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.
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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.
What a good reframe of anxiety! It’s the “welcome” that allows the anxietey to be felt and allows it to melt away. Great idea!
I’m going to practice this on the tennis court..thanks! 🙂
Helpful advice.again from Dr. Siegel. He makes an excellent case for using this practice.
My entire practice is about supporting clients and students in being able to be present with what arises. My specialty is prenatal and birth psychology so people often come to me expecting to dive into their story and cathart. I find myself explaining basic neurobiology of trauma to them and guiding them in learning how to be in present time and touch in on their history from here. I also teach Continuum Movement, a mindful movement practice as a way to support being present in life, not just on the cushion It’s all soon helpful!
Thank you again for another great article!
“Some degree of fear and anxiety is inevitable in life.” Interesting belief. Is it true? Acupuncture teaches to ALWAYS look for the underlying cause. The underlying cause for ALL fear/anxiety, in my experience in my life & my clinical practice of over 40 years, is negative imagination, e.g. what a child is afraid of in the dark is not the dark but the monsters the child IMAGINES to be in the dark. When my youngest daughter was less than a year old she awoke in pitch darkness and I heard her contentedly “singing” to herself & I thought “she hasn’t yet learned to be afraid.” As a Naval Aviator & at other times I have experienced Danger, with the adrenaline etc. rush of my Survival Instinct kicking in, but I never experienced fear/anxiety until the danger was handled, & my Egoic mind started Imagining what might have happened. Fear & the Survival Instinct are distinctly different – Fear can override & negate the Survival Instinct & cause to happen what one imagines. In the early 70’s we had a lot of LSD “bad trips” & a standard protocol was to have the patient simply sit, look around & repeat “Here & Now I’m aware of.” This was to include awareness using all the senses. Within 5 minutes or less, without fail they would be calm, realizing that here & now they were safe & there was nothing to fear. I find “The Emotion Code ” with its focus on “trapped emotions” a tremendous resource & a staple of my current practice.
It sounds like people are assuming you are saying this is a one-size-fits all exercise. This should be taken in context of an entire course, such as one with Peter Levine or Dr. Bessel van der Kolk who suggest to titrate strong feelings of anxiety.
I would also be sure to include in practitioner/client awareness that anxiety is pushing down natural biological signals of energy arising for a reason. By supportedly tuning in to the body sensations, we can learn more of what it’s all about. And decide appropriately. I feel these short pieces do not acknowledge that anxiety is always about SOMETHING. Especially in clients with trauma hx, unused to looking for meaning in anxiety they can & should usefully act on now, & generically protecting themselves from pain, overwhelm, which can be dis-abling. Is there real information, which, coming into awareness, might bring up overwhelming anger, causing more energy/Gestalt “aggressive towards something”, which may be crucial information of situation & actions needed NOW. We must be mindful not to encourage ‘It’s all in your head” with a partial approach. As folks say, weaving in education with increasing tolerance for biological information & processing so there will be learning it will all be more manageable, welcome & valuable.
This practical and clear exercise is the heart of teaching mindfulness to anxious clients It is nice to see that I can offer this as a practice that is endorsed by Associate Professor Ron Siegel especially for those that doubt the validity of mindfulness
I use mindfulness with individuals by asking, What can you do to get into here and now?..what do you see around you…while breathing find four words to describe something. I like giving individuals a script that they can use when they are in emotional distress by themselves. Something quick that can help change their minds.
I just used something similar with my brother who was hospitalized and overwhelmed at the thought of his self care upon release. We took the time to experience different sensations in the body, including the tremors in his hands that were coming from the anxiety and the warmth and pressure he was feeling from my touch on his arm. It was the beginning of helping him distance himself from the thoughts arising and move more into the body in the moment….that coupled with a few deep breaths helped the tremors stop.
I used to start the session with mindfulness exercise but found that a few minutes of checking in and finding out if they have someone pressing to bring up works better. Then when we start I weave a mini mindfulness experience in the session. Forcing it when they aren’t ready seemed to create more resistance. I provide clients a resource list, including names of people I recommend they look for when goggling, checking youtube or buying books. Ron Siegel is on my short list. Thank you for sharing this.
Great intervention!
