Crossing the Threshold

There is a point at which things happen.

Water in a teakettle must reach 100o C (at sea level) before it will boil.

The air temperature must drop below 0o C before rain will turn to snow.

So it is with humans, as well. Most of us will tolerate almost anything (pain, sadness, loneliness) to a certain point. Then we find we no longer can. We have reached our “change” point. We are no longer able stay the same.

We have reached a threshold over which we must cross.

According to the “Transtheoretical Model” of Western Psychology, there are five “Stages of Change” that we must go through as we seek to do things differently in our lives: pre-contemplation, contemplation, preparation, action, and maintenance.

One of the most challenging stages is “contemplation.” In the contemplation stage, we realize that there is a problem we need to deal with. Yet we are not quite ready to work on the problem. We are not quite ready to cross the threshold.

During this time of contemplation, we are existing in a transitional place that Buddhists call the “bardo state.” This is a time of suspended animation; a time of waiting. It is a time of “liminality,” which comes from the Latin word līmen, meaning “a threshold.”

Existing in the liminal/bardo/contemplative state can be frustrating and exhausting. It is during this time that we will continue to feel all of the things that help us to understand that we must change: pain, sadness, loneliness. We continue to see that we are stuck. Yet we can’t seem to move forward.

That is, until we reach the point at which things must happen; the moment at which we must proceed.

In 2006, I found myself at this place as a physician. Trained in family and preventive medicine, I had been in a solo family medicine practice for five years. During this time, I spent countless hours with patients, trying to help them attain a state of health and balance. In many cases this meant trying to help them change their behaviors.

I had varying levels of success with helping patients through behavior change. My patients, in general, were willing, but I just didn’t seem to have the right tools needed to help them. I didn’t seem to be able to help them out of their bardo states.

Wanting to find better tools for my patients helped me out of my own bardo state as a physician. It prompted me to study acupuncture and Traditional Chinese Medicine, and eventually medical Qigong.

My desire to be a more effective doctor pushed me over the threshold, and a more effective doctor I have indeed become.

It is a threshold I have never regretted crossing.