a big Zen discipline tool, but it is done with great compassion, respect and persistence. I will have to at work this forever myself.

    You know I read and share your blog posts frequently Carolyn. This is the only one I respectfully cannot support. It clearly hit the target for other readers though. It is your blog and I will continue to highly recommend it.

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    1. Hi Jaynie and thanks for telling us this powerful series of stories. It helps to know where you’re coming from – and no wonder you reacted this way to the Debra Jarvis story. Your own minister visit stories were shockingly inappropriate. As I responded to Barbara (below) about Debra’s story: “…it’s important to note that she’s not saying that to a patient in active treatment or early diagnosis.” Not only did your visiting ministers not know you at all or have any kind of personal history with you (as Debra certainly did with her patient), but one of yours even got your identity and room number wrong! These are very different scenarios than the one described in Debra’s example. As a Zen lady, you’re a person who likely rarely gets, as you say, “stuck in the water wheel of repeated miseries” – but as you know, many others are not there nor ever will be, and indeed seem to relish that state of stuck-ness as long as they’re around any willing ear. I’ve been in both situations – where I was the one rehashing every misery, and also the one feeling utterly overwhelmed and exhausted listening to somebody else doing that relentless rehashing. Neither is healthy – for both the speaker and the listener.
      regards,
      C.

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  8. P.S. There have been replicated scientific studies that show the immune response is LOWERED in people who LISTEN to other people’s pain, fear, anguish etc.

    So even if it is beneficial to the person who retells their story over and over, it is not healthy for the listener!

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    1. Oh! Such a good reminder, Judy-Judith! When I worked in hospice palliative care, we used to call this “compassion fatigue”. Yet it also makes me wonder about those, like you and other psychotherapists, who listen to other people for a living. I know that there are some people in my day-to-day life whom I deliberately avoid when I see them coming for this very reason: their self-absorbed endless whining seems to suck the very life right out of me. How do professional listeners cope?!?

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      1. “Compassion fatigue” has a real neuro-chemical basis – it’s not psychological.

        There’s also research on impaired immune functions for caregivers – I believe the research was originally done on those caring for loved ones with Alzheimers.

        There is also research that shows that “keeping secrets” also impacts the immune system.

        Because professional listeners must also hold the confidentiality (secrets), they are at risk for chronic/acute illness. A high percentage of my colleagues have developed serious medical conditions. A few have died in their 60’s from cancer.

        I thought I was “coping” really well until I was diagnosed with fibromyalgia and then heart problems .. .

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  9. 1. As a patient, a human cross-climber and a psychotherapist, my observation is that since Jarvis has seen this person for SIX MONTHS, ONCE A WEEK – she knew her pretty well and had a rapport built with the patient. My guess is that her advice was exactly what the woman needed. If I see someone in my practice that long and we have a rapport – they know me and I know them .. . well, there are some clients that I can tell them to “snap out of it”, so to speak. They reflect on it and appreciate it. It is not possible to be objective about ourselves (myself included!) and the HONESTY of someone we know who cares is precious.

    2. I stopped attending fibromyalgia/heart “support” groups because I felt worse leaving than going. As a result when I led a group for people with chronic medical conditions it was called “Purposely Positive”. They could tell their stories but we then focused on whatever was positive. Those who couldn’t see anything positive began to “catch” it from those who could. Lots of laughing was the drug we shared with each other.

    3. Being down and discouraged and depressed is normal. It’s not “healthy” (mentally, emotionally, physically or spiritually) to stay stuck in it.

    Bravo to Debra Jarvis!

    (I feel my sneaky thief stirring! – Will definitely be posting your post on my post that refers to your post that inspired my post)

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  10. Wow! This one struck a note with me! I must learn to practice what I preach! Practicing Mindfulness Meditation is all about ‘letting go’ and how many times have I written about that?! Too many to count. After all, letting go is a wonderful strategy.

    I am constantly rehashing with family members and friends who will listen (yawning, I am sure!) about all the ailments I have endured since my heart attack in 2013. I know I am boring them all, myself included.

    Although having almost lifelong fibromyalgia, I thought I had a good handle on it, at least I was managing my life rather well. Then the HA and the real threat to life – ruminating over and over again, blaming myself for not attending to the symptoms, envious of others who are well, over-exercising and hurting my hip, then needing a replacement, two bouts of vertigo and the positional manoeuvre, which has left me with what is called ‘hang over’, blah, blah, blah.

    So you, dear Carolyn, among others, are no longer going to hear me hanging from that cross and I intend to stop boring others with these details. (I may slip once in awhile)

    I really love that expression “suck it up”. I think that is basically what the minister is suggesting. There is suffering; there is joy… but my pessimistic nature is to focus on the glass being half empty. As an ex-catholic I think this kind of confession is good for me so I am confessing to you that I have been up on this cross long enough!