I love these sessions and find them very helpful! However, I don’t see how this explains anxiety for me, with PTSD from childhood with TBI from car accident heaped on top. Spect imaging shows low blood flow to my limbic system, several parts of it don’t get enough blood, day or night, so that means my limbic system is always aroused. Meditation has helped, therapy, CBT, interactive metronome, QEEG, Brainwave Optimization, talking, writing have all helped, but there is always a low level of anxiety, even when I sleep. I also have leaky blood brain barrier. I wonder what the answer is to physical changes in the brain. Meanwhile, I look normal, sound smart and no one believes that I am stressed.
I have just started reading more and more about mindfulness and here it is again. The exercise is simple, practical, and memorable. I will share this with others as well as using it myself.
It makes so much sense to me, and adolescents tend to progress quicker then some adults. It is something I need to practice…
I find myself using mindfulness right now. I do have a client I intend to work with. She fears she will never get into a. Foster care but is not recognizing her behaviors keep her in the group homes or hospital.
Facing anxiety while practicing mindfulness gives the anxious mind to bear more anxiety and eventually to win anxiety. This may take some time (while rewiring goes on the brain) and as Buddha said ‘one needs to cherish patience’.
It is good to have words to delineate fear from the object of fear, as well as to tether fear with the patient’s personalized experience of anxiety. Once a patient accepts and incorporates this paradigm, it is good practice to visit, and be present, with fear within the safety of the therapeutic relationship; revealing cognitive distortions, of which many consist of the maladaptive perception that anxiety is necessary to be responsible and motivated.
Facing fear, I’m pretty certain is much different from going back to a
dangerous situation and pushing through it….I know that does not work.
My mother used to say *Fake it ’til you make it* and I did, but in a very
important way, I did not make it…even though I did fake a lot of people
out.
You must, in my opinion, make some sort of progress that you can track,
in order to be (more) mindful through a frightening or dissociative situation.
I completely agree with you, Elaine.
Mindfulness is great for some anxiety disorders and it’s not going to be a complete solution for serious problems. At deeper levels there is a need to address the underlying issues of trauma, neurochemistry, lifestyle choices, relationships, diet, spirituality, etc.
A person who has generalized anxiety disorder, disassociative disorder, or ptsd cannot solve their problems with mindfulness alone. Trying to constantly subdue chronic, overwhelming anxiety without proper treatment will eventually lead to physical, mental and emotional breakdown.
I found this so annoying to watch because I was interrupted every time I tried to read the exercise from start to finish.
Please let me finish. I do not want any brochure or anything else.
A Note on Reductionism
This is how modern psychological approaches have become subtly moulded into reductionism. Its like the hidden message embedded amongst otherwise very good stuff. ………..
“We think over and over about the future — hoping for pleasure and dreading pain….”
Do you really experience yourself like that? What about meaning, what about the capacity for concern’ (Winnicott), what about the impulse towards values and meaning (Frankl).
My worries, and I have many – are not about attaining pleasure, or avoiding pain. That would make me some sort of mollusc. (However, I dont relaly know how molluscs think).
Anyone else think like this?
Clients desperately want so much relief when they seek help. It’s such a brave important step for them and one of my biggest goals is to help them with Hope, patience and accepting things might feel worse before they really get better. I like Mindfulness practice because it does not set clients up to experience shame when they cannot discover their passion or be grateful all the time or expect life to be happy and positive…this is a nice simple reminder about the ironic power of acceptance. Thank you!
Thank you for the article and the reference to the Buddha and Mark Twain. I was introduced to this practice some years ago with Tara Brach, who I know works in concert with NICABM, and it has been helpful to me and to some friends that are struggling with fear and anxiety. One of which was my thirty year old son. I shared the teaching of this practice with him and referenced the Buddha and his nemesis Mara and Buddha asking Mara to tea which is to say being with the fear and/or anxiety. Some weeks later I noticed my son was agitated and upset so I called down to him and asked is everything alright and he said yes, I am having tea with Mara. I smiled and said ok. So its a work in progress and it is helpful. I remember another saying that was passed on through Tara Brach, “whatever you resist, persists.” This is just another reason to embrace this practice and learn to face our fears and anxiety’s instead of letting them control us and our reactions to them.
Wisdom from Buddha and Mark Twain? Yes. Modern neuroscience and behavioral science also state the not so obvious: ‘we worry about so much which never comes true.’
I believe that it is 93% or 97% of what people worry about never comes to fruition. (anyone with stats?) Of course, the hardwired human, primal brain defaults to survival and protection; thus, worry about the worst, or even the bad consequences was very powerful for us. It still is — to a degree.
