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Nancy Henningsen, Ed.D, LCSW, 301.661.4433

Changing Lives Blog

Monday, November 30, 2009

Can Mindfulness Help My Anxiety?

Being mindful is about being aware of what's happening around us and inside us in any given moment. We all have thoughts about the future, the past, perhaps 17,000 thoughts in any given day. But those of us who live with anxiety can get stuck in a particular thought. We end up looping around, fixating on a particular thought such as "What if my train crashes on my way to work?" or "Will I lose my job today?" We focus on this thought until our mind convinces us something serious WILL happen. This is called catastrophizing. It can become a habit.

Mindfulness is about noticing automatic behaviors, simply noting them, not judging or analyzing them, just learning to be aware of them. Mindfulness is about experiencing the anxiety and then moving past it. It is about befriending it although this may sound counterintuitive.

The biological pathways of anxiety are becoming increasingly understood by researchers. Therapists like myself are using this knowledge in developing treatment protocols. These are based on the patient's particular life circumstances and state of discomfort. From a mindfulness perspective, avoidance and maladaptive habits are what our brains have learned to do and programmed into our bodies. It's about the brain, not a personal defect. A mindfulness approach is about what is happening in the present moment so it is positive and accepting. It can include meditation but it does not require it. It is awareness OF, rather than thinking ABOUT.

Those thousands of thoughts are like clouds passing above us. They come and go. They are temporary like our feelings and sometimes our body sensations. But they do repeat because our experiences have conditioned our reactions. Our hippocampus near the base of the brain stores emotional memory so that scary or traumatic memories can trigger alarm even when we merely think about possible danger. The evolutionary process has also shaped our neuralphysiological reactions. But the quick action we needed on the savanna to escape a predator can easily lead to road rage or anger at ourselves or others if we're always on automatic pilot.

Mindfulness is about acceptance. It is about noticing and separating the facts of experience from the conclusions our mind makes afterwards. Jerry, one of my patients, experiences frequent paranoic thoughts. He noticed when they popped up, learned to talk back to them for a brief moment, and then took deep breaths letting the thoughts go off in a white cloud. He would get up, and observe what the person next to him was doing. A reality check. Usually they would be absorbed in the words on the screen, not looking at him at all. All of us have triggers which stir up our emotions. Jerry grew up in a household with very anxious parents who carefully observed his actions trying to keep him safe.

We do not always identify our triggers, or schemas. During the first few therapy sessions we examine and identify these schemas, enmeshed strands of intense emotions, body sensations, thoughts, and/or feelings usually formed in childhood. Three of the most common I see at work are negativity, being hypercritical, and "there's something wrong with me". Mindfulness can help us see them, feel them, and then LET THEM GO. Therapy is yes, about change, but we probably want to change our behaviors and reactions, not our basic natures. Understanding and deconstructing our schemas is a part of the process. Mindfulness may sound easy but it requires practice and noticing and learning to let go.

Practicing self-compassion is another form of mindfulness. The early research in this area show that practicing it can reduce the impact of a negative event. It can also help us regulate our emotions. Self-compassion also relates positively to life satisfaction and emotional intelligence. We can also learn and practice this in therapy sessions if appropriate.

For more information, consult Christopher Germer, The Mindful Path to Self-compassion.

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Thursday, May 11, 2006

Hypnosis and Change

Hypnosis does not involve a swinging watch. That's for stage magicians, not therapists. Instead, therapeutic hypnosis is the practice of letting go, of relaxing deep into yourself, of accessing old feelings that have been walled away. It is being used increasingly to help relieve anxiety and depression. It's about reclaiming inner, buried resources.

For example, with hypnosis, Jennifer (not her real name) was able to visualize her graduation from college and get in touch with her feelings of pride and accomplishment. She remembered the beaming faces of her parents as they congratulated the first in their family to earn a college degree. She had forgotten these feelings and was fixated on her self-doubt. Now, with hypnosis, she could call up these feeling when she got mired down worrying about the criticism she received at work. This was the major goal of our work together; easing her anxiety and giving her tools for the future. She learned and practiced therapeutic hypnosis in our work together. She was then able to "go inside" on her own, whenever her anxiety was starting to grow.

Tom was overwhelmed by financial woes and concerns about his physical health. He thought he could never plow through his depression. But after working for several weeks in therapy on self-esteem, he was able to break down his cloud of self-doubt into smaller and more manageable pieces. Guided imagery and therapeutic hypnosis proved valuable for him as well. Under hypnosis, he first saw his financial worries as a huge bear eager to pounce on him. By suspending his conscious worry of "I'll never make it" and going deep into his memory bank, he recalled his feeling of power, of "being at the top of my game" when he first became a teacher. He saw that he was good at it. He helped his students break up work into separate pieces. He could do that for himself. Gradually, he was able to call up his old feelings of strength and turn the huge bear into a small, friendly one. His transformation took time, but less time with hypnosis than with regular talk therapy.

All of us have pass experiences which our conscious mind has closed down. Although some are painful, others are examples of feeling super competent or successful. Our conscious mind, when mired in a depressed or anxious state of mind, may shut down the times we felt competent. Guided hypnosis can unlock these experiences. They can be anchored in your mind so that you can call on them in current situations. Hypnosis can also break harmful habits such as smoking and/or alcohol abuse.

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