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4 Steps to Break the Anxiety Cycle

4 Steps to Break the Anxiety Cycle

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"Get a sofa bed." This unassuming project has been patiently biding its time in the murky depths of my Non-Urgent-Things-To-Do list. After having the girls, there's no extra room in our apartment to welcome the occasional guest.

In a classic two-birds-one-stone maneuver, I thought I would do a little online browsing for sofa beds (Yay! The satisfaction of progress!) while also procrastinating writing this blog post (Yay! The sweet sweet relief of avoidance!). Excellent. But then, in a paradoxical victory of sorts, looking at sofa bed videos brought me right back to writing this post.

More thrilling sofa bed updates in a moment. First, a little primer about fear vs. anxiety.

Fear vs. Anxiety

Fear is the emotional state that arises in response to an immediate perceived threat. It's basically nature's alarm to help you survive when your safety is threatened. Your body and brain change gears to give you the means to fight, flee, freeze, or take cover. To help you take protective action, your mind becomes more able to detect and focus on sources of danger (Barlow, 2002).

Anxiety is the emotional state that arises in response to an anticipated threat. You may feel apprehension, worry, and muscle tension. The experience of anxiety may be less intense compared to a state of acute fear, but it might be much longer lasting. This depends, in part, on what stories your mind is telling you (Forsyth and Eifert, 2007).

While fear is oriented towards the present moment ("The house is on FIRE!"), anxiety is focused on an imagined future (1) ("What if I make a mistake and the house catches on fire?!"). Used adaptively, anxiety can help motivate us to plan appropriately for the future and take action.

However, the creative human mind can also come up with brilliantly compelling stories about potential threats that are so distant or so beyond our realm of control that there’s nothing we can really do to take action right now. Like a deer in headlights, we can fixate on those disturbing stories and forget about any adaptive problem-solving. We can even get stuck in a maladaptive cycle of anxiety that feeds into itself without resolution.

The Anxiety Cycle: Mind-Body Looping

Clinical psychologist and meditation teacher Tara Brach describes stuck anxiety as a cycle of mind-body looping (Brach, 2013). Let's say the mind focuses on the perception that something might go wrong (e.g., “What if I write this blog post and it's stupid and irrelevant?”). If we get tangled up and carried away by that threatening thought, it generates physical sensations in the body as well (e.g., a slight tension and quivering in my stomach; my heart beat quickens a bit and my breathing is slightly more shallow).

In turn, the mind picks up these physical signals. The body’s felt-sense of fear tricks the mind into confirming that the potential threats are true stories (“Of course there’s some real danger here! Why else would I feel like this?”). With the mind on high alert for threats, we detect and focus even more on anxious thoughts...and the cycle continues.

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If the looping becomes habitual we might feel chronically anxious. Fixated on an imagined future we start missing out on anything enjoyable, useful, or interesting that’s available to us right here, right now in the present moment. So how do we break the cycle?

Experiential acceptance vs. experiential avoidance

There’s a kind of futon-type sofa bed I was checking out. If you want to open it up into a bed, you have to do something a little counter-intuitive. Just pulling outwards to try to pry it open won’t work. It just locks in place. You actually have to push the backrest inward, towards the seat first. This activates some kind of release mechanism and voila! The sofa opens up and you’ve just created some bonus space to rest.

Understandably, we want to avoid what we perceive as the aversive, unpleasant experience of anxiety. We want to NOT feel what we are feeling and we instinctively pull away from it. But this experiential avoidance doesn't actually get us away from the anxiety. If anything, it seems to lock the anxiety into place! So what if we try turning inward, towards the anxiety instead?

RAIN: A mindful 4-step practice

You can see for yourself what it’s like to turn towards your anxiety, lean in, and stay present using Dr. Tara Brach’s (2013) 4-step RAIN practice:

1) Recognize what is happening

Close your eyes and bring to mind something that arouses anxiety. To build confidence as you begin to practice these steps, start by choosing something that is only mildly or moderately anxiety provoking.

Become mindful of your anxious or worried thoughts and notice the different forms they take: planning, rehearsing, trying to figure something out, a voice or some sort of mental commentary or judgment, or some visual images. Once you've identified your worry thoughts, whisper "fear thinking."