This is where true awareness, mindfulness and practical techniques of feeling and accepting real problems, then applying ‘now’ thoughts of control, next positive steps and then living in that positive mode until your reality proves otherwise.
This is the true teaching principle, I believe, of the learned, sagacious and wise experts like Dr. Buczynski and Siegel.
Each time I read one of the articles on this site, my own understanding and peace of mind inherently grows.
Thank you.
I agree this isn’t for everyone. I do find it helpful to accept my feelings, whatever they are, and they do tend to dissipate (like they just wanted to be heard and seen, acknowledged and validated). But I could see that someone who has a certain level of trauma in their system and may not feel strong or resourced or safe enough to face it, this could be potentially harmful.
I would very much like you, Ruth, or Ron to qualify this and explain the kind of client this is appropriate for and the kind of client it is NOT appropriate for. This merits more discussion to find the boundaries of where this works and where it doesn’t.
Wise comment “Tamara, Student, Canada.” Yes indeed MANY folks who seek out therapy, have foundational needs to work through of traumatic experience, often before they can tolerate the quiet reflection of mindful meditation. Their efforts at quiet reflection may only expose them unbearable waves of the hellish torture that their body and minds have come to be burdened with… Without adequate understanding and attention to such generational trauma and its effects, well meaning therapists and spiritual and religious practitioners can inadvertently overwhelm and possibly re-traumatize sensitive trauma survivors. Therefore, any healing practitioner or educated spiritual or religious leader must assess for these common vulnerable folk, prior to attempting to provide the often helpful tools of meditation and mindfulness practice. Healing of these foundational needs often requires years of gradual and hard-earned therapeutic intervention and relational growth, which may lead to the capacity to make use of meditation. It would be very helpful, therefore, Dr. Buczynski and Dr. Siegal, to caution the public and mental health practitioners about the need to treat trauma survivors with sensitivity and knowledge, before naively recommending generic meditative techniques (That is, trauma survivors, ranging from people who have gone through ‘big T trauma,’ such as life-threatening or massively violating experiences, to extraordinarily common – but deeply hurt and damaged “relational trauma” survivors – which probably numbers in the 100’s of millions – of people who have experienced generational transmission of compromised attachment security of many varieties, at the level of severely thwarting their capacities for health and creativity.).
I have worked with complex PTSD attachment disordered trauma survivors for many years (and it never ceases to amaze me the huge numbers of folks who are suffering with foundational trauma associated with abusive caregivers, narcissistically disordered parents, who don’t necessarily look over the top abusive or neglectful, but who inadvertently transmitted shame and bodily held distress to their innocent children); and these trauma survivors deserve educated and trained provision of appropriate treatment of their pain/struggles.
Thanks for this comment! I’ve been in several classes recently where they do some sort of similar meditation/exercise and it has always increased my anxiety to the point that I cannot stand to be in the room. I’ve mentioned this repeatedly to them, but they keep stressing that I need to use Opposite Action and that doing so will lessen my negative reaction to the exercise. (The reality is that my negative reaction is getting stronger each time.) Thanks to your comment, I think I finally begin to understand what is happening and why; I’m a survivor of “Big T” Trauma and do have PTSD.
May I please share your comments with the therapists in question?
Thank you, Philip, for validating my comment. I appreciate you picking up on what I said — and then adding so much more fully and brilliantly to it for added depth and information.
Thank you, this is helpful. I have ptsd due to long term relational trauma and although nowadays after much healing I can do a bit of mindful awareness when I am calm, often there is just too much going on in my body and I get flooded or retraumatised by trying to sit quietly. I have a lot of dissociation and I used to see this as personal failure but now I recognise it as necessary for the moment. Mindfulness can breach the walls of dissociation prematurely, so can any practise that focuses on the body, and needs to be handled with great care. Having said this, when I feel my anxiety is out of hand there are occasions where accepting the symptoms has done the trick and it has faded away. Not a one size fits all but useful in some situations.
Very interesting approach. This article (as well as many others in this nicabm subscription) is helping me understand much as I search for a therapist for my teen daughter. If any of you therapists are in Los Angeles, I’d love to know who you are. Maybe you’re the therapist my anxious, panic-attack proned daughter needs. Please reply below with your contact info. Thanks!
Check out the find a therapist section of USABP
Check out the find a therapist section at the untied states association for body psychotherapy
Once again, more helpful pieces of information. Thank you.
