Evolution Medicine: Meditations for mind, body and spirit - by Sonya Lazarevic MD

Dear listener,

It’s been quite a while since I’ve written. I think I’ve been preoccupied with the stages of healing, which include gaining enough strength to walk again, wound closures, adjusting my nutrition to support the healing, and implementing ways to improve the quality of my sleep- one of the cornerstones of the repair process.

When the body is in a state of stress, it operates as if there is an emergency. And emergencies take priority over standard maintenance issues. For example, if you have a fire in the kitchen, you’re probably not going to focus on the small leak under the sink. The leak can wait. The fire takes priority.

Having said that, someone I know recently asked me to comment on the intersection between meditation and psychiatry. I have a topic in mind based on a recent verse of the Bhagavad Gita. However, I want to finish the verse and consult a expert teacher, if I can, before I attempt to make what I hope will be a well-informed exploration of the topic. I might need another month for that- I’m still taking time off to digest the past three to four months. The end of the summer is a good time to rest then shift gears before the uptick in professional activity in the fall.

In the meantime, I’d like to comment on some films I watched at the Middlebury Film Festival in Vermont. They were surprisingly moving, creative, and thought-provoking. If you ever get a chance to see these films, I highly recommend them, particularly for someone who is facing :

* Headwinds, whether personal, financial, or social, which appear to blow against a creative, professional, or personal project.

* Actions that aim to defeat the odds .

* Hurdles- which can be overcome by a strength powered by the love for a projector craft.

* Negative thought that your work doesn’t matter, wont have an impact- which is a derailment from that each person and their contributions DO MATTER.

* A crisis of faith- and need to witness what might be called divine guidance or intuition in action.

* Struggles with isolation, and can benefit from remembering how connection catalyzes healing and persistence.

* Mechanical or pressured living causes a forgetting of what it means to be human, and how divine creative expression is transformative.

While the stories of the people featured in these films involve very different degrees of fame—some are virtually unknown, like the single woman living in Northern Vermont, another film reflects architects and designers whose work developed something of a cult following, and still others feature people like Billie Jean King and Billy Preston—they all have something to say about being human.

I’m not a film reviewer. However, as a psychiatrist and fellow journey-woman, I found myself seeing the messaging in these stories through a particular lens. I could see how each of these stories can be transformative to the viewer, and for very different reasons.

At the bottom of this essay, I’m going to provide the names of the films. I strongly recommend you view them—not simply to see the films themselves, but perhaps to understand yourself a little better. Each film reflects some aspect of being. I also suggest watching them with other people, because I think each of them prompts a discussion.

A quiet woman in Vermont

The film about the woman in the Northern Vermont, called Glorious Obscurity—struck me as a deeply spiritual short film. I experienced it as a film about a woman who interacts with nature, objects, and farm animals in an incredibly still way. A little spoiler alert: she created a museum of ordinary, commonplace objects. One of her installations, which features tea bags, might make me never drink tea in quite the same way again. When I saw the installation piece, I thought about all the cups of tea I’ve ever had. Tea alone. Tea with another person. Tea under different circumstances. My tea-drinking days. My abstaining-from-coffee days. My medicinal-tea-for-healing days. The days of experimenting with different herbs, whether North American, Ayurvedic, or just English teas. And then there was the moment when she talked about her donkey at the end. Personally speaking, that just broke me.

I could feel her love for this animal. And I personally love donkeys, too. But there was something more to it—the stillness that this creature invited her to experience. That stayed with me. She had her own stillness as she spoke.

Design/builders who play with form

This design-build film was based on an architectural group that started near Sugarbush, Vermont, in what I believe was the late 1960s. They built some of the wildest, wackiest architecture. Some of the exteriors, I think, would take time to grow on me, while others I absolutely loved. The interiors, introduced the concept of living space as something playful and creative. The space itself became part of the creative process.

And then there was the way they actually constructed the buildings.

I’ve never seen a creative process quite like this because, normally, you have a plan. You make the plan, and then you build according to the plan. They didn’t quite do that. They figured it out as they went along. Innovation emerged from including what would normally be called mistakes. That was such a prime example of the artist’s process: experimentation, having some kind of vision, and then experimenting along the way—folding errors into the process as something to interact with and contemplate rather than simply something to correct. I personally loved how they took their time building. They would contemplate. Since their work was seasonal, they had the winter to pause work and contemplate the space and design as they returned to the site.

The community evolved over time. The builders and designers initially lived in the spaces they created. Then people started having families. And eventually they were living in these spaces with all these children. They became something like a little village. I found that fascinating.

