Ah, Anxiety, Welcome! Can I take your coat? Depression is already here
On return from my holiday, I went directly to the doctor, terrified that the panic attacks were going to continue. The feelings I had been battling were most objectionable and I knew I couldn’t continue to feel this way without it culminating in something dreadful. The one doctor I could get an appointment with (not my usual doctor) was not terribly sympathetic, but gave me a one-week supply of pills to take in an emergency if it happened again.
It did happen again. But I didn’t want to take the pills. Having only recently come off my second course of anti-depressants, the last thing I wanted was to be defeated by a new set of mean forces within me. So I did a little research about panic attacks.
The previous year, as well as being prescribed with anti-depressants, my doctor had referred me for counselling. This culminated in me receiving Cognitive Behavioural Therapy (CBT) eventually, but first being signed up for an 8-week course in Mindfulness-Based Stress Reduction (MBSR). This program (developed in the 1970s by Professor Jon Kabat-Zinn and colleagues at the University of Massachusetts Medical Centre) was designed to take the principles and practices of traditional Buddhist mindfulness, and apply them in an accessible and secular way, for people suffering from chronic pain and other long-term health conditions or life issues that were difficult to treat in a hospital setting.
Jon Kabat-Zinn, defines mindfulness as:
“The awareness that emerges through paying attention on purpose in the present moment, and non-judgmentally, to the unfolding of experience moment-by-moment.”
Mindfulness can help reduce stress by developing a new level of awareness of:
- the thoughts that trigger stress
- the emotions that can bubble into conflict (internally and with others)
- the physical signs that the body is excessively stressed
- the behaviours that might contribute to heightened stress and also those that help relaxation and calmness.
As I explored a little deeper into anxiety and panic-attacks, I started to realise that everything I had learned about mindfulness could totally help me with this new pickle I found myself in. I read that one of the reasons panic attacks escalate so damn quickly is that when those fearful feelings start to arise, our fight or flight mechanism kicks in – that pesky evolutionary response that causes people to lash out when they are scared, run away screaming, or crumple into a sobbing heap on the floor (that one would be me). As anxiety rises in our bodies, since we cannot fight our own internal organs (and wouldn’t do so at this point in any case – as we are pretty sure they are going to give out on us all on their own), we try and run away from them. Also impossible. This urgent need to escape from the deeply unpleasant feelings we are experiencing, and our exact inability to do so, causes the whole darn predicament to quickly reach a fever pitch.
What I had learned from my mindfulness training, and subsequent reading on the subject, was that when an unpleasant emotion or feeling arises, we should not try and shut it down, run from it, or ruminate over it, but instead look at that feeling with compassionate interest and accept it for what it is. This is not an easy thing to do; it takes practice.
Dan Harris, previously an extraordinarily successful anchorman for ABC News, had his first ever panic-attack live on air in front of over 5 million viewers. This shocking experience woke him up to some of the unhealthy life choices he had been making to sustain himself, in a very competitive and stressful work environment. In an unexpected, and at first unwelcome twist of fate, it led to him being introduced to what he had once considered the “irredeemable bullshit” of mindfulness and meditation. Given this perspective, he is rather surprisingly now one of its most enthusiastic exponents. In one of his many entertainingly delivered talks on the subject he describes how meditation practice has changed his life in ways he could never have anticipated. Speaking about his first experiences of mindful meditation he says:
“I will tell you the truth, it’s not like I liked it. It’s a pain in the ass. It’s really hard, and so is going to the gym, and it’s the same kind of thing. Wrestling the mind to the ground is like holding a live fish in your hands. It’s tricky”.
Tricky it can be for sure, especially if you are a person to whom such activities are alien, or towards which you are profoundly sceptical, or even utterly dismissive. But for me, one of the beautiful things about mindfulness is you do not need to have any prior experience to give it a go and to receive some benefit from it. And, with practice, these benefits only grow and grow. There is a wealth of medical research which supports this. You do not need to know anything about Buddhism or meditation to start applying these techniques in your daily life. In fact, mindfulness is an inherent skill we all have had from birth, but we forget how to use it. It gets drowned out by the fast pace and intensity of the modern world and all of our daily lives, obligations and demands.