2) Allow the experience to be there, just as it is

Instead of avoiding or struggling against your inner experience, experiment with just letting it be. You might even experiment with saying “yes” or “I consent” as if you are giving yourself permission to fully experience and mindfully explore whatever is there.

3) Investigate with interest and care

Drop into your body, bringing your awareness below the neck with curiosity, openness, and kindness. Where does the worry and anxiety show up in your body right now? Bring your awareness to wherever you feel the anxiety most strongly in your body and notice the physical sensations: any pressure, tightness, ache, heat, movement, or other sensations?

It takes a lot of courage and willingness to stay present with unpleasant sensations. You can support yourself through this exploration with slow, gentle breaths.

4- Nurture with self-compassion

What does the anxious part of yourself most need to hear to feel comforted at this time? You can explore the ways you might deliver a message of kindness and care to the vulnerable part of you. Using a gentle tone of voice, you might offer some words like “it’s ok, I’m with you” or “that’s then and this is now”. You can also offer a caring physical gesture of some sort, like softly placing your hand on your heart.

After completing the four RAIN steps, use your senses to ground yourself in the here and now. Feel your feet on the floor or feel any other points of contact where your body is physically supported in this moment. See the light, shapes, and colours around you. Hear the sounds and let them flow through you. Take some time to notice what has changed in your body and your mind.

Each time you practice these steps, you’ll be further de-conditioning the tendency to get stuck in a useless anxiety cycle. Unlike the “false refuge” of distraction or rumination, we can lean in and open up a “true refuge” (Brach, 2013)—an inner space that’s always available to us… even in the midst of suffering and discomfort. Even when special guests like anxiety show up.


Maryann Joseph is a clinical psychologist in Westmount, Montreal, Quebec, at Connecte Montreal Psychology Group. The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogspodcast, follow @connectepsychology on Instagram or @ConnecteMTL on Twitter, or like us on Facebook.



References

Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press.

Forsyth, J. P. & Eifert, G. H. (2007). The Mindfulness and Acceptance Workbook for Anxiety: A guide to breaking free from anxiety, phobias, and worry using Acceptance and Commitment Therapy. Oakland, CA: New Harbinger Publications.

Brach, T. (2013). True refuge: Finding peace and freedom in your own awakened heart. New York: Bantam Books.

T. Steimer (2002). The biology of fear- and anxiety-related behaviors. Dialogues in Clinical Neuroscience, 4(3), 231-249.


Notes

1) Although this is an important conceptual difference, there may be a great deal of overlap in the body’s physical response: the basic fear-based brain and behavioural mechanisms that evolved to protect us from imminent danger may be re-used to some extent for the fancier task of protecting us from distant or virtual threats (Steimer, 2002).

Back to the Present! One Time-Travelling Hack To Be Here Now

Back to the Present! One Time-Travelling Hack To Be Here Now

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Do you remember the DeLorean travelling through time in the Back To The Future movies? This post is going to be just like that...only different.

In my last post, I wrote a bit about how my experience as a mom to newborn twins was, um, how shall I put this, an effective new form of psychological torture not quite how I had pictured it was going to be. My mind slipped into functional zombie mode and I felt like I was flipping past chapters of my own life.

Time rushed by but I was tangled up too far away to notice all the casual magic unfolding around me. I needed to find my way back to the present. Back to the NOW.

Contact with the present moment

Contact with the present moment is a core aspect of mindfulness and a key skill we practice in Acceptance and Commitment Therapy (ACT). It's about being fully here now, even for a moment. It's being consciously and flexibly aware of our inner and outer world, as opposed to the very common state of being tuned-out of our experience or caught inside certain thoughts and feelings.

You can check out my last post about contacting the present moment to see if you might benefit from this skill. It also covers three basic steps to get you started, plus a brief practical exercise that you can do anywhere, anytime to reconnect with the moment using your physical senses. That exercise is essentially a “bottom-up” approach; we start with all the little sensory building blocks of experience to build up to a more richly detailed picture of here-now.

