As a socially anxious college student sitting in class, terrified of being called on by my professor, if you’d told me (Mitch) to “gently rest my awareness” on the physical sensations of the fear-sparked knot in my throat, I would have laughed at you. This assumes, of course, I could even squeeze any air out . . .
As a psychologist and author specializing in mindfulness approaches, I believe I’ve lost touch with that experience of high anxiety from my youth. However, I’ve benefitted from the reminder that, as powerful and helpful as mindfulness can be in managing anxiety, it can legitimately feel (and be) inaccessible to those struggling with bouts of acute anxiety reactions. Mindfulness instructions often suggest for practitioners to place attention on their bodily sensations, to “let go of judgment” and to “rest” or “simply notice” their experiences “just as they are.” They often include well-intended reminders like there’s “no wrong reaction or experience”—no way to mess meditation up. These kind sentiments can make the practice of mindfulness all the more daunting for those whose anxiety is regularly at fever pitch. Consider my co-author Joe’s experience of using mindfulness to help curb his panic attacks:
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For me, having been diagnosed at very young age with an anxiety disorder, I tried virtually all the therapies and strategies. I had minor success with some, and next to no relief from most. I kept feeling like I was missing something. I felt I could—no should—be having much more success in ridding myself of my own personal, virtual omnipresent, experiences of panic attacks. That’s why I was so intrigued by a therapist’s suggestion that I try mindfulness meditation. He told me in detail what it was and what it entailed. And when I found out it was generally absent of negative side effects, that it had been around for millennia, was scientifically proven to help with my condition, was free of cost, and that I could use it whenever and wherever I was, I remember saying, “When can I start?”
Over many years, I delved deeply into learning about mindfulness and practiced it as often as I could. I went to meditation centers, read an assortment of well-regarded books and various literature on the subject, practiced guided meditation by way of recordings from some of the most distinguished experts on the subject. I also practiced solo, unguided meditation.
But the quality of my life largely depended on mindfulness “working” for me—a major obstacle that made mindfulness practice inaccessible. I needed to be able to get to class, to visit friends and family. Spending Thanksgiving alone because you can’t make it to your aunt’s house a few towns over because of your anxiety is an exceptionally depressing feeling to say the least. I didn’t want to miss any more weddings, christenings, or funerals because of it. I wanted to go to the dentist and primary care physician whenever I felt like it and not just in cases of emergencies and extreme pain. It’s a terrible feeling to not be able to simply go see a movie you really want to in theaters, go out to eat at a restaurant, or attend your favorite sporting events or concerts. It’s one thing to slowly lose friends over time and not be able to maintain a romantic relationship because of avoidance and self-isolation. It’s another thing when you find yourself hungry and on your own on a Saturday night in a grocery store unable to wait long enough in a short checkout line because your condition decided to rear its ugly head and start a panic attack so intense that you have to leave your cart in the checkout aisle and quietly exit the store, filled with hunger pangs and awash in shame.
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What Joe realized about his mindfulness practice was crucial for him, and is a very important point for those who suffer from acute levels of anxiety. What is your intention for practicing mindfulness? What Joe learned is that you can’t control or force your way into awareness of anxiety and at the same time access non-judgmental awareness regarding excruciating sensations you are then experiencing in your body. To the degree there is a pressured goal of “making anxiety go away,” it can be much more likely that practitioners will criticize themselves as meditative failures and either write off mindfulness altogether, or worse yet, add to a growing sense of self-loathing. It is imperative to approach mindfulness (because, as Joe has learned, mindfulness is too well-established scientifically to dismiss) with a revised perspective, a renewed intention.
While it’s certainly understandable to want to reduce one’s suffering, it’s important to learn to view mindfulness as a process of gradually opening to experience, versus suddenly damming up the flow. Basically, have an intention to be free of suffering, but learn to release the immediate agenda for making it be the case in every moment of practice.
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I needed mindfulness to be successful for me and I was my biggest critic every time I sat down to practice. Compassionate curiosity without labels, watching feelings and emotions come and go like clouds passing overhead on a clear blue day? I don’t think so. I had way too much at stake to just temporarily forget about who I was and what I was dealing with. To suggest to someone who has had countless traumatic intrapersonal experiences to just take a break from this intention and/or just temporarily let go of self-critical thinking in order to learn to let such awful thoughts and emotions “gently wash over you” can be essentially impossible. And when you fail to do that, time after time, year after year, it can be extremely depressing as well.
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Joe’s voice is a reminder to step out of my author/clinician mindset and remember my own experience of acute distress. It’s a cue to compassion for the suffering that brings many of us to mindfulness practice. We all need to consider, however, how to make mindfulness practice a better fit for those whose anxiety boxes them in. Joe and I agree that many mindfulness practices could come closer to the reach of those experiencing extremes of suffering by embedding a dollop of self-compassion, or self-directed kindness, into any meditation practice session. In addition, practitioners need help easing into more traditional, formal meditation practices; they need help in recognizing the mini-successes along the way. People need much more than the unintended condescension to “just let go”—they need the validation of the urgency their suffering creates for their mindfulness practice, as well as a structure for accessing practice when pain is most of what they’ve known.
Individuals suffering from acute anxiety need help easing into more traditional, formal meditation practices; they need help in recognizing the mini-successes along the way.
A Mindfulness Practice for High Anxiety
When mountain climbing, it is crucial to anchor your rope as you ascend a sheer rock face—to literally secure yourself as you inch upward with a successive series of stakes or bolts. Those climbing through episodes of anxious suffering need an anchoring structure as well. Instead of just launching into 30 minutes of mindfulness of the breath or a body scan, it can help to create a series of self-compassionate anchors as you practice. Such a structure can help create the space for noticing gradual progress, and can help minimize the self-berating criticism so common for those whose anxiety seems to place meditation out of reach.
1. Sit upright in as comfortable a position as possible. Eyes can be open or closed—whichever is more comfortable.
2. Silently begin with a recognition of the reality of anxiety. Make the words your own, but quietly say something like: “I’ve suffered a great deal. This pain is real and intense.” Place your attention on the words, and repeat them quietly a few times.
3. Place your attention on a single breath—feel the air coming in, and feel it leave the body.
4. Silently repeat the phrase above and consider adding the following: “In this pain, I’m caring for myself.”
5. Now try placing your attention on two full cycles of the breath, feeling the sensations of the air coming and going.
6. Add the following self-compassion anchor: “This is hard, and right now I’m giving myself permission to understand that.”
7. Expand the practice out to mindfulness of three to five cycles of breath.
8. Say to yourself: “Though the pain continues, may my practice and care for myself continue as well.”
9. Continue in this way, allowing self-compassion to anchor your practice of mindfulness. Let it be a scaffold on which to stand in self-acceptance, and let it help you disarm the inner voice of criticism and failure.