Hi Ruthie
I do not agree to invoke anxiety. I would rather not ask anyone having problem to imagine anxiety and then tolerate. no doubt logically it may work or may not work at all.
secondly , invoking anxiety is a problem. many people may have fear before imagining anxiety.
simple method would be
1. first move in the state of mindfulness
2. move awareness to different parts of the body – experience sensation
3. let subject discover , how mind labels one sensation as anxiety and other as pleasure.
4. let the subject move mind 2-3 times and to help them to recognize that labeling by mind triggers anxiety
regards
Girish Jha
He mentions the Buddha and rightfully so; whawwt he is offering here is actually pure Buddhism–‘the Vippissana technique. Focusing on the issue , not avoiding it actually diminishes it. So it is.
Thank you for sharing these wonderful insights and practical exercises. I have a very anxious client right now, and I’m going to share this exercise with her.
Thank you and Ron Siegel for your generosity in sharing these snippets. Vera Smith.
I tired something like this with my client but her resistance to tuning into the feeling in her body of anxiety caused her to be resistant in the whole process. She told me she wold rather take a xanax and use medication to alleviate her angst. Those with panic disorder are terrified of the impending anxiety surfacing so this is not somethign they are open to at all at leas ti have found this to be so.
I have the same problem. When I sit with my anxiety and (try to breathe normally), it escalates and then I spiral into the dark hole of anxiety and depression. I’ve become so afraid of that sensation, I don’t dare do it.
Stephen Levine used to tell us to invite fear in for tea. “Come in, take tea.” I envision the negative emotions as cartoon monsters all sitting around having tea with me.
Love this, Elizabeth! Thank you for sharing! I will invite my feelings in for tea and a chat, maybe a cookie! Not sure how I’ll visualize them…maybe as my inner children having a tea party. Thanks for sparking this for me. A lovely approach! 🙂
I love this idea too, thanks for sharing Elizabeth ,I also like to imagine a smiling Budda sitting in my heart with flower petals at his feet, he has light and sunshine all around him too.. so when I have a spark of fear I think of him smiling and it makes me smile and calms me!
Just got it Ron, that this is exposure therapy and somatic experiencing…rocking in and out of it…but not running away…Mindfulness? Yes, I suppose.
Wow. It worked. Stomach ache went away almost instantly when I welcomed it. It is hard to maintain it. Then I moved on from mindfulness to my email and it came back, but not as strongly. I welcomed it again, it’s less. Thank you! Mindfulness is better than a pill!
It’s amazing how negative emotion is powerless in present moment awareness
I would love to hear some tips on relaxing them mind to open to posibillty to face emotion not to run from it
Thank you
People with severe depression and anxiety can experience that dread, sadness ,and fear as overwhelming almost all the time. Their anxiety can take a stake-out overwhelming position when focused on during meditation or mindfulness practice and not dissipate. What then ?
That’s me. I live in hell most days.
I like your image about “Live in Hell”–a Christian metaphor with great meaning. Buddha having tea with Mara remnds me of Jesus and Satan in the desert. Right before that was the trauma of the execution of John the Baptist. Scholars believe Jesus was a disciple of John. Right after that, Jesus began his ministry, having confronted his demons and gained insight and inner peace. I don’t believe you are a fundamentalist, but I do believe that if any therapist has a fundamentalist client, this might be a helpful image. Just a thought about images and metaphors. I know from personal experience of about 50 years ago about “Good Morning, Blues”, which may be similar to living in Hell. Thank Heavens, I no longer experience this.
“Confronting my demons” doesn’t make them go away….now what?
Hug them. Whatever the demons are feeling — fear, anxiety, anger, grief — they only want to be heard and seen, their suffering acknowledged, witnessed and validated. Hug them every time they come to you, validate the pain — and see what happens. Do they stay demons? Or are they soothed by being witnessed and validated at long last?
Repeat as necessary (if this shifts something)….
This works. Mine presents as nausea on my way to the job d/t my fearful thoughts of what could happen. I take deep breaths and send it to the belly and it’s been working. I do this with pain also and it is very effective. I remember a patient yelling out ” I can’t hold onto this pain anymore”. I stated ” why would you, let it go and breath”. She became quiet and more relaxed as I helped her remove her attention from the fear and the pain through her breath.
I have used mindfulness with clients to help them sit with their fears. I like the idea of sitting with the anxious feelings because most clients will do anything to try to avoid these feelings, which can be a vicious cycle.
