How to Be Happy in Hell: Dr. Christiane Northrup’s Special Annotated Version

Dr. Northrup (photo)
Christiane Northrup, M.D.

“This episode was the perfect catalyst to get me to slow down and really look
at my life in a new way, something that we often don’t do until life grabs us
by the throat and gives us a good shake.” —Christiane Northrup, M.D.

By Cat Saunders

Note: The following personal story and annotations by Dr. Christiane Northrup are reprinted here with permission. They are excerpted from Dr. Northrup’s newsletter “Health Wisdom for Women” (January 2003). Dr. Northrup’s words are highlighted in blue for you here.

Dear Reader–

I’m personally beginning the New Year with enormous relief and gratitude. As you may recall, I told you in the last issue of this newsletter that I had an eye problem that was getting better. Well, that’s what I thought when I wrote to you last month, but my soul had other plans for me. My cornea problem turned out to be far more serious than originally thought. In fact, I came dangerously close to losing most of the vision in my left eye.

I was diagnosed with a very rare condition called infectious crystalline keratopathy. There aren’t more than 60 cases reported in the world literature. What happens is that some kind of organism, such as a fungus or a bacteria, gets into the cornea and forms a branching crystalline pattern–like a balsam or pine branch–that causes clouding of the vision.

By the time I got to a corneal specialist at Massachusetts Eye and Ear Infirmary in Boston, the vision in my left eye was so cloudy I couldn’t read the top line of the vision chart. Working at the computer was out of the question. Not only that, but I also had eye pain, aversion to light (photophobia), and a bodywide feeling of malaise from the unchecked infection.

I needed an eye biopsy (not pleasant) and then was on hourly antibiotic eye drops (you heard that right–hourly around the clock) for 72 hours. After that, I was allowed to sleep for 3 hours at a time at night without getting up for the eye drops. This turned out to be a very good time to record lots of dreams in my journal.

My doctor as Massachusetts Eye and Ear told me that the condition was very serious and that I would be seeing him a lot. He was right. For the next week, I went in for a visit nearly every day. Progress was very slow. Despite the hourly antibiotics, I didn’t seem to be getting any better. Since I usually heal from anything within 24 hours, I couldn’t believe it. I was scared. I got down on my knees and prayed.

And then I saw my bottle of ascorbic acid–1,000 mg capsules. I knew that ascorbic acid at high doses worked as a reducing agent to combat free radical damage. I also knew that it was very good for quelling infections, so I started taking those capsules by the handful. (Luckily, I have a cast-iron GI tract and was able to easily take 50-60 grams a day. You know you’ve reached tissue saturation when you get loose stools. The amount this takes varies widely from person to person.)

I also called Deena Spear (the vibrational healer I wrote about in my August 2002 newsletter), and asked her to “tune” my energy field. She started immediately. In follow-up sessions, she told me that my body was wide open to receiving the energy. I don’t know what did what, but that was the day when my eye started to feel better. I knew deep inside that I had turned a corner and that all would be well.

About four days later the cloudiness started to clear. On a follow-up visit, my vision was almost back to normal and the doctors confirmed that the lesion in my eye was much smaller. But they cautioned me that I wasn’t out of the woods yet. Still, my improvement prompted an adjustment in my diagnosis to “atypical” infectious crystalline keratopathy.

I later learned that this condition doesn’t generally clear up. Hence, the modifier “atypical” in my case. The infection usually goes away but it leaves the cornea permanently scarred. Luckily, I didn’t know this. I was willing to do whatever it took to look at everything and anything in my life that required a new perspective.

It was clear to me that this illness was my chance to create a new vision for myself, and that’s what I spent the last part of 2002 doing. I cancelled speaking engagements, dropped out of some new business endeavors, and basically cleared the decks of everything that no longer served me.

My eye served me well and I am very grateful for the experience even though it terrified me. This episode was the perfect catalyst to get me to slow down and really look at my life in a new way–something that we often don’t do until life grabs us by the throat and gives us a good shake.