Artists who think as one

Three Is Four was another film about creatives which was filmed and edited by creatives, so the experience of watching it was more dynamic. It was about four avant-garde designers—eventually reduced to three—their trials and tribulations of their growth and creative process in the face of what looked like an inability, or perhaps severe limitations, in running a business. And how much that financial strain—this is my interpretation—handicapped them.

But the three designers appeared to function as one mind, one unit. That was fascinating to watch. I personally want to follow their growth over time.

For the love of sports

The Billie Jean King movie, Give Me the Ball, is really important for any woman to understand or remember how much women’s rights have changed in the past fifty or sixty years. And how much Billie Jean King, amongst other trailblazers of her time, helped pave the way for equality in pay in sports and established women’s sports as an equally shared seat at the table, rather than an unpaid afterthought.

I’m thinking about this in the context of my mother’s generation. It was not long ago women could not own property without a man’s signature. Nor could a woman have a credit card in her own name. I recall my mother opened a few charge cards at various stores in New York City, because that was what was available to her. Hers was the first generation in the United States that was able to have that without a man’s consent.

For this reason, I want to highlight something that was said at the very end of the film. I think it was Coretta Scott King: Freedom is never really won, you earn it and win it in every generation.

That idea stayed with me. What it means is that, even if a previous generation did legwork, time adjusts, cultures adjust and (now) technology adjusts- rights, thus they need attending to, like a garden.

Music, God and the conduit

The final movie, about Billy Preston, is not simply a story about an extraordinarily talented young man with a deep love for God, which developed as he grew up in the Baptist Church. For those of you who don’t know, Billy Preston played with many hugely famous bands, including the Rolling Stones, the Beatles and Ray Charles.

And he had a magical presence yet lived with his own skeletons. He chose, for very understandable reasons, to keep them so private that even the people closest to him didn’t know. While watching the film, I found myself wanting to make note of the singers who were also highlighted in the story, to listen to their music as well as Preston’s - his piano and organ playing was just phenomenal.

There is something else about his story that stayed with me. If you choose to ignore something that haunts you, you know, that energy winds up going someplace. And because it is packed away and covered over, it can take a person down.

I will be honest: when I’ve witnessed my patients face their own demons, they are more liberated—mentally, emotionally, physically, and spiritually (which can be a connection with nature).

For Preston- as a Black man, he faced incredible headwinds in bringing his own demons to light. Even today, those topics can be challenging to find safe, supportive environments in which to heal. I feel for him. He was such a light upon the world. His talent, gracefulness and ease—these remain gifts to humanity.

And perhaps that is one of the reasons I found myself so moved by these films. They reminded me that healing is not simply about repairing what is broken. It is also about what allows us to keep going: creativity, connection, courage, love, intuition, community, and sometimes simply the willingness to face what we’d rather not face.

These are, in their own ways, reminders of what it means to be human.

The following meditation is a little one, please share it with anyone in need of a drop of calm, self acceptance and knowing they are not alone. As always, take care. SL

* Prickly Mountain and My Design/ Build Life. director Allie Rood

* Glorious Obscurity. director Ronan Future

* threeASFOUR: FULL CIRCLE. director Sean Ono Lennon, co-director Brian C. González

* Give Me The Ball! directors Liz Garbus and Elizabeth Wolff.

* Billy Preston: That’s the Way God Planned It. director Paris Barclay

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Deal Listeners,

It’s been another interesting and, in many ways, adventurous month since I last wrote.

I’ve been thinking a lot about the healing process—and how basic some of its foundations are. Proper nutrition. Minimizing sugars and caffeine. Restorative sleep. Hydration. Supporting the body in returning to homeostasis, rather than overwhelming it. Even supplementation, at least for me, has felt most useful when kept simple and intentional.

During and after antibiotics, I made sure to include probiotics, but also focused on foods that support the gut. I paid attention to hydration in a way that felt almost like a daily practice. And then there were the less measurable, but equally essential elements: connection with others, a sense of humor, and the effort to maintain a grounded, realistic—but not overly negative—perspective.

Healing as a Relational Experience

At some point, it became clear to me that no matter who is on your care team, and no matter how skilled they are, there is a layer of healing that is fundamentally a relationship between you and yourself. Even with family, friends or neighbors who help — this process boils down to something deeply personal. Even Spiritual. Its not a “solo” journey—that sounds too isolating…. diagnosis, guidance, and support matter from all those around you—but rather it is an intimate journey- with yourself.

Finding Agency

Part of that relationship is learning the language of your own body. Understanding what is normal for you. Neither overreacting or dismissing what matters. For example, I know my baseline complete blood count (CBC). I’ve repeated it over time, not out of anxiety, but out of curiosity and awareness. I had to learn what my ‘normal was’. Having this knowledge allows me to understand how my immune system behaves, so that when something shifts, I have context. And that can be communicated.

