Silence in Sangha, Stillness as Medicine
By Sabella Larkin
When I arrived at Ananda Ashram in Monroe, New York for my first ever Silent Meditation Retreat among others living with Type 1 Diabetes, I knew I was exactly where I needed to be at that moment.
We gathered in silence, each offering something to the altar — a stone, a photograph, a letter, a wish — and the room filled with quiet intention. As Noble Silence began, space opened…to breathe, to listen inwardly, and to feel the rhythm of diabetes — not through control or management, but through curious observation and compassion.
A Whole-Person Condition: Interwoven, Integrated & Invisible
The thing about diabetes is it is an all-encompassing condition. It affects every dimension or “layer” of the human experience.
Yoga philosophy describes these layers as koshas — the sheaths of being that make up our physical, mental, emotional, and spiritual existence. Dr. Suzie Carmack calls them the Koshas of Well-Being: the physical, mental, emotional, spiritual, and social dimensions of health.
I often say, “I am not diabetes, but diabetes is a huge part of my life. There is literally nothing that I can do that doesn’t impact diabetes, and that diabetes doesn’t also impact.”
And yet, as all encompassing as diabetes is, the condition itself and its impacts are often “invisible.”
When expressing what type 1 diabetes is to people who are unfamiliar, I usually say, “I exist in a body that can’t keep itself alive on its own, without my constant intervention.” While currently opting to reframe this language for my own health and healing, it’s a powerful statement — one that helps people who don’t live with diabetes truly pause and grasp what that means.
The majority of people exist in bodies that function and survive with ordinary rhythms — drinking water, eating meals, etc. But for those of us living with diabetes, every one of those rhythms is shaped by conscious intervention, spanning all the layers of human existence.
Diabetes is not just “watching blood sugar.”
It’s fine-tuned management — the 180 extra decisions a day that have been quoted across social media, validating the mental strain of living with this condition.
Diabetes affects everything and everyone, and everyone and everything affects diabetes.
And yet, while it is constant and all-encompassing, traditional healthcare, treatment, and research has been limited in its reach.
That is why retreats like this matter.
Integrative care, like healing itself, works on both conscious and subconscious levels. It doesn’t have to be about diabetes to affect diabetes. Practices such as meditation, movement, and mindful community ripple into every relationship — with self, with others, with life, and with diabetes. When embodied, these practices translate philosophy into living wisdom.
Living Well With Diabetes: Partnership Instead of Opposition
When the frameworks of yoga philosophy and integrative medicine meet through the lens of diabetes, they reveal a path toward living well: not in opposition to the condition, but in partnership with it.
One participant captured this beautifully, writing:
“The retreat helped give me space to work on creating trust within my body — a way to start becoming friends with it again after some rougher times.”
That reflection landed deeply. For me personally, it wasn’t until I surrendered the “fight against diabetes” mentality, that I began to experience something much needed after many years of fighting – rest.
Through yoga, mindfulness, and meditation, my relationship with diabetes experienced healing when attention shifted from resistance to relationship.
Movement • Mindfulness • Medicine & Community
These pillars — Movement, Mindfulness, Medicine and Community— form the foundation of an integrative, Whole-Person approach to diabetes care and advocacy. The DiabetesSangha retreat beautifully embodied this framework in practice.
Movement, Meditation, Mindfulness
Before the formal retreat began, a group of us met for an optional morning hike along the Indian Hill Loop — a 4-mile trail unfolding through damp green forest and mist-softened views. It became an early lesson in shared movement and diabetes care — the sound of musical CGM + pump alerts mingling with the sound of our footsteps, collective pauses for low-snack breaks, and the quiet rhythm of breath syncing with the forest. Midway through, facilitators Peter Friedfield & Sam Tullman, invited a segue into Noble Silence, turning the hike into a moving meditation — a supportive bridge into a weekend of silence, presence, and observation.
The next morning, fully immersed into the weekend retreat & Noble Silence, Sam led a sunrise Qigong practice on the deck by the lake. Fog rose off the water as the sun steadily shone through mist — each movement a gentle exchange of energy and breath. A partner exercise invited us to give and receive through the openness of the back of the heart — we sat back-to-back exchanging energetic vibrations through breath and felt heartbeat — a wordless reminder of the multilateral flow of energetic connection, openness, and empathy that transcended language that weekend.