Now that I’m on the other side of it, I can see that my eye predicament was related to some unresolved life issues that I’m still working through. I don’t have all of the answers yet, but I do know they have to do with creating healthier boundaries for myself and reconstructing and deepening my sense of coming home to myself.

I’ve been writing in my journal a lot lately and will be sharing what I learn with you in future issues of this newsletter, as well as in my mother/daughter book. My eye health crisis was another chance to use everything I’ve been learning about and teaching to others for 25 years. I took a big dose of my own medicine. And I’m happy to report that it works!

How to Be Happy in Hell: The Good and the Terrible at Once

By Cat Saunders

“People who have not been in Narnia sometimes think that a thing cannot be good and terrible at the same time.”  —C. S. Lewis

Introductory note by Christiane Northrup:

I have been a long-time admirer of the work of Dr. Cat Saunders, a counselor, artist, writer, and healer who also runs a “Rent-A-Monk” prayer service. I was first introduced to her work when she sent me a copy of her wonderful book, Dr. Cat’s Helping Handbook, which is a veritable treasure-trove of practical wisdom designed to help you successfully navigate the times of grief, loss, and stress that are an inevitable part of life.

Having just come through a very difficult and frightening health problem in my left eye, I can vouch for the importance of having some well-honed skills available in times of stress. “How to be Happy in Hell” is a wonderful and wise compilation of exactly the kinds of skills that work. It’s a stellar example of Dr. Cat’s work. I’m honored to share it with you in this issue (along with my commentary) as a way to help you begin 2003 with maximal access to your own healing power, regardless of your present circumstances. —Chris

Dr. Cat’s article “How to Be Happy in Hell” (shown in black) is annotated by Dr. Northrup (shown in blue).

Anyone can be happy in heaven. It takes skill to be happy in hell. While I’m no expert on the subject of being happy in hell, this isn’t due to a lack of hardship. It’s just that the stakes are always raised whenever I make progress, so I remain a beginner. It’s like that mountain climbing allegory. Whenever you make it to the top of one mountain, you can see that an even higher peak awaits you.

Since I can’t claim mastery of a “happy in hell” attitude, how come I’m writing about it? Well, if I wait until I master the subject, I might be waiting for a very long time. Also, people teach what they need to know. If I offer some tips about being happy in hell, I’m sure faithful readers will point out my errors or offer additional tips. I welcome corrections and additional tips because they will help me grow.

In Dr. Cat’s Helping Handbook, there’s a chapter called “How to Love Your Shame.”  In that chapter, I suggest that shame feels so awful that most people act compulsively in the midst of it, instead of doing what’s truly helpful. Shame is like quicksand. If you don’t know how to deal with it, you might dig yourself in deeper trying to flail your way out.

The same thing applies to being happy in hell. If you have some tricks up your sleeve for dealing with shit, you’ll probably do better when it hits the proverbial fan. Also, stress can debilitate memory function. So it’s good to have additional tricks to help you remember your tricks!

Acronyms are one of my favorite memory jogs. Apropos to the subject at hand, I’ll use the acronym HAPPY IN HELL to outline a few techniques for parrying life’s onslaughts with grace.

H stands for HONOR WHAT’S HAPPENING. In a 1989 Sun magazine interview, I asked Ram Dass how he prays. He said, “When I pray, I never ask for anything, because I don’t even know why things are the way they are. How could I ask for them to be different? The only thing I ask is, ‘Help me understand better what’s happening so my actions will come out of more wisdom.’

CN: There is no better attitude than this one during difficult times, particularly those that involve our physical health. I had the chance to test this out directly during my recent bout with the infection in my left eye. When something this serious comes seemingly “out of the blue,” you know that your soul is tapping you on the shoulder and that there’s a message for you. The dilemma is that you won’t know what the message is until fairly late in the process. Until then you have to simply move forward on faith.

A stands for ASK FOR HELP. My favorite shaman, Michael Harner, says that there is no self-help. I love that! His statement does a number to the control-addicted part of me that thinks I can–or should–do everything myself. The truth is, I can’t even take a breath without the support of the entire universe.