In one of my favourite mindful meditations by Jon Kabat-Zinn (and a concept described in more depth in his book on the subject ‘Wherever You Go, There You Are’) he suggests that we might imagine our emotions, thoughts and feelings as a body of water, be that a babbling brook, a swaying ocean, an incessant waterfall, a violent torrent. We have choices to make about how we want to engage with this water. We can, if we wish, sit on the shore and observe it flowing, or we can dive right in and get wet through. As a bystander, an observer, we can watch the waters pass by, ebb and flow, as they always will. Our thoughts and emotions, which are not facts but constructs of our own minds, do the same. And, like bodies of water, sometimes our thoughts and emotions rage, and when raging, only a fool would dive in and try to swim.
Over time, and with practice, I have learned that it is possible to sit by the river and watch my thoughts and emotions pass by, and not necessarily get dragged into them. It helps me sometimes to consider some of my more difficult thoughts and feelings as entities in their own right, creatures that I recognise and speak to with understanding and compassion – a technique I learned from my very favourite and most influential book on the subject by Paul Gilbert and Choden entitled ‘Mindful Compassion – Using the Power of Mindfulness and Compassion to Transform Our Lives’. This book is a beautiful collaboration combining fundamental principles and practices of Buddhist mindfulness, with a clear-sighted psychological perspective on why our minds work in the way they do, and accessible exercises helping to train our minds to be kinder to ourselves, and ultimately to all other humans we engage with. What a beautiful world indeed it would be if we could all master these skills!
As described in their book, it is not our fault that our minds are endlessly pulled away from the present moment in the ways that they are. This is to do with the uneasy interactions and skirmishes between our old-world brains, (those that deal with fear, anxiety, anger, lust, the need for sustenance and so on), and our more evolved new-brain capacities (such as those that deal with self-identity, reflection, feelings of purpose, imagination, planning and so on). This internal battle can cause us serious trouble, as our minds learn to deal with all of these discordant stimuli, influenced further by our own life experiences to date.
“Unlike the zebra who is chased by the lion but manages to escape and then very quickly returns to grazing on the savannah, humans have the capacity to relive the incident endlessly: ‘What if the lion had caught me? I would have been done for’, images of being ripped to pieces or eaten alive might pop into our minds – all very scary and traumatic. Humans are also constantly thinking: ‘what if …. and suppose that …’ for good and for bad”
Once we learn to become aware of our internal motives and external triggers, (which coordinate our thinking, attention, feelings and behaviours), then we can start to learn how we might be more compassionate toward what we find, allowing us to stand back and decide if we want to go down that road or not.
“This means making space for all the different elements of our experience. In the words of Jon Kabat-Zinn it means being open to the full catastrophe of being alive, or in the words of Rob Nairn in his teaching, it means being willing to drop into our own ‘compassionate mess’, that is both uncomfortable and yet rich with possibility. And then, from this non-judging attitude of mind we inquire of every mental state or emotion that arises: ‘Is this really who I am or is this just an experience that is moving through me?’. In the case of anxiety, we inquire ‘Has it become who I am in this moment?’ ….
If one day you suddenly get diarrhoea and an attack of vomiting you don’t think you are diarrhoea and vomiting – you recognize that these are just temporary physiological processes going on inside you, unpleasant as they may be; and mostly you let them run their course ….
When it comes to disturbances of the mind however, we have a perverse (and very unhelpful) tendency to identify with them and think that ‘I am an anxious / angry person’, as opposed to recognizing that anger or anxiety gets triggered in us in certain circumstances and are temporary ….
Identifying with mind states like anxiety causes our mind to contract around them tightly so that our mental landscape becomes closed and painful. Underlying this process is a subtle judgment and reaction to our experience – somehow feeling that it is not okay that we are going through what we are experiencing. But through making space for our experience, essentially by not judging it, our mind is able to relax its tight grip on the anxiety and a greater sense of freedom can arise. The difficult emotion is given space to unravel, work its way through, and change”.
