Mindfulness for Anxiety - Barriers and Benefits of Practice

Candice
Mindfulness for Anxiety - Barriers and Benefits of Practice

“Never in the history of calm down has anyone calmed down by being told to calm down.” ~Anonymous

If you are someone living with anxiety, you have undoubtedly fielded all sorts of unsolicited, overly-simplistic advice about how to feel less on edge. You may have heard from well-meaning friends or family that should try meditation to relax. Research on anxiety and mood disorders (among many other mental and physical wellness issues) has consistently shown that mindfulness and meditation practices can dramatically reduce symptoms and increase wellbeing. However, many folks with anxiety find traditional mindfulness exercises triggering, making it less likely that they’ll adhere to a regular practice. Let’s take a closer look at how we can upfit mindfulness practice for anxiety.

What is Mindfulness?
Mindfulness has roots in Hinduism, and has been adapted by a diverse set of religious and secular groups spanning the past 2,500 years. While Eastern traditions emphasize the power of mindfulness to facilitate spiritual growth, Western practices focus on mindfulness as a tool for relieving discomfort. John Kabat-Zinn was one of the first psychologists to integrate mindfulness into his therapeutic approach, and his definition of mindfulness has become a foundation of clinical practice. He describes mindfulness as “paying attention in a particular way, on purpose, in the present moment.”

What’s the difference between mindfulness and meditation? Mindfulness is a mental state, characterized by a relaxed, open awareness, while meditation is a type of activity we engage in to cultivate mindfulness. Mindfulness is the muscle we are strengthening, while meditation is one of the workouts we can use to focus on that muscle. Mindfulness is a broader term that can include breathing, relaxation, and even yoga, while meditation is typically more structured with an emphasis on stillness (walking meditation is one exception) and concentration.

Why is Mindfulness So Hard?
When I introduce mindfulness to my counseling clients and students, I inevitably hear “I’ve tried mindfulness and I’m not good at it.” Digging into this assessment, I often find that folks try mindfulness with the goal of completely emptying their minds of thought, or eradicating some unpleasant feeling. When the same worries, judgments, and physical sensations were still swirling after 15 minutes of sitting, they figured mindfulness wasn’t for them.

A regular mindfulness practice can improve how our brains respond to stress, lower blood pressure, and reduce many symptoms of depression and anxiety. But these changes (unfortunately) don’t happen immediately and aren’t the result of becoming blissfully unaware of discomfort. Instead, over time, we learn to relate to worry thoughts, physical sensations of tightness or pressure, and other distressing internal and external experiences from the safety of the present moment. Mindfulness helps us find the space between what we think about what is happening and what is actually happening.

Initial Discomfort
Most of us try mindfulness because we are looking for relief from something. The unfortunate truth is that mindfulness can feel uncomfortable before it feels good - noticing our thoughts and feelings intentionally can seem like turning up the volume on an annoying, staticky radio station. We can offset this issue by balancing concentration practices that emphasize noticing whatever is showing up in the moment (usually unpleasant) with energizing practices that help us build concentration and awareness by focusing on pleasant experiences and sensations. 

The Breath Problem
Beginner mindfulness practices generally start with the breath. For many folks, the breath is an uncomplicated, living anchor to the present moment. For folks with anxiety, breathing can be a source of, you guessed it, anxiety. Since intense anxiety can generate physical responses such as shortness of breath, chest tightness, and light-headedness, focusing on the breath can make us hyper aware of discomfort. Add in some fear-based thinking that these physical sensations indicate something is dangerously wrong, and mindfulness becomes a vehicle for an anxiety-laden feedback loop. 

Mindfulness for Anxiety
With some intentional preparation and direction, mindfulness can be an incredible tool for managing anxiety. One of the primary mechanisms of anxiety is that it puts us in future mode - we become consumed with imagining, planning for, and attempting to prevent potential negative outcomes. Finding our way back to the present moment offers us some relief from the pain of constant worry. Being present will require different tools depending on how anxious we are, so let’s break it down by levels.