Sometimes I’m willing to ask for help, but don’t know what I need. In that case, I ask someone I trust–a friend, mentor, or consultant–to help me figure out what I need. Then, if what I need requires additional support, I ask the relevant person.

This brings up the fear of rejection. When someone says no when I ask for help, I try to remember that it’s my request–not me–that’s being rejected. It’s never any particular person’s job to help me. Rather, it’s my job to ask other people until I get the help I need.

CN: During my eye problem, I had to call the emergency doctor on call at Massachusetts Eye and Ear very early one morning. As a physician, particularly a very healthy physician, I’m not at all used to being in this kind of vulnerable position. But I knew that my recovery depended on taking the risk of asking for help. I was surprised and humbled by the truly gracious and skillful help that was offered to me.

P stands for POLISH YOUR PERCEPTIONS. For years, I used mood-altering substances–primarily marijuana and caffeine–to deal with emotional pain, anxiety and fear, shame, fatigue, boredom–even excitement. My “allies” helped me survive. However, they also hurt me, because drugs enhance certain perceptions while clouding others. The overall result is decreased clarity and destabilized emotions.

I don’t know about you, but in hellish situations, I like to have all my wits about me. I want my perceptions polished and my emotions stable. That way, my actions–and my internal experience–can arise from a centered place in me.

Drugs were a valuable crutch when I didn’t know how to walk. But walking with crutches is nothing like walking free.

CN: We live in a culture in which addictions run rampant. The purpose of an addiction, whether to substances such as alcohol, marijuana, or obsessive cleaning, is to numb us so that we are out of touch with what we know and what we feel. There are times, as Dr. Cat notes, when addictive substances can act as crutches that help us move forward when we can’t yet walk on our own. But continued use of them as a habitual way to deal with life’s stresses is self-defeating.

As Dr. Cat says, you can’t really respond fully and healthfully to a difficult situation–with full access to your own inner guidance–if you habitually use substances or processes to numb your perceptions. Note: if you feel the need to lie about or minimize your use of a substance, then you can be sure that your use of it is an addiction.

P stands for PRACTICE CRAZY WISDOM. Crazy wisdom means imagining the wildest or weirdest thing possible, and then doing it–or some symbolic representation of it. For example, I was raised to be extremely polite. Sometimes I lament this training when I encounter intractable people who treat good manners as an invitation to attack.

One of my crazy wisdom techniques for dealing with these people is to imagine myself as a Tyrannosaurus Rex, an Arnold Schwarzenegger, or an Andrew Vachss. Then I say whatever I need to say in my own well-mannered style. But I say it with the extra “kick butt” support of my alter ego’s persona.

CN: My own crazy wisdom usually takes the form of doing something silly with my mind (or with a good friend) during a difficult time. For example, on one of my multiple visits to Massachusetts Eye and Ear Infirmary, I was trying to read the eye chart and failing miserably. When the eye technician asked me what kind of doctor I was, my friend and colleague, Dr. Mona Lisa Schulz, piped up with “plastic surgeon.” We both burst out laughing.

Y stands for YIELD THE RIGHT OF WAY. When things don’t go my way–whether for moments or years–I can either persist in my arrogant assumption that things should go my way. Or I can yield the right of way. Yielding changes my perspective on a situation, which–according to quantum physics–inevitably changes the situation itself. Yielding the right of way also helps me focus on changing what I can change, namely, myself and my own expectations. This is obviously more effective than trying to change the world.

CN: I couldn’t agree more.

I stands for INHALE AND EXHALE. In 1974, I fell in love with a tantra teacher who was deep into breath work (we called it “rebirthing” back then). Years of training with him and many others taught me how “circular” (continuous) breathing can rejuvenate the body. It can also stimulate brain function, balance emotions, increase creativity, heighten spiritual awareness, and improve sex.

Hellish situations tend to put a damper on everything I just mentioned. So the single most important thing to do during stress–or anytime–is to keep breathing. Inhale and exhale!