Not everyone has medical training, but I’ve seen many patients (of mine) become remarkably informed and engaged in their own care. They ask thoughtful questions. They learn. They participate. They decided to learn what they could and it made a difference for them. That participation changes the experience of illness. It transforms you from a passive recipient into an active participant.

A Crisis Reveals

What I noticed most during this experience—now stretching over several weeks—is that a healing crisis doesn’t just affect the body. It reveals- thought patterns, emotional tendencies, habits of mind that may have been present all along, but not fully seen. It acts as a distributor, challenging habits, routines, patterns, expectations, and more…

At times, what surfaced was uncomfortable. There were moments of fatigue so deep that even simple mental reframing felt out of reach. There were moments of pain where the only real practice was allowing and enduring. And yet, having tools—journaling, reflection, even simple awareness—created space. Space to notice without being completely overtaken. Giving myself grace became essential. Especially on days when progress felt invisible. Because even then, amidst the storm, something was moving.

Tiniest Movements

There was a period where healing was very challenging and uncomfortable, progress looked very small. First my toes could slightly wiggle. But then then they could curl. Then my ankle could flex. Eventually, I could extend the ankle. Draw small circles.

In another context, this might seem insignificant. But in that moment, it was everything. I could have focused on how far I was from full function—and that thought did arise. But what I kept returning to was what was improving. If I went the other direction (how long it would take to recover) I knew I would feel depressed. The focus was on the here and now. The swelling was decreasing. The wounds were healing. The pain was softening, even if only slightly. This became a practice: orienting toward what is working, surrendering to the present, without denying it challenges or getting stuck in them.

Inner Work

If there is one thread through all of this, it’s this: Healing asks something of us— as an invitation. At different moments, what was asked shifted. Patience. Hope. Perspective. Trust. The willingness to stay with the process even when it felt slow or uncertain. There were so many moments of that. Other moments were quiet. Private. Decisions made internally that no one else could see. That, to me, is the “between you and you” aspect of healing.

Choosing Inputs Wisely

Another unexpected lesson was how important it is to be intentional about what—and who—you allow into your mental space.

Well-meaning people sometimes shared stories of worst-case scenarios—complications, prolonged recoveries, things that could go wrong. I understand where it comes from. But in those moments, it wasn’t helpful. So I learned to gently set boundaries. Sometimes with humor because that took the edge off and I had to see how nutty this whole journey was. The other aspect of that was what I read, or which show I watched. I decided against anything with violence- because my state was too tender. I just changed the channel. I did this to protect not just physical recovery, but my mental landscape.

Attention Impacts Biology

From a psychiatric and neuroscience standpoint, this process reflects several well-studied mechanisms. Attention shapes experience. What we repeatedly focus on—threat versus progress—modulates activity in networks related to stress and emotional regulation, including the amygdala and prefrontal cortex.

Perceived control and active participation are associated with improved outcomes, partly through reductions in stress physiology and increased psychological flexibility. Even small markers of progress can reinforce dopaminergic pathways related to motivation and learning, making continued engagement more likely. In other words, the stance we take toward our experience is not just philosophical—it is biological.

An Invitation to Grow

I know there are people reading this who are struggling. With pain. With anxiety or depression. With loss. With uncertainty. With situations that feel draining or even unfair. If you’re in that place, see if you can do a few things:

* Find the support you need—clinically, emotionally, relationally.

* Find an outlet for your feeling, even if it’s messy and its just you and a piece of paper. Avoid ‘over staying your stay’… in other words- move on.

* Gently look for what is working, growing or changing, even if it’s small.

* Protect your mental environment when you can, and intentionally cultivate the positive by gravitating towards hopeful, inspiring or humorous stories, lean on talks or books by spiritual teachers- if that speaks to you.

And perhaps most importantly, remain open to the possibility that something in this experience is asking you to grow—not as a demand, but as a gentle invitation. If this is too challenging to notice today, shelve it someplace and come back to it later when you have the bandwidth for it.

This week, you might experiment with this: Notice one small sign of movement in your life—physical, emotional, or relational—and let it matter. You matter, you count.

Today’s meditation focuses on the energy, lightness, softness and beauty of the rose and everything it brings forward. If you find this meditation or brief essay helpful, share it with a friend.

Take care of yourself, SL

for those interested in the work I do and how this all comes together, go to my practice website www.evo-md.com

equally welcoming flowers

flower power

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Dear listeners,

I’d like to speak about the power of being seen.

For many people, their lived experience remains largely silent — held within the mind or the body, unspoken and, at times, even unexamined. There can be a tendency to undershare, to withhold, or to avoid visiting the deeper regions where struggle resides.