Green level - minimal anxiety
We can engage the breath and the body more effectively when our anxiety levels are low. It’s also easier to learn and integrate new skills like mindfulness when we are relatively calm, so if your urge is to wait until you're really distressed to try mindfulness, consider starting or maintaining your practice when you feel some relative calm. If you’re learning to throw a curveball, you’d probably rather learn at practice than game seven of the world series. 

When anxiety is low, we can notice breath from a distance. Taking a natural breath, notice if you feel the breath moving in your back or shoulders instead of in your chest. You can also notice the sound of your breathing as opposed to the tactile sensations of breath. Spend five to seven minutes noticing breath in a way that feels comfortable for you. When you have distracting thoughts (notice I said “when” not “if”), imagine using your breath to blow the thought away the way you might blow a flower petal off the palm of your hand - gently, with minimal effort. 

Yellow level - moderate anxiety
As anxiety begins to creep up, we can use mindfulness to prevent an escalation to a full on panic or anxiety attack. With moderate anxiety, we want to soothe our bodies and remember that thoughts cannot physically harm us. As anxious thoughts begin to swirl, our bodies react creating a feedback loop - a tense, anxious body reinforces fearful, emotion-based thoughts and vice versa. 

If taking deep breaths feels available, go for it! Deep belly breaths can turn on the parasympathetic nervous system, which acts as an “off” switch for the fight or flight response. It’s even better if you can breathe with someone else. If you’ve got a supportive person nearby that you feel comfortable asking to breathe with you, you can borrow their calm through what’s called “co-regulation.”

For a non-breath focused dose of mindfulness, apply slow, rhythmic pressure to your palms, finger tips, and the web between your thumb and index finger, gently pinching each location and holding the pressure for a second or two. Put your attention on the sensations of warmth and pressure, inviting your breath to slow and deepen. As anxious thoughts try to push into your awareness, say to yourself “I am aware of my thoughts. I am not my thoughts.”

Red level - severe anxiety or panic
If you’re in the red zone, unable to concentrate, having difficulty breathing, feeling a sense of panic or doom, the most important thing is to recover your sense of safety. Keeping your eyes open, sit down on a chair, and press your feet firmly into the floor. Count to yourself slowly, “1, 2, 3, 4.” Release the pressure and relax your legs, counting again, “1, 2, 3, 4.” Repeat this cycle of pressure and release until your breath starts to slow, then add the breath to the cycle by breathing out when pressing down, and breathing in when releasing. You can focus on counting or the sensations of pressure instead of the breath.

Anxiety comes with a host of uncomfortable sensations, and can make it difficult for us to feel engaged in our lives. Mindfulness can help us carve a path back to the present moment, creating space around our discomfort, and empowering us to embrace the full range of experience. 

What challenges or successes have you experienced using mindfulness? Share your thoughts in the comments!

Written for Fitness Blender by Candice Creasman Mowrey, PhD
Licensed Clinical Mental Health Counselor

References

Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., ... & Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. The Journal of clinical psychiatry, 74(8), 0-0. 

Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General hospital psychiatry, 17(3), 192-200.

Nilsson, H., & Kazemi, A. (2016). From Buddhist sati to Western mindfulness practice: A contextual analysis. Journal of Religion & Spirituality in Social Work: Social Thought, 35(1–2), 7–23. https://doi.org/10.1080/15426432.2015.1067582

Kabat-Zinn, J. (2003). Mindfulness-based stress reduction (MBSR).  Constructivism in the Human Sciences, 8, 73-107.

Austin, J. H. (1999). Zen and the brain: Toward an understanding of meditation and consciousness. mit Press.

Delgado, L. C., Guerra, P., Perakakis, P., Vera, M. N., del Paso, G. R., & Vila, J. (2010). Treating chronic worry: Psychological and physiological effects of a training programme based on mindfulness. Behaviour research and therapy, 48(9), 873-882.