Presently, I'd like to share a complementary “top-down” approach; we start with whatever is precious to you in the big picture of your life to come into closer contact with little elements of the current moment that may otherwise be flying under the radar.

To The DeLorean!!!

To practice this “top-down” way of contacting the present moment, we can start by packing for a little time-travelling exercise. We can travel light. Start with your intention to make better contact with the present moment and just add the following 3 concepts to your inner carry-on bag:

1) Hedonia and Eudaimonia

Think of hedonia and eudaimonia as two separate but interconnected paths to well-being. A hedonic orientation involves seeking happiness, positive feelings, life satisfaction, and reduced negative feelings. On the other hand, a eudaimonic orientation includes seeking meaning, authenticity, excellence, and personal growth (Huta & Waterman, 2013).

Basically, there are many difficult moments in which you might not feel happy, but in which you might find some sense of personal meaning (Frankl, 1963). In ACT we explore this by not getting too hung up on a perpetual search for pleasant feelings (nor a constant mission to avoid unpleasant feelings), asking instead, “Who and what is important to you?”

2) Acceptance

“Whatever the present moment contains, accept it as if you had chosen it.”
--Eckhart Tolle

For me, this quote captures something essential to mindfulness and the capacity to be present in the here and now.

In ACT, acceptance is the idea that instead of playing tug-of-war with challenging elements of your experience, you can choose to “drop the struggle”. The key idea here is to accept and then act so that you work with the moment and not against it.

3) Shift Perspectives on the Present Moment

One way to shift perspectives on a situation is to wonder what it looks like from a different point of view, taking on the vantage point of a different person, a different place, or a different time.

ACT encourages us to shift perspectives as a means of increasing psychological flexibility (i.e., having awareness and responses that are more adapted to a given situation and more in line with your values). Compassion-focused therapy (CFT; Gilbert, 2010) encourages shifts in perspective as a means of increasing self-compassion (relating to yourself with kindness and non-judgment).

That's why this next video blows my mind. It's an incredibly poignant perspective shift:

“We take it for granted that life moves forward. But you move as a rower moves, facing backwards—you can see where you've been, but not where you're going. And your boat is steered by a younger version of you. It's hard not to wonder what life would be like facing the other way…” – John Koenig, Avenoir, Dictionary of Obscure Sorrows

Koenig's brilliant video points out that we naturally look at where we are in relation to where we have previously been. He offers a seismic shift in perspective by wondering what the present moment would look like to your older future self, with all of your additional life experience already within you.

 

Well. The DeLorean is fully charged now and you have all you need to hit 88 miles an hour. So let's put it together and experiment, shall we? Drawn from ACT and CFT, may I present:

The Back-to-the-Present Time Travel Hack!   

Imagine that one day, far far ahead in the future, there is a much older, much wiser, more compassionate Future You. Future You has lived your whole life and knows every page, every chapter, start to finish. Intriguingly, Future You can time travel (!) and specifically chooses to come back to this very moment, right here, right now.

What challenging elements of your current experience can Future You see with wise, compassionate understanding? (e.g., difficult thoughts/feelings/sensations?) 

What important sensory elements of the present moment does Future You want to experience one last time? (e.g., what is meaningful or precious to you in this moment and how do you experience that with your senses?)     

What does Future You want to do right here, right now? (e.g.,Is there something Future You wanted to tell you? Perhaps there is something Future You wanted to do again? Perhaps there is something Future You needed to go back and do differently?)

I challenge you to give it a whirl yourself right now or anytime you want to practice contacting the present moment, especially in a moment that is a bit challenging for you on some level. Notice what might shift in terms of your sensory, mental, and emotional focus of attention.*

I was trying not to let this post get too long, so consider that the end of the official post!

You've got the goods now. But of course you're welcome to read on if you'd like an example of how it all played out in my case:

Original Experience of The Moment: Scene 1 Take 1

It's the middle of the night and I feel like I've been awake for eons. I'm standing in a dark room just big enough for two cribs, trying to block out the grating sonic loop of two babies bawling in tandem. The twins are a few months old and it's a particularly difficult night.