And so, when someone encounters the right person — a friend, a therapist, a partner, a spiritual guide — someone capable of bearing witness without judgment, something meaningful happens. In that moment, the individual who is sharing permits themselves to fully inhabit their human experience, however difficult it may be. The one who listens does not need to have walked the same path; presence, when paired with compassion, is often enough.

There is a quiet completion that occurs in this exchange. Healing, in part, is relational.

At a more refined level, when the listener is able to reflect back — clearly, without fixing, correcting, or imposing — the speaker hears their own experience echoed with coherence. This reflection can move something forward. It offers validation not as agreement, but as recognition: this is your experience, and it is real. That recognition, when honest, becomes stabilizing.

Of course, this process can be obscured. Pain is not always straightforward. At times, individuals may attach to narratives that are not entirely their own — adopting collective grievances or external causes that offer a sense of meaning, but may bypass more personal, internal truths. The impulse is understandable; the search for purpose is deeply human. But it raises an important question: how do we cultivate personal honesty?

This brings us to the practice of Svadhyaya, or self-study — the fourth niyama in Yoga Sutras of Patanjali. It is the disciplined act of observing oneself with clarity.

One way into this practice is through the study of enduring texts — teachings that have withstood time. For me, this has included the Yoga Sutras and, more recently, the Bhagavad Gita. These texts serve as mirrors, offering frameworks through which to examine one’s own life.

But study alone is not enough. It must be lived. In the yogic tradition, this means practice — movement (asana), breathwork (pranayama), and attentive awareness — each offering an opportunity to observe oneself in real time.

What often emerges is this: the first pain point a person identifies is rarely the complete story. It is, more often, the outermost layer. Beneath it lies something more fundamental — an imbalance, a deficiency, or perhaps an excess elsewhere in one’s life. To reach that deeper layer requires patience, curiosity, and a willingness to stay.

As I write this, I am traveling and attempted to record a meditation with limited tools. It became too rough, so I will include a placeholder for today and record when I make my way back to my (rudimentary) equipment — I can see, maintaining the cadence of this has been important, the meditations will come.

I’ve included a meditation below by the senior teacher Jack Kornfield who is ever so soft and sweet.

Jack Kornfield’s Embodied Presence Meditation which you may listen to here as well on SoundCloud.

As always, share this with one person you believe who can use a little support, and check back for the updated meditation. Take care of yourself, SL

For further information about my clinical practice go to www.evo-md.com

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit evolutionmedicine.substack.com/subscribe

Dear Listeners,

I’d like to share a reflection, on the intersection of spirituality and commerce — a pairing that struck me as contradictory when a teacher proposed it a few years ago. Then, I struggled to understand how business could be conducted in a manner that left everyone involved feeling nourished, joyful or fulfilled — how an exchange such as buying a scarf might become, simply put, mutual gain.

A recent experience in India offered some clarity.

While traveling in Rajasthan, India this past January, I visited a small shop near Ranthambore National Park known for its handmade textiles. I had asked my driver to take me somewhere local, where crafts held meaning. What I found was not merely a store, but a living ecosystem.

I spent hours there — far longer than I had intended. I moved slowly through tapestries, scarves, and rugs, each piece carrying a distinct texture and history. The women who worked in the shop shared their stories with a quiet pride: how their work supported their families, how children had been educated, how lives had gradually, meaningfully changed. Some worked in the shop itself; others contributed from home. The owner moved in and out of conversation, offering tea, creating space — not directing, but tending.

What unfolded was less a transaction than a relationship. By the time I chose a few pieces — including a patchwork textile composed of older, storied fabrics — the act of purchasing felt almost secondary. The value was not simply in the object, but in the exchange: attention, time, care, and genuine human connection.

As I was preparing to leave and check out, we were all met with unexpected emotions. There were tears, joys, more stories — theirs and mine — shared. Not out of sentimentality, but from a common recognition of something real exchanged between us. The owner later remarked that in decades of running the shop, only a handful of such moments had occurred- this was one.

It left me considering perhaps value is beyond price, it includes appreciation. And that appreciation, when deepened, becomes connection.

In a Western framework, we might call this the spiritual dimension of commerce: an exchange not only of goods, but of presence. Of heartfulness. Of mutual regard. Where what is given and what is received extend beyond the material.

If I were to name its essential elements, they would be these: presence, connection, and heart.

Today’s meditation, then, is an invitation to return to the heart — to find steadiness there, even as the world continues its rapid shifts. Peace, when cultivated internally, has a quiet but meaningful impact outward. It shapes how we meet others, how we give, and how we receive.

Do not underestimate the contribution you make when you find peace within yourself.