So, for example, I greet my own anxious feelings and let them know I recognise and respect them. I do not deny their existence. I consider them with warmth and understanding, but I am not going to dive in and join them in the mire, instead I will seek to help them out of it.
“Mindfulness helps us witness the constant chatter, plans and inner dramas going on in the movies of our mind. It helps us to step back and pay attention, ‘observing from the balcony’ so to speak. In this way we become keen observers of the inner workings of the mind; and as the Buddha discovered, the mind becomes our greatest teacher of all”.
What is even more extraordinary and fabulous to consider is, as we understand and engage with our own emotions and motives more consciously, and then learn to extrapolate this to considering the motives and emotions of others around us (with conscious awareness and compassion) over time and with practice we can change the way we perceive the world and engage with it going forward, having activated and gradually strengthened different pathways in the brain and nervous system.
“Through systematic training in mindfulness and acceptance, we can learn to distinguish between the part of us that observes and what is observed, and we learn to inhabit this observing mode more and more. We learn to step outside the thought bubble. This is a crucial shift in awareness – learning to be an objective witness of our thoughts and emotions. This does not mean we become cold and dispassionate; it does not mean that we are no longer connected to the vitality and richness of life. In fact we become more present and more connected to life, but we find ourselves standing in a different relationship with our experience ….
Increasingly, we begin to be aware of the impermanent nature of our mental and emotional experience. Everything flows and changes; nothing is fixed. At some point the penny drops that we are witnessing this awareness ….
Once we are in this witnessing mode, we are able to relate to what we are experiencing with kindness and compassion”.
So, when I feel that ball of fear starting to expand and grow in my stomach, rather than trying to run away from my own body and feelings, I instead imagine looking inward, to this ball of fear, my friend, anxiety. I welcome it, I say “Hello there anxiety, yes I see you, I’m sorry you are not feeling so good. You know what? I am going to sit here with you, and we are going to breath through this together”. By accepting and sitting next to my anxious feelings, the strength of their fears starts to lessen, their breathing starts to calm, taking a few deep breaths so that my ball of fear can follow suit. I know this may all sound a little strange. Maybe a little cuckoo? You know what? That doesn’t matter so much. If it helps me to feel better, calm me down, prevents me having an all out meltdown, then a little cuckoo is fine by me.
Dan Harris too recognises the extraordinary transformative potential of mindfulness as:
“the ability to see what is happening in your head at any given moment, without getting carried away by it …… to see what is happening in your head without taking the bait and getting yanked around by it ….
And that, my friends, is a super-power, a super-power”
Though I did, at first, find it strange that I would start having anxiety attacks at this point in my life, I guess it is the culmination of some of the life-stuff that has gone before, and my rampant emotions trying to find an alternative outlet (given that I am not so often letting it have sobbing fits in public anymore). Who knows, I am not qualified in such matters. But I know what I know, and that is mindfulness works at calming me down when I need it the most. It is powerful magic, for all sorts of life’s troubles, and even just to enable you to enjoy life to a greater depth, see life with a lens of greater intensity and clarity, (even if you don’t have any troubles. But, you’re human right? So, I’m guessing ……..)
You can find a huge range of mindful meditations for free online. Look them up on YouTube. Jon Kabat-Zinn himself has an unusual and beautiful voice for these, the quality of his voice a lovely distraction when you may be feeling uptight, or whatever it is you are feeling. Here is a talk by him, including a guided meditation, but there are many, many more.
There are also a large number of free apps now available to download to your phone, including tailored meditations to suit whatever state you may find yourself in.
I have a huge amount of material about the power of mindfulness, and plan to write more about it the future. In the meantime, I send my warmest compassion to those with anxiety in their stomachs. Running away from it is not only entirely impractical, but will send you faster into the spiral of full-blown ‘Aaaargh!’. Perhaps try and befriend it and care for it when it starts to go a little bit crazy. What have you got to lose?
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