It goes like this: I pick up baby 1, eventually soothe her, put her down, pick up baby 2, eventually soothe her, put her down; meanwhile baby 1 is crying again, and rinse, repeat, on and on. I feel hopelessly inadequate to mother these two at the same time and I just want all the crying to stop.

Sensory focus of attention: 

  • hearing crying
  • seeing darkness
  • feeling physical exhaustion

Mental/emotional focus of attention: 

  • trying to block out the crying and wanting it to stop
  • thinking I will be stuck here for ever
  • thinking I'm failing them during a critical developmental period
  • thinking I'm not meeting the needs of either baby and it will screw them up for life
  • feeling hopeless and inadequate
  • feeling the heartbreak and guilt of not being able to give each of them my undivided time and attention in their time of distress

Back to the Present! Scene 1 Take 2

Then I imagined Future Me choosing (whaaaat?!) to come back to this very moment and everything started to shift. Wise Old Future Me saw my exhaustion and feelings of inadequacy with compassionate, understanding eyes. Then she just went straight to drinking in what she knew to be the ephemeral beauty of the situation: me standing upright in my relatively young, strong body, holding the girls in their temporarily tiny form.

Sensory focus of attention via Future Me:

  • the soft warmth of baby skin, especially the top of their heads
  • the tiny dimensions of their small delicate bodies, especially their hands
  • a decrease in my muscle tension
  • noticing the vitality still coursing through my middle-aged body and holding me upright
  • special shout out to the strength in my arms and legs

Mental/emotional focus of attention via Future Me: 

  • feeling a strong sense of surprise and wonder at how tiny the babies are (after all, I was used to seeing them as the biggest they have ever been relative to The Past)
  • feeling waves of gratitude for another moment with my babies
  • thinking the cries no longer sound so loud and so laced with reproaches--rather they have a certain nostalgic sweetness somehow

Soaking up all the parts of the present experience from Future Me's point of view, my harsh judgments dropped away. Instead of wasting my time struggling against feelings of inadequacy or trying to block out the crying, I instinctively shimmied a little closer to what is truly precious to me.

It was the difference between pulling away from the discomfort of a challenging moment and the willingness to lean in and experience it.

From the outside not much looked different. The epic crying relay continued on. But on the inside, if only for a limited time, it made all the difference in the world. It was a radical gear-shift out of zombie auto-pilot and back into my own experience. Back to The Present!

 

(*Figurative DeLorean and flux capacitor included. Some psychological flexibility may ensue. See your own experience for details.)


Maryann Joseph is a clinical psychologist in Westmount, Montreal, Quebec, at Connecte Montreal Psychology Group. The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogspodcast, follow @connectepsychology on Instagram or like us on Facebook.


References

Forsyth, J. P. & Eifert, G. H. (2007). The mindfulness and acceptance workbook for anxiety: A guide to breaking free from anxiety, phobias, and worry using Acceptance and Commitment Therapy. Oakland, CA: New Harbinger Publications. [This is a great ACT self-help workbook and there are others in the series, e.g., for depression.]

Frankl, V. E. (1963). Man’s search for meaning: An introduction to logotherapy. New York: Washington Square Press. [A poignant classic, as relevant today as ever.]

Gilbert, P. (2010). Compassion Focused Therapy: Distinctive features. New York: Routledge. [A richly theoretical clinician's guide to CFT.]

Harris, R. (2009). ACT made simple: An easy to read primer on Acceptance and Commitment Therapy. Oakland, CA: New Harbinger Publications. [This is an excellent, accessible resource for any clinician.]

Huta, V. (2015) The complementary roles of eudaimonia and hedonia and how they can be pursued in practice, in Positive psychology in practice: Promoting human flourishing in work, health, education, and everyday life, Second Edition (ed S. Joseph), Hoboken, NJ: John Wiley & Sons. doi: 10.1002/9781118996874.ch10. [Conceptual, research-based aspects of well-being.]

Polk, K. L., Schoendorff, B., Webster, M., & Olaz, F. O. (2016). The essential guide to the ACT matrix: A step-by-step approach to using the ACT matrix model in clinical practice. Oakland, CA: Context Press. [Clear, concise, and wonderfully practical ACT resource for clinicians.]