Share this with people who can use a lift, some inspiration or hope in their next step. Be well, SL

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit evolutionmedicine.substack.com/subscribe

Dear Listeners,

I have a small snowy tale to share — one that, only after I was nearly finished shoveling, revealed itself as a lesson in the difference between pain and suffering.

During New York’s most recent blizzard in late February, I began shoveling the night before in hopes of getting ahead of the storm and clearing a few pathways. By Monday morning, before starting work, I was back outside with the shovel. Instead of doing yoga or attending my usual morning class, I chose to listen to the Bhagavad Gita being chanted — recordings I have access to through a teacher. I listened to the first ten chapters while I worked.

What I noticed was simple and striking: I became focused on the action itself, rather than my feelings about the storm. I could tell many feelings were readily available. I had just finished navigating them the prior week or two in work. In the Northeast, we endured unusually cold temperatures after an additional major snowfall a month prior. The cold was oppressive and somehow felt personally challenging. By the time this storm arrived, most of us were simply exhausted.

As I shoveled, my mind turned toward the timelessness of the earth and the rhythm of the seasons — how snow comes and goes, how temperatures rise and everything melts into water, the grass returns, trees grow, and birds begin to sing again. Eventually, the grass will need trimming and they will be the new ‘problem’. It struck me as a living example of how a situation such as this storm may be painful, and even physically grueling… yet suffering remains optional. Because my mind was settled on the singing of the Bhagavad Gita there was space to notice these thoughts pass as I worked.

I could see thoughts float by and pass- Here we go again, Why does this keep happening? Not caught in frustration about inconveniences or delays, the theft of my morning or personal disciplines I was building upon… Instead I was simply shoveling snow.

Another thing I noticed was the generosity of neighbors. Even in the city, people were helping one another clear sidewalks. And then, unexpectedly, a neighbor’s husband arrived with a gas-powered snowblower — like a mechanical angel that graced us all.. He cleared the entrance to our driveway: an eight-foot-wide, four-foot-deep, two-foot-high layer cake of snow. I had looked at that mound earlier and thought, I’m not doing that today. I didn’t know how or when it would be cleared. And then, it was.

It was a gift, which had I been lost in the suffering, might have been tougher to appreciate. And really, you should have seen the guys face... He was happy too.

Today’s meditation is about letting go and understanding that life may have situations that are painful, however suffering which is due to our interpretation of that event, is optional. It is about meeting what occurs or ‘what is’ without resistance, and receiving help with an open heart. While freeing ourselves of suffering can take more time than this simple story when the experience is complex, the process which delivers us remains the same; in which we learn to let go and accept what is.

Enjoy the meditation, and take care of yourself. SL

For more reading

* an article from insight Timer on how non-attachment allows you to be more adaptable.

* A personal story from an author at University of Virginia School of Medicine, discussing how suffering is defined as wanting things to be different than they are.

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit evolutionmedicine.substack.com/subscribe

Dear listeners,

What a year. And it’s clear- there is more to come.

As we move through this changing landscape together — over the coming months and years — whatever shape the ride may take, I’d like to offer a simple rhythm to lean on: pause, reflect, act. Then repeat. Pause. Reflect. Act. And remember that non-action is sometimes a form of action.

I say this because the momentum of change right now is extraordinary — at times nearly nauseating in its intensity. Trying to keep up can feel impossible. So how do we metabolize all of this? We pause. Reflect. Act.

The pause comes first. Always. Even if it lasts only a fraction of a second. The pause is the breath. Reflection is the practice of observation — particularly starting from self-observation — spoken about here before, Svadhyaya. With such clarity, best action follows naturally.

Svadhyaya: a Sanskrit term means “self-study” or “one’s own reading,” is one of the niyamas (ethical observances) in the Yoga Sūtras of Patañjali, traditionally rendered as introspective study of the self. It involves not only reflective awareness of one’s thoughts, behaviors and patterns—both on and off the (yoga) mat—but also contemplative reading, chanting or meditation on spiritual texts to deepen insight and clarity. In a broader context, it serves as a mirror revealing conditioned tendencies and supports the unfolding of Self-realization and alignment with one’s true nature.

People often ask how to slow time — without medication, distraction, or escape. Here, I offer meditation, because it is the heart of this space. It is flexible, adaptable, portable, and takes many forms. My preference is to begin with a solid foundation — traditional practices grounded in the body, breath and awareness — before moving into more hybrid or esoteric approaches.

Breath-focused meditation is a powerful place to start. So is movement meditation: yoga, tai chi, qigong, etc. Repetitive, calming activities — gardening, knitting, baking, swimming — where mind and body move together around a single action can also quiet the nervous system and invite steadiness.

This steadiness is what opens the door to pause, reflect, act.

