I've woken early.  Lying here I feel an unfamiliar hollow pressure in my gut.  What is this?  Fear?  Anxiety? Tension?  "Tense apprehension" seems to fit.  I'm lying here in the early hours of the morning, a hollow tense apprehension in my belly.  And it isn't surprising.  Pretty normal in fact as I move closer & closer to major surgery.  Consciously.  By my own decision.  On this journey, travelling down the "kidney donation river", I can hear the roar of the approaching rapids.  Surgery soon.  It's a pretty standard, basic, healthy response to tense a bit as I move towards the crux, possibly the most intense section of this "donation river".  And I don't have to tighten the rest of my body around the belly apprehension.  I can let go, loosen in my arms, my face.  It's OK. Nothing to do right now.  I can let go ... move into "not doing", not holding on.  Letting go and softening in my body generally. And the hollow gut tightness can just be.  I can almost cradle it ... with kindness. Like caring for a frightened child.   

And I think of the other people around the world donating one of their kidneys this week.  Generous, good people.  I wish them very well on their brave journeys.  And so many people donated last week, last month, over these last years ... and next week, throughout next year.  A multitude.  Generosity.  Kindness.  It brings tears to my eyes and my heart, thinking of this.  The goodness in human beings.  Crying a little now.  It gives me hope and fills my heart to know that ... in amongst all the hate, cruelty, stupidity ... there's goodness, compassion, generosity.  Precious.  And of course, this river of kidney donors is just a small stream amongst the huge rivers of kindness flowing along beside us.  People risking their lives all around the world.  With courage.  Open-eyed, stepping forward to help others in so very many ways.  Some huge and life-sacrificing.  Some small, daily, essential too.  So many good people.  Of course we want to be part of this multitude.

Body softening, face a bit wet with tears.  Letting be.  Peaceful.  And a sense of kindness around me.  Dear friends, dear family ... my wife & kids, my closest friends.  Seeing their faces one by one.  Hearing them saying "Well done. We're with you.  Well done.  We love you."  Imagining them reaching out.  Touching my arm.  Looking in my face. Smiling with love.  Blessed.  Blessed to be held by their love.  And even imagining my mother (my parents have been dead for years now).  Precious, strong, loving woman.  Saying "I'm proud of you.  I love you.  Well done darling."  And my father.  He used to say "What I want in life is to leave two blades of grass growing where only one grew before." And soon I hope to have two healthy humans ... a good kidney each ... where there was only one healthy human before.  Tears.  Gratitude. Peaceful body.  Peaceful, open mind.

Self-compassion.  This is an exercise in self-compassion.  An opportunity for self-compassion.  An opportunity to learn more about it.  Really learn.  To swim in it.  Feel it.  Understand the taste of it.  And writing about this now ... still early in the morning ... I note that researchers have suggested that we can see self-compassion as composed of three aspects - common humanity (v's isolation), mindfulness (v's over-identification), and self-kindness (v's self-judgement). And you can see in the dance of self-compassion I've described in the previous three paragraphs, how these three aspects can weave together.

Kristin Neff is one of the key figures in the scientific study of self-compassion.  Her website contains a wealth of helpful resources including a 2016 overview "Self-compassion: embracing suffering with kindness" with its abstract reading "This chapter will explore the link between self-compassion - a positive way of relating to oneself - and wellbeing. Self-compassion involves treating ourselves kindly, like we would a close friend we cared about. Rather than making global evaluations of ourselves as “good” or “bad,” self-compassion involves generating kindness toward ourselves as imperfect humans, and learning to be present with the inevitable struggles of life with greater ease. It motivates us to make needed changes in our lives not because we’re worthless or inadequate, but because we care about ourselves and want to lessen our suffering. An overview of research on self-compassion will be provided, which a burgeoning empirical literature has shown to be powerfully associated with emotional wellbeing, motivation, health behaviors, personal responsibility, coping, and better interpersonal relationships. Research also indicates that self-compassion can be increased through relatively short-term interventions. Finally, similarities and distinctions between self-compassion and mindfulness and their relative relationship to wellbeing will be discussed."  What's not to like!

Besides links to full text research articles, her book & a variety of workshops, Kristin's website also generously gives access to downloadable self-compassion meditations and other exercises.  If you're interested in this approach, also rich in resources is the linked & broader Center for mindful self-compassion website.  And very active in this field too, is the parallel but somewhat different Compassionate mind foundation website.

Riches.  Managing approaching challenges.  And I'm writing again on this blog a little later.  This is the fifth post I've written in the sequence - see "Kidney donation: why it's well worth considering", "Kidney donation: what are the risks?", "Kidney donation: preoperative preparation ... values are central" and "Kidney donation: preoperative preparation & facing challenges more generally - goals and journey".  I've commented that I find it helpful to organize my coping responses into four general categories ... Values, Goals, Journey, and Self-Compassion.  I've talked a bit about Self-Compassion in this post, with its three components of mindfulness, kindness, and shared humanity (and greater more general perspective - see "Reappraising reappraisal").  The Journey splits into arriving at the operation in as good a physical & psychological state as I can, the initial days & weeks of recovery as I work back towards full functioning, and the long-term management of my health when I'm living with just one kidney.  

While the Goals primarily centre on donating a healthy kidney & recovering well, I'm also intrigued to see if this challenging time can deepen my relationships with others, and I'm inquisitive more generally to see what I can learn from this whole experience.  Self-compassion feels very precious to learn & practise better.  And I want also to emphasise the key importance of relationships.  The first part of this blog post was written yesterday morning. Yesterday evening I went to an ongoing Men's Group I've been a member of for nearly two years now (we meet for a few hours every month or so).  I read them the first three paragraphs of this post.  I felt deeply known and cared for by them.  And as well there's the deep loving support from my wife ... and even the recent, kind, reassuring email from someone I've never met, who has already donated a kidney and has been reading this blog.  This morning, writing now, I feel much more at peace.  Managing challenges can so helpfully involve a cluster of responses ... some that we practise on our own and some that come through the blessedness of deep relationships with others.

For the next post in this sequence, see "Kidney donation: the operation & first few postoperative days".  If you're a prospective kidney donor or one of their family or friends, it would be worth looking at these "postoperative" posts before going in for the operation.