BE HERE NOW...BUT HOW? 3 STEPS TOWARDS EXPERIENCING LIFE MORE FULLY

BE HERE NOW...BUT HOW? 3 STEPS TOWARDS EXPERIENCING LIFE MORE FULLY

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The first year of mommyhood was a bit of a blur for me. Forget my lofty Pinterest-inspired aspirations—I was in basic survival mode for the better part of my first year with twins. My general recollection of that period is fuzzy at best. But somewhere in that intensely sleep-deprived haze, there are a few indelible moments that still shine so clear and bright. Little beacons of light in a foggy mommy mind. Moments when time stood still...or at least the blurry whizzing abstractions of the everyday-hustle seemed to pause and come into sharp focus.

Interestingly, the most compelling, graphic memories for me aren't the special events or never-ending list of firsts that one might expect on a classic first-year highlight-reel. They're not the moments I recall just because someone snapped a photo that I've seen multiple times since then. Nope. The few clear, specific moments that come readily to mind are mainly just vivid little slices of average everyday stuff. Like this one:

I'm holding one of the babies and I see her look at the window with fascination. The gauzy white curtain is fluttering gently with the breeze. Sunshine is streaming through the folds of fabric and everything looks ethereal. I approach the window so she can touch the soft material for herself and she squeals and laughs with delight. Her face lights up like she's having some kind of revelation.

Contact with the present moment

This high-definition memory stands out in that first year as a moment where I wasn't just a mombie on survival-focussed auto-pilot. Instead, I had the wonderfully contrasting sense that I was fully present in the moment as it was unfolding. In the NOW. Acceptance and Commitment Therapy (ACT) (see Brent's blog post, The Skinny on ACT) refers to this core aspect of mindfulness (see Natsumi's blog post, Mindfulness: An Introductory Guide) as “contact with the present moment.” Being fully here and now, consciously and flexibly aware of our inner and outer world, as opposed to being lost in our thoughts. For me it felt like I had brushed away some cobwebs and could see clearly again for a time. Like I was taking part in my experience rather than the creeping feeling that I was somehow missing out on my own life. And in those days, I was missing out—I was typically too tired and overwhelmed to notice all of the rich detail that makes everything so interesting.

That's the thing about “contact with the present moment”. It's so easy to miss even though it sounds like a given. Of course we exist here, now. We realize that, cognitively. But experientially, in any given moment, you have the choice between engaging with this one specific “here-now” or getting sucked into the infinite other time points, places, and experiences that your mind can conjure up. One VS. INFINITY, folks! The odds are stacked heavily against the singular present moment, even before we factor in the prevalence of fatigue, ill health, stress, depression, anxiety, and other states that can impact upon our capacity to focus. So instead of experiencing the present moment, understandably, more times than not, our minds take us elsewhere.

Do I need this in my toolbox?

You might be fascinated to observe how often your mind pulls you out of the present moment in your everyday life. Your body might be taking a shower, or driving a car, but your head is off figuring out dinner/tomorrow's meeting/yesterday's fight. At times, escaping the present moment (through daydreams or TV shows, for instance) may be useful or enjoyable. But let's say you spend some time with a loved one while stewing in frustration and anxiety about all the work you need to do. Or you totally miss out on what a friend is saying while thinking about what you'll say next. When our checked-out moments accumulate, we wind up feeling disconnected and missing out on what's right in front of us. You might be especially rusty in terms of contacting the present moment if:

  • you're frequently preoccupied with thoughts or feelings related to the past or the future
  • you often feel psychologically numb, tuned-out, or like you're on auto-pilot
  • you act impulsively or mindlessly
  • you feel disconnected in key relationships

Fortunately, you can practice and improve your ability to be here, now. Learning to better contact the present moment can bring about some majorly life-enhancing benefits. Basically, the more you tune-in and get an accurate real-time reading of what's going on in your inner and outer world, the more you can make well-informed choices that move your life in the direction you want to go. Higher quality input yielding higher quality output, all while feeling more engaged, more satisfied and more fulfilled in your life. Nice.