As we move into 2026 and beyond, I invite you to reflect on the smallest things you do that bring genuine joy. Fixing clocks. Baking. Coloring. Pottery. Painting. Gardening. Writing poetry. Making jewelry. You’ll notice many of these are creative acts. Creativity is an innately human trait — perhaps one that distinguishes us most — and it allows us to metabolize the full spectrum of feelings we experience.

Whatever crosses your path, remember this: being human, challenging as it can be, is a sacred experience — and a rare one in this universe. Remember you are loved. Remember you are cared for.

I’ll see you in the new year.As always, take care of yourself. SL

If you wish to read more, here are some related topics to feed your mind

* the topic of mindfulness and present moment awareness

* the power effect of guided imagery on anxiety

* guided imagery and its positive impact on the brain by way of reducing stress levels

* I just felt like adding this because so many of my patients have physical health issues as well: meditation and its impact on multi-factorial health conditions like diabetes, hypertension, and pain syndromes

This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit evolutionmedicine.substack.com/subscribe

Dear Listener,

When it rains, it often pours — and lately, it seems as if the tempo of life has quickened again. The holidays amplify that pace, adding weight, expectation, and emotional static. In times like these, when everything accelerates, the wisest response is often to slow down.

I know it can feel as though the world is not working in humanity’s favor. Yet I’d offer a counterpoint: we now have more tools than ever to support ourselves, and one of the most powerful is learning to place the mind in an optimal state — nimble, clear, adaptable, and grounded.

Today’s visualization is inspired by a recent yoga practice centered on two seemingly opposing actions: a downward, rooting motion and an upward, expanding lift. Though contradictory, the two coexist beautifully. We, too, are full of contradictions — and it is often these internal tensions that make us human, and interesting.

Do not underestimate the power of visualization. It can reframe experience, shift perspective, and help the nervous system settle. This week has been full, so I’ll keep this brief. I want you to sit with the simple idea that visualization, practiced as meditation, can support your mental and emotional well-being.

Research shows some benefits of Guided Imagery.Guided imagery and visualization practices have been shown to reduce stress, improve mood, and support emotional resilience. A randomized trial in The Journal of Behavioral Medicine found that guided imagery significantly lowered cortisol and improved perceived stress in adults managing high daily demands. A study in Psychology & Health reported that guided imagery significantly improved emotional well-being, reduced perceived stress, and enhanced emotional regulation after just two weeks of daily practice. Participants reported better mood stability and greater resilience when facing everyday stressors. However, the sample size was relatively small, and the short intervention period limited understanding of long-term effects. The study also relied on self-report measures, which may introduce bias and cannot fully capture physiological changes. Lastly, research published in The Permanente Journal demonstrated that imagery-based relaxation improved quality of life and reduced anxiety in patients with chronic medical conditions. These findings underline what contemplative traditions have long known: what the mind rehearses, the body begins to remember.

Peace be with you — and happy holidays, everyone.

SL

observing the observers

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Dear Listeners,

If you’ve been thinking about making a pivot, this week seems to carry its own momentum -you can hitch a ride on. I say this because several patients have told me recently, ‘I can’t keep doing (X, Y, or Z) anymore. It’s not sustainable.” To add, in my opinion, they were making a healthy leap forward.

What they’re describing isn’t a single behavior, but a pattern disruption— one that’s become too costly to maintain. The expense might be mental, emotional, physical, or even spiritual. When the cost outweighs the benefit, something within insists on change.

Consider, for instance, the person who has come to see themselves as the healer in their family — the one who absorbs everyone’s pain, who listens, soothes or fixes. Here’s the hook: not everyone wants to be healed. Some seek relief without real change; others are attached to their suffering. And so, the helper ends up pouring energy into an empty vessel, mistaking self-sacrifice for love, for significance, to relieve guilt, or a myriad of other reasons. If this is you, its worthy of reflection.

When the cost outweighs the benefit, something within insists on change.

A true pivot begins with clarity. It means recognizing your role and your limits — that you may be a gifted listener or a natural caretaker, but that it’s okay to let go. Accept everyone has their own pace, their own path, and surrender to what is. Helping people who don’t want to change often says more about our need to help than their need for help- which is about the ego.

I’ve seen this dynamic unfold repeatedly lately — in families, workplaces, friendships. Maybe the shake up of the local and global patterns is affecting us on a personal level- It’s all interpersonal, all about how we conduct ourselves in the world. And it’s not about right or wrong; it’s about fairness — to others, and to yourself.

Even in family systems, where the ties feel immovable, you can set boundaries. You can decide how much time to spend, how deep to engage, when to step back. The holidays, for instance, tend to amplify these questions. Maybe this year, you visit briefly. Or stay nearby rather than under the same roof. Or, for the first time, simply stay home. It’s not avoidance; it’s discernment.