Thank you this is so very useful! I often explore anxiety with clients by what I call “following the fear”. When a client expresses an anxiety, I ask, “then what happens”? We continue exploring what next, then what, etc. Often they can get to a place of seeing the experience they have of “the fear of the fear”, rather than something concrete in the world. It can be very helpful to verbalize all the various anxieties.
Very useful procedure to control and reduce anxiety/fear by combining anxious feelings with mindfulness and thus avoiding the ‘avoidance of fear’. This is simply ‘winning anxiety/fear’.
Do you believe this method could be used with anger, as well?
Just my 2 cents’ worth, Laura, about using this with anger. Just from what I know (personal experience and lots of reading and listening to the pros), I can see sitting with anger would work — any emotion, in fact. My thought, though, is that these feelings might need a “container”. Yes, we can feel them rise up in our bodies and listen to their wisdom (they usually have something to tell us), and sometimes that is enough.
But in case this opens up to more than we might have been expecting or anticipating, I think it’s important to have a “container” that makes it safe to do some processing — even if it’s just a journal or open document on the computer to write out what anger has to say, or a quiet space where we can feel free to feel our feelings. A container could include a certain amount of time we make available and then we move on. I think a container offers safe boundaries on whatever we might experience, and also a place to “put” whatever might arise, all to help with the processing.
Just my thoughts, hope you understand what I mean. Have you tried it with anger?
I tried this and it made me feel more anxious for days afterwards. Didn’t try it again, but did experiment with a variation that has been more helpful to me. No need to deliberately call up some anxiety, it will come on its own soon enough anyway. Definitely no need to keep the anxiety going longer by calling to mind the content of specific fears, which only seems to reinforce the fears. But when I do feel anxious, now I notice each of the physical sensations, then focus on breathing slowly. Then ask myself that, keeping in mind that my lifespan is limited, do I want to spend a large portion of it feeling upset about whatever triggered my anxiety, or about anything else. The answer is inevitably “no” and this creates a sort of permission to let go of whatever triggered the anxiety and instead and enjoy whatever there is to enjoy about the present.
Excellent suggestion.
much like pain, physical or emotional, our attempts to snuff out fear or anxiety, or ignore it or talk ourselves out of it tend, instead, to tangle us up with it more. I try to treat these uncomfortable emotions like I might treat a neighbor who comes too often or stays too long. we have to live together, so acknowledging each other is appropriate and greases the wheels of social comfort. it is in my best interest to attend to my neighbor at times, to “keep the peace”. Ignoring them will increase judgement and irritation. so it is with anxiety. ignoring it does not work. attending too closely to it, ties it to us, involves us with it. allowing fear and anxiety to come and go as they will, so to speak, frees us, not from ever feeling these feelings, but from being forever engaged in fighting them.
thanks for your insight Virginia – I completely agree…. I wonder if those who suggest these excercises have ever really felt the all consuming dread of trauma or traumatic reactivation ??? I’d hardly call it an old Pal…. anxiety is a value judgement that tries to describe a plethora of interpretations of whats happening…. focusing on THE SENSATION is a much more productive thing…. inviting a person who’s got ongoing terror and dysregulation to focus on their anxiety – I don’t think so…. how about focussing on the SENSATION… instead of the concept of anxiety…. ?
Wow here showcases the healing power of words! Fascination. Well written Virginia!!
I do a form of this with some clients. An additional component is this: I have the client observe themselves in their anxious state from a perspective above the anxious part of them. If it feels compatible with who they feel they are, at that time in their lives, I suggest they say to the anxious part, “Hm, he (or she) is doing anxiety now. What does she (or he) need from me to help move this along in a natural, organic way?” It is quite common to have the anxious part say, “I just want you to know that (something that is in need of their attention).” Then I have them show gratitude for the knowledge they have received from the anxious part. In many cases the anxiety evaporates or at the very least is reduced to manageable proportions. This intervention is contraindicated for those with a tendency to disassociate. Relatively high functioning clients, though, generally benefit.
I have a friend who has had “anxiety attacks” frequently. I have recently learned that this is true also of her sister, her mother and her maternal grandmother. I was surprised to learn that she has recently experienced temporal lobe seizures and that “anxiety” appears to be a part of the aura. I have a hunch that working with mindfulness and the vagus nerve could be helpful for her. Any ideas?