How do I contact the present moment?

Sometimes even zombies get a wake-up call. Months seemed to crawl by yet whiz past. Then suddenly I realized that my babies had grown a lot because they didn't fit in the same clothes anymore. Putting away the tiny onesies, I knew that time was gone—there's no re-do. I became aware of how blurry the memories were, how faraway I felt. I didn't want to miss out on these moments—I wanted to be more present in the present! That turning-point realization got a much needed signal boost when I had more energy and was sleeping relatively well again. I dusted off my inner clinical toolbox and got to work renewing contact with the present moment. I'll share a few simple exercises below.

STEP 1: Make a conscious commitment to be here, now.

STEP 2: Do what you can to maximize your physical and mental energy. If you want to be here, now, I can't overstate the importance of sleep (see Ava's blog post, Getting Back to Bed) or getting treatment for anemia, hypothyroidism, depression, anxiety, and other draining, attention-zapping conditions.

STEP 3: Practice, practice, practice making contact with the present moment, and don't wait to finish Step 2 to do it. Start now. Of course, you can just wait for a moment so special that it will pull you into the present. But YOU can also pull the present moment into you. As we do in Acceptance and Commitment Therapy:

  • Really notice what is happening here and now. When you stop and observe with all your senses, you will notice all sorts of internal and external stuff. The Zen concept of “beginner's mind” can be especially useful here. Like an infant, when you explore something with openness and curiosity as though encountering it for the first time, even a white curtain can be fascinating.
  • Differentiate between noticing (simple conscious awareness) and thinking (going off on a mental tangent). You can notice thoughts and feelings as though they are floats in a parade, letting them come and go past.
  • Pay attention to both your inner and outer world and work on shifting your attention flexibly between the two (like noticing a painful thought or feeling while also noticing what you see and hear around you).

You may have heard of mindful breathing in which you practice bringing your awareness here and now for a period of time by noticing when you breathe in, when you breathe out, and the sensations that accompany each inhalation and exhalation. Experience it for yourself with Professor Mark William's “Three-minute breathing space” guided meditation.

Here's another useful but perhaps lesser known way to practice contacting the present moment:

            Notice Five Things (adapted from Harris, 2009, p. 171):

This is a simple exercise to get present and connect with your environment. Practice it throughout the day, especially any time you find yourself getting caught up in your thoughts and feelings. This exercise relies on the senses, so if you have any serious sensory impairments you may want to omit that sense, swap in another (like the sense of smell), or go a bit further in noticing things with the senses you do possess.

  1. Pause for a moment.
  2. Look around and notice five things that you can see.
  3. Listen carefully and notice five things that you can hear.
  4. Notice five things that you can feel in contact with your body (for example, the shirt on your back, the air on your face, your feet upon the floor).
  5. Finally, do all of the above simultaneously.

Conclusion

Whether you're totally overwhelmed and the days are a blur, or whether your brain is relatively functional but you're getting caught up in your head, you can choose to practice contacting the present moment. Better engaging with the here and now won't make you less sleep deprived, finish your projects for you, or babysit your children (dang!). But it will add a richness and fullness to your experience. Less zombie. More cowbell! Or more gauzy curtain, as the case may be. So forget Pinterest. These aren't pictures snapped from the outside. This is my lived experience, and when I make contact with the present moment, I feel like I am truly living it.


Maryann Joseph is a clinical psychologist in Westmount, Montreal, Quebec, at Connecte Montreal Psychology Group. The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogspodcast, follow @connectepsychology on Instagram or @ConnecteMTL on Twitter, or like us on Facebook.


References

Forsyth, J. P. & Eifert, G. H. (2007). The mindfulness and acceptance workbook for anxiety: A guide to breaking free from anxiety, phobias, and worry using Acceptance and Commitment Therapy. Oakland, CA: New Harbinger Publications. [This is a great self-help workbook and there are others in the series, e.g., for depression.]

Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.

Harris, R. (2009). ACT made simple: An easy to read primer on Acceptance and Commitment Therapy. Oakland, CA: New Harbinger Publications. [This is an excellent, accessible resource for any clinician.]