CN: As you probably know, I’m a big fan of the power of breathing. Breathing (and singing) are part of our emotional digestive system. Breathing fully (especially in through the nose and out through the nose) activates our parasympathetic system, which restores balance to the “fight or flight” sympathetic nervous system–which, when overactive, inevitably wears us down physically and emotionally. One of my favorite books about breathing is Body Mind and Sport by John Douillard. Another is the book (and video) called The Art of Breathing by Nancy Zi.

N stands for NURTURE YOURSELF. During a long period of adversity, I rented space from a much loved, but very boisterous and boundary-less group of friends. Imagine a solitary, privacy-loving cat trapped in a pack of barking, bantering, bickering dogs. That image will give you some idea of my daily (and nightly) experience with what I came to call “Grand Central Circus.”

For the first few years of my tenure in “the pack,” I naively assumed that simple consideration would be granted if I merely meowed politely enough. When that failed, I meowed louder. Occasionally, in fits of sleep-deprived exasperation, I growled.

These methods had some effect on the local majority. They mercifully decided that curbing a few of their behaviors was easier than listening to some obnoxious cat yowl about them. However, curbing inconsiderate behavior is much different from eliminating it. Eventually I realized it was unfair to keep asking dogs–however human–to act like cats.

Ultimately, I knew that my stay at Grand Central Circus was “graduate school.” My assignment was not only to survive, but also to thrive. I succeeded in surviving. But I had a tough time thriving on less than three uninterrupted hours of sleep every night for years.

Sleep–the mother of all nurturing activities–was virtually impossible at Grand Central Circus. And other unmentionable characteristics of the place made that it a royal nightmare for me. Yet its lack of external support–and the general adversity of the time–caused considerable internal growth.

That period provided harsh lessons in the temptation–and futility–of revenge. It also challenged me to remain civil in the face of torment (I didn’t always succeed). Most of all, it taught me the absolute necessity of nurturing myself no matter what. It was, as C. S. Lewis would say, terrible and good at the same time.

CN: During my eye dilemma, I had to cancel some speaking engagements that had been planned for over a year. I also had to curtail all my writing for several weeks. (This issue is the first thing I’ve worked on in weeks.) I took naps, slept long hours, and made a career out of taking supplements and putting in eye drops.

I learned that nothing I did was more important than self-nurturance. The alternative had come dangerously close to leaving me blind in one eye. Though I thought I had been nurturing myself enough, my illness left me with a new perspective on what self-nurturing was really about.

H stands for HANDLE YOUR HANG-UPS. Whenever I find myself in hell, I notice that the local demons always look mighty familiar. The local demons, of course, are my own peculiar set of emotional hang-ups. The local demons are that strange and mysterious collection of karmic myths, cultural conditioning, and family patterns that contribute to, and detract from, my innate personality.

This eclectic mix of gold and garbage sometimes triggers an unfortunate array of automatic behavior during stressful situations. Needless to say, automatic behavior–the garbage part–increases the likelihood that difficult situations will become downright hellish. Thus, I’m a big advocate of handling hang-ups through various means. These include personal observation, reflection, ongoing behavioral modification, and the help of watchdog friends and consultants.

Ram Dass said that after decades of work on himself, “I haven’t gotten rid of one neurosis. Not one. The only thing that has changed is that while before these neuroses were huge monsters that possessed me, now they’re like little shmoos that I invite over for tea. I say, ‘Oh, sexual perversity! Haven’t seen you in weeks!’ They’re sort of my style now. When your neuroses become your style, then you’ve got it made.”

CN: One of the things I learned recently was how conditioned I’d become over the years to sacrificing myself for the good of others who didn’t really respect or honor me fully. This pattern started in childhood. It was the way I “earned” love. I now “see” this fully. Remnants of this pattern will no doubt be with me for the remainder of my life. I have decided to fully accept and love this aspect of my personality. By befriending it, I find that I’m far less likely to act from it.

E stands for EXPAND PERSONAL RESPONSIBILITY. To me, personal responsibility is the number one issue in life. If everyone on the planet suddenly took 100% responsibility for themselves and their actions, heaven on earth would manifest overnight.