The larger point is this: the world is changing, and rapidly. The question becomes, how will you change with it? Perhaps by choosing differently — making decisions that are gentler, wiser, more supportive of your health and peace of mind.

If long travel strains your body, maybe this is the year you rest. If constant engagement exhausts you, perhaps you reclaim stillness instead- unplug, put your phone in the drawer, go for a walk in the park. Gaining clarity around such choices requires quiet — a breath practice, yoga, tai chi, swimming, or walking without distraction. These moments of stillness help us check in rather than check out.

If the world’s pace won’t slow, the best way to change this is to do it from within. In doing so, we have better odds for success in finding our next best step. Today’s meditation was inspired by a conversation with a colleague who practices mindfulness, when I led her though moments in a Slovenian cave which was a UNESCO world heritage site.

Thank you for reading. If this reflection resonates, this meditation moves you, consider subscribing, and share it with two people who need a gentle reminder to pause, breathe, and have the courage to pivot.

You are not alone. SL

(note: I’m attempting to teach myself how ‘clean up’ audio recordings of meditations… my preference is to remove background hiss/hum, unfortunately I didnt have my regular the right filter as I recorded this. My Once I figure this out, I’ll move through my archive. Bear with me as I learn this process… thanks for your patience!)

Here is another fav video which kinda sums it up:

This is Ram Dass (likely after his stroke) on letting go: “Move your identification from your ego to your soul”

one long and yet amazing talk by Ram Dass (his early years)

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Dear Listener,

In recent weeks, several patients have confided a longing for clarity around purpose. I’d like to offer a few thoughts on this, beginning with an important clarification: purpose is not a single, fixed destination. It is not something one “arrives at” once and for all. Rather, purpose is fluid—changing with our roles, relationships, and seasons of life. The question What is my purpose? can feel spiritual or pragmatic—or both, depending on where one stands.

Purpose takes different forms depending on context. Within a family, it may look like nurturing or guidance; within a career, it may look like leadership or innovation with a particular lens; within a community, it may look like introducing a novel shared experience. As responsibilities evolve—when one shifts from being part of a team to leading a team, or from singlehood to parenthood—so too does purpose. To treat it as static is to miss its nature:

Purpose is a process, not an endpoint.

That process requires loosening the grip of ego. The guiding question shifts from What do I want? to What outcome would serve the greatest good? This perspective opens the door to what philosophers and contemplatives have long described: a yielding to something greater than oneself—whether conceived of as divine intelligence, natural order, or God. Practices such as meditation and silence are indispensable here. They help peel away the mental and emotional filters that cloud perception, enabling one to discern with greater clarity what is needed in the present moment.

One common stumbling block is expectation. The insistence that purpose should reveal itself at a certain age—“I should know my purpose by now”—often signals a deeper habit of judgment, which blocks natural self-inquiry. On the other hand, joining causes solely to feel important can masquerade as purpose, but actually reinforce ego and displaced feelings. In these cases, action can obscure, rather than reveal, authentic direction.

Compassion offers a truer compass. As Sri Yukteswar writes in The Holy Science (pdf book link here), compassion is “the expansion of individual consciousness to embrace all beings.” It is a state of being in which the ego steps aside, giving way to service uncolored by self-interest. In psychological research, compassion has been linked with increased resilience, lower stress, and improved social connection—qualities that naturally sustain a sense of meaningful purpose.

Purpose grows through trial and error.

Small acts of care—tending to one’s health, nurturing relationships, or contributing modestly to the lives of others—become experiments in meaning. Through these everyday gestures, one learns about oneself, refines direction, and discovers how actions resonate with the wider world. Notably, studies show that even mundane prosocial behaviors (like helping a neighbor or volunteering briefly) enhance well-being and strengthen a sense of life purpose .

Why does purpose matter? Beyond the personal satisfaction it generates, purpose has measurable effects on health. A strong sense of purpose has been associated with lower risk of depression, improved cardiovascular outcomes, and even greater longevity. In times of uncertainty, purpose functions as a filter: it clarifies direction, sorts the essential from the trivial, and prevents us from being swept away by global drama. It anchors us in the present, reminding us of what can be done here and now—with sincerity, and with heart.

Today’s meditation is designed to facilitate the quieting of the mind, opening of the heart for improved clarity and exploring one’s purpose.