Thank you! So helpful for two very anxious students facing a new situation today. Placing them in their fear and walking through what to expect on their fieldtrip was so helpful! Gee, one couldn’t do both at the same time and soon was more interested in the fieldtrip:)
Thank you!
Is it possible that one can learn to do thid forthemselves with out a profrssional? My experience has been all about the need to “be seen” just as I am! When I sit with just myself, my inner critic shows up pretty fast and interrupts the whole process of greeting that fear or anxiety as a “friend”! It seems that some people really need the presence of another to witness or interrupt their dialouge, so they do not keep feeling hopeless to do this on their own.
Hi Ron
That’s similar to seeking out someone that bullies you and call them out. Brave or foolhardy?
Is it not better to avoid these situations and try and learn to deal with them if they return.
Joe
Why would you want to conjure up fear?
The patient is already experiencing anxiety, or at least stress
(name a person who is not under stress these days, except perhaps the Dalai Lama?)
that should be enough for your breathing exercise to prove its worth
and to persuade the patient to practice the breathing / mindfulness (same thing to me).
Can anyone talk about how this might relate to excessive flushing/blushing. SE work has helped the most, but if I welcome it and encourage it and try to ride it out, which is usually what will occur anyway, can’t escape a meeting, — it is severe, and invites not so nice comments. Is it that I welcome it when I’m alone (with visualization etc) and more of that might help it not be so severe in the actual setting?
Thanks for any input.
Hi Dr. Siegal,
I am a therapist and love all the new neuroscience and how it supports Buddhist Psychology. However, I have heard Dr. Hanson speak about how we are hardwired to noticing threats and tend to have a bias towards finding the negative side of life. However, then I wonder how millions of years of evolution could be so easily fooled by non-terminal threats. Then I thought “what if the existential threats are not the true source of dysregulation but a catalyst to our most basic fear of being alone or abandon. Commercialism seems to reek havoc on us by reinforcing the message that we need to be “this or that.” Social media spends a huge amount of energy creating inner and outer group distinctions based on acquired stuff. However, if you take Dr. David Burns fear fantasy exercise starting with a person’s existential threat and begin to look deeper the answer always goes back to being excluded or marginalized, which is not an existential threat. Tich Naht Hanh describes this as the primary human fear. So perhaps we are not biased towards noticing more negative, and the tripping our ANS from social engagement to mobilization/immobilization may be the result of being confused by cultural messages that exploit our innate need to be a part of a clan/group/team. Because when one can transcend these messages through enlightenment, the nervous system does not react. Our nervous system was designed to mobilize that resulted in resolution or death; either way, mobilization ceased. When dealing with existential threats, neither resolution (well perhaps perceptional resolution) or death occur, so mobilization continues. I guess the thought goes back to TNH description of looking far enough back in the chain of events to see this as a cultural problem that produces plenty of collateral damage. So maybe we are not becoming more sensitive to more threats more easily; instead, we are being bombarded with many messages (existential threats) that are trigging our one and only true fear of not being a part of a greater whole.
Brilliant and insightful, imo! Thank you so much for sharing this. I agree the messaging in our world is at least in part responsible for so many of our fears and anxieties being brought to the fore — usually for no good reason (other than to sell something!). And yet these fears and anxieties are innate, as you say, hard-wired, because we are social beings and wired for connection. So threatening “disconnect” is truly…horrible! I’m glad to be aware of this frame for what’s going on, so I can be mindful when I’m being manipulated this way and how that compares to the reality of the situation. 🙂
Good points, Scott. Thanks for your long but very thoughtful post.
I have clients I am working with on the phone or in person do a deep breathing exercise that involves visualization, and imagination. I call it “smell the roses and blow out the candles”. I will ask the client to sit comfortably, relaxing body, especially hands and feet, close eyes, picture favorite aromatic thing, whether flower, coffee, baked cookies, and smell deeply through nose, to a 3-5-7 count. After breathing in through nose, I encourage them with same closed eyes, to blow out with puckered mouth, like blowing out birthday candles, romantic candles, or any other thing, that they might smell and blow out slowly, bubbles have been suggested, and this to a 3-5-7 count as well. It has been amazingly effective, and people have asked for it on occasion.
Thanks for sharing. I will use this visual to help my clients.
Thank you for posting this, Katie. I felt myself relax just imagining myself inhaling a lovely fragrance and then pretending I was blowing soap bubbles with the out breath.
Thank you for this, Katie.