Some degree of fear and anxiety is inevitable in life. But for some people, these emotions can become truly debilitating, keeping them trapped in cycles that can lead to depression and even chronic pain. So how can we help patients better manage fear and anxiety when they come up?
Below, you’ll find a simple exercise that anyone can use to work through these painful feelings. It’s courtesy of my friend Ron Siegel, PsyD.
Ron is an Assistant Professor of Psychology, part time, at Harvard Medical School, an internationally-renowned teacher, a long-time student of mindfulness meditation, and a well-known author.
One of the first things we notice when we pick up mindfulness practice is how often we have frightened thoughts about the future.
We think over and over about the future — hoping for pleasure and dreading pain.
And even the most subtle thought can cause anxiety.
Mark Twain described this brilliantly near the end of his life when he wrote, “I’m an old man now. I’ve lived a long and difficult life filled with so many misfortunes, most of which never happened.”
How Mindfulness Retrains the Brain to Lower Anxiety
It’s remarkably easy to see this for ourselves. Just take a moment to think about something that makes you anxious (it shouldn’t take long to come up with this). Is it a thought of the past, the present, or the future?
Sometimes people say, “I’m really anxious about what happened this morning.” But on closer examination, we realize we’re actually anxious that we’ll be incarcerated tonight for what we did this morning.
So it’s not surprising that one of the ways mindfulness practice can help us with anxiety is simply by training the brain and mind to bring attention to the present moment. Since for many of us, the present moment is usually pretty safe, doing this can really help cut anxiety.
How Mindfulness Increases Our Capacity to Bear Anxiety
The other way mindfulness helps is a bit more counter-intuitive.
We’re hard-wired to find anxiety unpleasant. After all, if we weren’t, we might gravitate toward dangerous situations, and eventually this would keep us from passing our DNA on to the next generation. Ancient hominids who didn’t find anxiety to be unpleasant probably weren’t our ancestors – they mostly died off before reproducing.
So naturally, we want to get rid of unpleasant anxious feelings. But attempts to avoid anxiety are actually the fuel at the heart of most anxiety disorders, keeping them going.
In a mindfulness-oriented approach, instead of trying to get rid of anxiety, we help our patients increase their capacity to bear it.
And this is not a new idea – here is what the Buddha said about anxiety 2500 years ago:
“Why do I dwell always expecting fear and dread? What if I subdue that fear and dread, keeping the same posture that I’m in when it comes upon me? While I walked, the fear and dread came upon me. I neither stood, nor sat, nor lay down until I had subdued that fear and dread.”
What he’s saying is when the fear or dread arises, instead of doing something to try to feel better and make it go away — he’s going to stay with it. He’s going to ride it out, until it goes away by itself.
A Simple Practice You (and Your Clients) Can Use to Befriend Fear and Anxiety
So, let me share an exercise that can help you or your patients do just this:
Start by bringing attention to some sensation in the body – perhaps the breath or another object of attention. Continue gently returning the attention to this object for a few minutes.
Next, see if you can locate some anxiety within the body. Just notice how it feels.
If you can’t find any anxiety, generate a scary thought or an image to help conjure it up. We want to get the
anxiety going strongly enough to be able to practice feeling it, but not to be overwhelming.
Once you’ve got some anxiety going, just breathe, and feel it. Notice how it feels throughout the body. Greet it like an old friend, “Oh I know you, you’re my old pal fear. You’ve visited me on so many occasions. Welcome back.”
If the sensation of anxiety starts to fade, do whatever you need to do to bring it back. Keep breathing, and keep practicing just welcoming and feeling the fear.
It’s best to introduce this practice at the beginning of a therapy session. If you give the exercise enough time, and keep encouraging your client to breathe and welcome the anxious feelings, eventually almost everyone will have difficulty maintaining the anxiety.
This can be enormously helpful, since it’ll help clients see that simply being with fear allows it to come and go like all other mental content.
And this can really help crystallize for folks that it’s often the attempt to make anxiety go away, not the anxiety itself, that traps us in anxiety disorders.
Now I’d like to hear from you – how have you used mindfulness practices in your work with anxious patients? Please share your experience in the comment section below.
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