Please share this if you find it useful, or know someone who it might help.

be well, SL

somewhere along the Mediterranean

To read/learn more about purpose and its impact on heath

Hill, P. L., & Turiano, N. A. (2014). Purpose in life as a predictor of mortality across adulthood. Psychological Science, 25(7), 1482–1486. Link

Cohen, R., Bavishi, C., & Rozanski, A. (2016). Purpose in life and its relationship to all-cause mortality and cardiovascular events: A meta-analysis. Psychosomatic Medicine, 78(2), 122–133. Link

Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology, 69(1), 28–44. Link

Klein, N. (2017). Prosocial behavior increases perceptions of meaning in life. The Journal of Positive Psychology, 12(4), 354–361. Link

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Dear Listener,

Since my last post, life has been fast, demanding, and full of change. Visitors, home repairs, and a caseload in which several patients required extra care all made it difficult to carve out time for myself—let alone for this Substack. By the time I reached my scheduled nine days off, I was already so depleted that recovery would have taken much longer.

At the end of an unforgiving eight weeks, I somehow found the foresight to schedule a Panchakarma, a traditional Ayurvedic detox designed to restore balance to the body’s constitutions, or doshas. (For those unfamiliar, I’ll include links here and here to trusted voices in the field who can explain the practice more deeply.)

Preparation began with several days of a simple vegetarian kitchari mono-diet, which I continued through the treatment and for a few days after. What unfolded was not only a period of physical restoration, but also a deep recognition of just how far I had overextended myself—juggling commitments like repairs, family visits, and professional demands. Life, I realized, is always about timing, and my pace does not always match the world around me.

One of the more striking treatments within Panchakarma is called Basti: a ring of dough is placed on the body, filled with warm ghee, and allowed to soak into the tissues. It may sound simple, but in the hands of a skilled practitioner it is profoundly soothing to the nervous system. (I would not recommend attempting this at home; it requires expertise.)

Panchakarma is not for everyone—it requires discipline, a willingness to set aside electronics, to reduce stimulation, and to build new rhythms of rest and nourishment. But its effects reach beyond the physical. Emotional, mental, and even spiritual “debris” can be loosened and released. During this period, I had some of the most vivid, symbolic dreams of my life—both at night and during treatments—opening unexpected insights and sensory perceptions.

I was deeply moved by how quiet the body and mind can become when intention, gentleness, and consistent practice come together. Of course, this way of living—massages, careful food preparation, daily sauna blankets, unhurried rest—is not sustainable in the modern world, where bills must be paid and responsibilities attended to. Yet even a short immersion reminded me of what is possible.

Over the years—indeed, over decades—I have explored many modalities, from the esoteric to the deeply traditional: Chinese medicine, Japanese practices, Ayurveda, and yoga, which I began in the late 1980s and still find endlessly deepening. Lately, I’ve been devoting more time to Iyengar yoga, whose meditative rigor continues to resonate with me, even when taught in flow classes by my more disciplined teachers.

I realize I’m rambling—it is hard to summarize the past two months. But I suspect I needed that pause to move through a transition, both external and internal.

If you find resonance in this, I encourage you to share it with others who may be searching for alternative ways to steady themselves in turbulent times.

I believe we are in the midst of a profound collective transition—humanity in a kind of birthing process.

And while the moment can feel unsettling, I see opportunity here: to remember our humanity, to honor ourselves more deeply, and in so doing to build harmony within.

Today’s meditation is one I suggest you return to weekly—a gentle reminder of who you are, your potential and what you can offer yourself and the world.

a grasshopper nestled in my flowers.

Some additional reading below

Panchakarma

* A longitudinal observational study of a 5-day Ayurvedic retreat (Panchakarma) showed improvements in quality of life, psychosocial functioning, and behavioral change in participants PMC.

* A clinical study reported that Panchakarma therapy combined with lifestyle modifications improved cardiovascular function—including global longitudinal strain and VO₂ max—in patients ijmedicine.com.

* A therapeutic review concluded that Panchakarma offers a multifaceted approach to alleviating stress and enhancing mental well-being through cleansing therapies such as Abhyanga and Basti WJPMR.

Basti

* A clinical evaluation of Anuvasana Basti (oil enema) found it to be an effective alternative for oleation therapy (Snehapana), demonstrating therapeutic potential PMC.

* A study of Basti therapy’s effects on gut microbiota reported significant changes post-treatment in patients undergoing Panchakarma, suggesting systemic benefits scholarsliterature.com.

* A clinical review emphasized Basti (medicated enema) as more than evacuation—it serves curative, rejuvenative, and tissue-nourishing roles within Ayurvedic therapy ResearchGate.

Ayurveda & Doshas

* A recent stress-management review described how personalized Ayurvedic interventions—diet, lifestyle, and herbal remedies—can effectively alleviate stress jaims.in.

* A journal overview (Verywell Health) outlines classical Ayurvedic concepts—such as the three doshas (Vata, Pitta, Kapha), personalized treatments, and integrative therapies—making the tradition accessible to a mainstream audience Verywell Health.

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