Evenings closed with an optional Yoga Nidra practice facilitated by Kelsey Madison Dietrich. Yoga Nidra is a restorative and deeply meditative practice that invites full-body relaxation and somatic healing. Kelsey’s guidance created an opening for stillness that felt safe, nurturing, and profoundly grounding after full days of silence. Kelsey is the author of Mindfulness for Type 1 Diabetes and also shares guided meditations on Insight Timer, including a Loving-Kindness meditation for the T1D community. She offered a version of that meditation during the retreat—an invitation to extend compassion toward the body, our care teams, and the full circle of life with diabetes. Her voice carried us through the subtle layers of body, breath, and awareness. It was incredibly powerful to experience together.
Throughout the weekend, Noble Silence became a shared space of observation and acceptance.
Stillness and silent observation transformed glucose fluctuations and emotional waves into shared data points of compassion — a beautiful reminder that every reading, like every thought and emotion, is simply information, not identity.
Mindfulness and yoga philosophy teach that everything arises and passes. Within that awareness, both glucose and emotion can fluctuate without shame.
“I was surprised at how much more present and aware I felt within Noble Silence,” another participant shared. “Speed and focus aren’t necessary; slowness isn’t negative.”
Moments of group reading and intention setting deepened that connection. Poems like Rumi’s The Guest House and Walcott’s Love After Love became anchors for reflection and self-compassion.
Saturday evening’s meditation introduced Tonglen, a Tibetan Buddhist practice of giving and receiving — breathing in suffering, breathing out relief. It is a meditation of compassion that softens the boundaries between self and other.
During the meditation, emotion moved through the room — quiet sobs, trembling breath, the sound of release. I opened my eyes to see another participant weeping softly, and I felt drawn to sit beside her. With a gentle touch and her nod of permission, we breathed together — holding space for what needed to be felt, not fixed.
It was a reminder that compassion is both a practice and a presence — one that can arise spontaneously, even without words or instruction. There was a moment when the lights flickered, and it felt as though something greater — grace, spirit, or simply shared energy — was acknowledging the circle of compassion that had formed.
Medicine & Community as Care
Conventional healthcare often measures progress in numbers — A1Cs, time-in-range — yet living well with diabetes calls for something deeper: coherence between mind, body, data, and the integration of life with diabetes itself.
Within silence and stillness, self and others, nature and nourishment, that coherence began to take form. Medicine extends beyond insulin, sensors, and algorithms — it includes the medicine of community, compassion, and shared humanity. Integrative care expands the definition of treatment to embrace these dimensions as essential.
To live with diabetes as part of life means recognizing that treatment and care are interwoven — just as the condition itself is. Shared meals prepared with Ayurvedic care, quiet nods between sessions, the unspoken understanding of alerts and alarms — all formed a circle of empathy.
“It was the first time I’ve felt seen and understood by anyone.”
Silence did not separate us; it connected us beyond words. In that shared quiet, compassion became tangible.
When practices like movement, meditation, and mindfulness are embodied — especially within community — their influence ripples far beyond blood sugar management, shaping how we relate to ourselves, each other, and the world around us.
The Quiet Revolution of Community Care
Among the participants was an endocrinologist — there not as medical staff, but as part of the community. That felt quietly revolutionary. This was healthcare reform in action.
It’s something I’ve long envisioned: spaces where providers and patients practice with one another rather than on opposite sides of care.
In a recent conversation with my diabetes care provider, John Walsh, we talked about data fatigue — not only for people living with diabetes, but for clinicians, too. Continuous streams of information can be overwhelming for both sides.
Retreats like this — grounded in mindfulness and community — offer a rare opportunity for recalibration, inviting both patients and providers to slow down, listen, and practice presence together.
As I’ve written before in The Space Between, this is what healthcare reform looks like: connection between systems and humanity, data and lived experience.
This retreat represented more than a weekend of silence; it revealed what integrative, whole-person care can look like in practice — care that honors diabetes as the interwoven, integrated, and all-encompassing condition it is.
In a healthcare landscape that often prioritizes outcomes over experience and a fight against diabetes, gatherings like this offer a quiet yet transformative reminder that while many of us would gladly take a cure yesterday, our goal is living well with diabetes today.
Honoring the Hearts That Held This Space
With deep appreciation to Peter Friedfeld and Sam Tullman for holding this space with intention and care; to Kelsey Madison Dietrich for her teachings, presence, and grace; and to Ananda Ashram for offering a sacred environment for communal healing and living.
Heartfelt thanks also to every participant — for their presence, openness, and willingness to show up for themselves and one another. Each person’s energy contributed to a field of trust, compassion, and shared understanding that made this retreat what it was: a living expression of community care in action.
With gratitude and presence,
Sabella Larkin
Writer & T1D Advocate
💫 Drafted in mindful collaboration (me + ChatGPT)
Part of my ongoing storytelling and advocacy work through Betes Breaks™, in collaboration with the American Diabetes Association Scientific Sessions.