I’m not holding my breath waiting for that to happen. Besides, taking 100% responsibility has nothing to do with anyone else and everything to do with me. All I can do is work on myself and my own behavior. Considering the magnitude of this project, it should keep me busy for, say, the rest of my life.

CN: Taking responsibility for the events of your life and for your health is the most powerful method I know of to access the enormous power we all have within us. I completely agree with Dr. Cat that taking responsibility is, indeed, the number one issue in life. It holds the key to everything–including health, happiness, and serenity.

L stands for LAUGH. When I distill the essence of my soul into one image, it’s always the same: a cosmic grin. During ghastly experiences of pain, loss, hardship, or fear, something will suddenly strike me as funny, and I’ll crack up laughing. Humor in the midst of hell–and perhaps even because of it–is my saving grace.

Some people think this makes me a masochist or a bona fide nut case. But I cultivate this quality in myself. For one thing, it makes me feel good. Laughter stimulates endorphins, after all. Also, humor helps me remember the big picture. Namely, the trials and tribulations of material existence are merely different aspects of the same lila (Sanskrit for “God’s play”).

CN: In his classic book, Anatomy of an Illness as Perceived by the Patient, Norman Cousins first documented the healing effects of humor on the immune system. I’m a huge fan of humor. It’s one of qualities that I share with Dr. Cat. One of my favorite sayings is that “Anything worth taking seriously is worth making fun of.”

I personally love the way the writers of the NBC sitcom “Scrubs” make fun of medical training–with great accuracy, I might add. Quite frankly, I think that comedians like Robin Williams and Barry Humphries (who plays the character Dame Edna) are great healers of our times.

L stands for LET GO. When all else fails–and in general–I remind myself to let go. I remind myself to let go of grudges against self or others. Let go of the illusion of control. Let go of needing to be seen or heard, wanted or appreciated. And let go of needing to be important at all!

I remind myself to let go of pride, perfectionism, and preconceived definitions of happiness. Let go of entitlement-based notions about deserving to be happy. And let go of shame-based fears about not deserving to be happy.

I remind myself to let go of needing to feel happy in order to be happy. Let go of needing to be happy at all! In short, let go of anything and everything that stands in the way of experiencing heaven on earth, even when it’s hell.

CN: During the course of my recent illness, I realized that there was a portion of my business that I needed to let go of completely–despite trying to make it work for over seven years. Though I never would have dreamed I’d end up withdrawing completely from this aspect of my business, I realized that letting go was the only choice if I were to maintain and regain my health.

On the day I made my decision, I went to see the latest Harry Potter movie. At one point, the character Dumbledore says to Harry, “Your talent and skills are not what’s important in life. It is the choices that you make.” I felt that those words were meant directly for me.

As you begin this new year, may all your choices serve your highest possible purpose on all levels.

“How to Be Happy in Hell” was originally published by The New Times (June 2002) and updated in June 2017.

Christiane Northrup, M.D., is the author of Women’s Bodies, Women’s Wisdom, The Wisdom of Menopause, Mother-Daughter Wisdom, and The Secret Pleasures of Menopause. A graduate of Dartmouth Medical School and a past president of the American Holistic Medical Association, Dr. Northrup has been in private practice since 1979. She is much beloved pioneer and authority in the field of women’s health care, and a longtime veteran of many PBS specials.

Dr. Northrup’s work has been featured on the Oprah Winfrey Show, the Today Show, NBC Nightly News, The View, the Rachael Ray Show, and Good Morning America. For more information about Dr. Northrup and her work, please visit her website at

If you’d like to read Cat’s personal tribute to Dr. Northrup on this website, please click here.

Cat Saunders, Ph.D., is a counselor in private practice in Seattle, Washington. She is also the author of Dr. Cat’s Helping Handbook: A Compassionate Guide for Being Human (available through Amazon). Contact Cat by emailing her or by calling 206-329-0125 (24-hour voicemail).