    ‘It is what it is’ – I do love these new sayings :-)!

    Thank you once again for a good shake! I needed this blog. I am not cured of worrying but I don’t have to constantly bore others with my incessant worries.

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    1. Thanks for your comment, Barbara (and for your quotable quotes that I use so often here – like about that Toronto support group whose members are only allowed to talk about their wellness, not their illness!) I think you’re right – Debra Jarvis is saying “Suck it up!” – but it’s important to note that she’s not saying that to a patient in active treatment or early diagnosis, but to a person who is in the habit of telling and re-telling a story that once served her well, but no longer does.

      I also like Pauline’s comment (below) about how shifting the focus from me-me-me to another person’s story is both helpful and healthy. For me, it was the part in the Jarvis example where both of the patient’s daughters stood up and left the room as soon as their mother started in (again!) on her story that really illustrated this point.

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  11. I think this is great. “Getting of your cross” and living again is a challenge not just in health issues but general life issues too.

    No matter what setback or bad decision you made, wake up in the new day and start over. Start living again.

    Now I could also take this the wrong way as I actually had doctors telling me this after my triple bypass 8 years ago at age 46. Left main blocked and the right system of my heart I was missing a lot of arteries and what was there was tiny. After 6 1/2 years of complaining and a new cardiologist, it was decided that since it was safe to stent open my left main now as I was safely bypassed, maybe that would boost the blood flow enough for comfort. I had a stent in my left main a year ago!! Wonderful!

    I was able to get off my cross and start living again. I really only tell my story to those that still feel ill and doctors are not listening. But my heart problems don’t define me. My thyroid problems don’t define me. They are truly a small part of who I feel I am.

    I have learned to slow down and listen to how I am feeling every day and my husband will know because it effects his life but no one else really knows or needs to know.

    Thanks for the message today.

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    1. Six years of pain! So glad that’s been addressed at last. We’re not talking so much about that kind of complaining (i.e. in order to get appropriate medical treatment – which is important complaining!) but rather that kind of endless telling and re-telling of our medical drama – or what my friend Dave calls “the organ recital”. As you wisely say here, your diagnoses do not define who you are. Thanks for sharing that important tip, Jennifer.

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  12. This reminds me of myself. When talking with my sisters, my part usually was to list my most recent pain or heart problems. This changed big time when all four of my siblings were diagnosed with cancer within 16 months!

    When my youngest sister was dying from a failed bone marrow transplant after developing a secondary cancer from chemo for the first cancer, it was clearly time to refocus my thinking, and therefore my speech. At first, it felt like I was squelching my own reality, but I found it became easy with practice. Now, a few years later, I still share deeply with my sisters. I just use a thicker filter!

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  13. I think Debra Jarvis should get off of her high horse. Who is she to tell anyone how to live their lives? If that’s the way people are then so be it, it’s not up to her to judge them, surely she should be helping them get over what’s bothering them, not telling them to get off their cross, especially in such a manner, what kind of ‘minister’ is she?

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    1. Debra is an ordained United Church minister. Do you also disagree with Dr. Seligman’s views that “staying stuck in complaining actually worsens physical and emotional symptoms by focusing our attention on them”?

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      1. Yes I do disagree with this. We are all individual people with different ways of coping with the ups and downs of life, some people do it this way and others don’t, but there is no way a minister should be talking to anyone in this manner, and as for Dr. Seligman, he may be a psychologist, but he’s still just an ordinary human being just like you and me, he can get it wrong too. My Mum is like this and has been since I can remember, she had relatively good health until about 70/71 when things changed, this is her way of coping and she’s still with us now heading for 85 next year.

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        1. I agree with Mag Affleck. There IS such a thing as ‘talk therapy’ and some people need to do that more than others.

          It seems as if Rev Jarvis forgot the first of the Three Cs (comfort) and jumped straight to ‘challenge’.

          If it hadn’t been a minister but a friend that told the patient to get off the cross it would be a different thing—- but a minister?? Sigh.

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          1. I agree with your important point, Cave, when you write that there IS indeed such a thing as talk therapy. It can happen in a close relationship with a willing listener, or in a therapeutic setting led by an experienced facilitator so that the “talk” doesn’t simply deteriorate into endless complaining (which helps nobody, especially the complainer). Typically, it doesn’t mean telling our story to everybody we meet who asks “How are you?”

            As a heart patient, I’m learning to be very careful in choosing (and it IS a choice) who I decide to confide in about my health issues. As that old saying goes:
            “Don’t tell your friends about your indigestion.
            ‘How are you?’ is a greeting – not a question!”

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            1. As a heart patient as well I choose not to tell people about my own health and I certainly would not like someone like this minister to say that to me, YES how are you is just a greeting and my reply is always fine thanks whether or not I am, that’s my business.

              Just as a matter of interest if you don’t want people to talk about themselves why do you have this blog?

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