MINDFULNESS – THE SLOW PATH TO RECOVERY FROM ANXIETY
Anxiety relies on our world’s insistence that life must be led at breakneck speed – which means that our greatest weapon to fight against it is a slow appreciation of what others miss in the blur.
And in the same way that modern consumer-based life’s relentless pace is designed to instil anxiety with small “a” (author David Foster described the perfect advert as being able to “create an anxiety relievable by purchase”), so that same pace is reflected in Anxiety (with a big “A”) Disorder.
Just look at some of the symptoms of generalised anxiety disorder as listed by the UK’s National Health Service. First the psychological ones:
Restlessness. Feeling constantly “on edge”. Difficulty concentrating. Irritability.
And now the physical ones:
Dizziness. Tiredness. A noticeably strong, fast or irregular heartbeat. Muscle aches and tension. Trembling or shaking. Dry mouth. Excessive sweating. Shortness of breath. Stomach ache. Feeling sick. Headache. Pins and needles. Insomnia.
Don’t they all seem in some way reliant on living life in fast-forward? Don’t they seem inherently exhausting?
Therapy can certainly help someone living with social anxiety to look at their current situation in a new light and set new goals based on that new assessment; antidepressant medications such as SSRIs can change the serotonin levels in your brain (although new research in Europe is threatening to derail some of our beliefs about the link between anxiety and low serotonin levels) – but neither of these methods of tackling anxiety provide you the ongoing skills to slow down.
And that’s where mindfulness steps in.
What is Mindfulness?
Being mindful means being aware of the world around you and tempering your thoughts and emotions in three specific ways: in the here-and-now; purposefully; and non-judgementally.
Because social anxiety is characterised by hyperfocus – the preoccupation that everyone around you sees your discomfort and is judging you – it’s important to stop concentrating on your inner turmoil and look outwards.
So how do the three aspects of mindfulness work?
- Being in the here-and-now allows you to ignore the two most difficult aspects of anxiety – dwelling on the past and being fearful of the future. Taking timeout to meditate on a simple scene; relaxing while being aware of your breathing; watching the world around you; or thinking about the face of someone you love allows you to centre your mind in the present. This, in turn, will help you understand the futility of anxiety based on past events and help you prepare your mind for what’s ahead. The understanding of the present-moment experience provides an understanding of the cues and triggers to anxiety and allows you to ditch negative habitual patterns and “automatic” actions in preference of flexible responses.
- Being purposeful means treating your mind and your body as one thing. As we’ve seen, anxiety manifests itself in physical and psychological ways so it makes sense to approach treatment in a similar way. “Purpose” can involve trying to create a stillness by sitting or lying down, it can also involve following breathing techniques which give you a physical sensation linked to a feeling of calm. Meditation and mindfulness is not a passive treatment – it’s not something which is handed out in a bottle or something which suddenly comes to you in a classroom, it’s something which takes training and rigour.
- Being non-judgemental allows you to pay less attention to any perceived shortcomings in yourself, build a more accurate appreciation of yourself and understand why your thought processes work in a specific way. By understanding more about those around you, you are also able to see common feelings of nervousness (which, after all, are perfectly normal in everyday stressful situations like public speaking and meeting new people) and also understand the ways others can help you cope with trigger situations and you can help them.
Mindfulness in practice
So that’s how to be mindful in theory – what does that mean in practice for people living with anxiety on a day-to-day basis?
The idea is to learn to accept feelings, capture your thoughts, and then let them flow away from you.
In order to help you get to grips with your thoughts and emotions, mindfulness meditation divides the mind into three parts:
- Your emotional mind (in charge of your knee-jerk reactions driven by feelings)
- Your rational mind (in charge of controlled, logical thoughts which lead to sensible decision-making)
- Your wise mind (the cooperation of emotion and reason where you can understand feelings without letting them control decisions)
And once you’ve understood that your “wise” mind is the goal, you can turn to developing your practical skills:
- Pay attention to your feelings to see how they change, how long they last and what physical reactions they produce. Describe those feelings in non-emotive language so you can understand them without judgement.
- Try to ditch using words such as “should” and “must” because they automatically create judgemental thinking. Equally, try to stop seeing things as right and fair, or wrong and unfair.
- Try to devote total attention to everyday actions – mindfulness doesn’t always require a quiet meditative state, you’re just as likely to find peace through giving your undivided attention to simple actions and learning to ignore distractions.
- Living in the situation you are in rather than reaching for situations you’d rather be in should help you avoid feelings of resentment and anger – both of which add fuel to anxiety and prevent you from letting your emotional mind cooperate with your rational mind.
Mindfulness changes our brains
Over the past decade or so, researchers have tried to look at how effective mindfulness has been at treating anxiety disorders and what’s actually going on at a chemical level in the brain when someone living with anxiety undertakes a mindfulness course as opposed to other traditional forms of treatment such as therapy and medication.
Based on the premise that Cognitive Behavioural Therapy is “in short supply and expensive”, Swedish researcher Professor Jan Sundquist tested how effective the one-on-one CBT sessions were in comparison with group mindfulness sessions of around 10 patients per group.
(It’s interesting to note that the research was as much based around the cost and efficienty of treatment as effectiveness – but that’s just the way of society today!)
Sundquist’s 2012 study trained two mindfulness instructors at 16 primary health care centres and then randomly divided 215 patients with anxiety, depression and reactions to severe stress between CBT sessions and the group mindfulness sessions.
After eight weeks of treatment, questionnaires from the 215 people revealed that self-reported symptoms of depression and anxiety had decreased across the board – with no discernible difference between the two groups.
“The study’s results indicate that group mindfulness treatment, conducted by certified instructors in primary health care, is as effective a treatment method as individual CBT for treating depression and anxiety,” Sundquisttold sciencedaily.com. “This means that group mindfulness treatment should be considered as an alternative to individual psychotherapy, especially at primary health care centres that can’t offer everyone individual therapy.”
So that seems to point towards empirical evidence that mindfulness mediation can provide treatment for anxiety – but what’s actually happening in the brain?
In 2014, research published in the Journal of Social Cognitive and Affective Neuroscience showed how mindfulness meditation was linked to specific activity in specific regions of the brain called the anterior cingulate cortex (the control room for thinking and emotions) and the ventromedial prefrontal cortex (the control room for worrying).
The study, at Wake Forest Baptist Medical Center on 15 people with no history of anxiety disorders and who hadn’t meditated before, involved taking brain scans and measuring levels of anxiety and then giving the participants four 20-minute classes on how to meditate mindfully, before taking more brain scans and measuring anxiety once more.
The results were quite convincing.
Not only did meditation increase activity in the area of the brain concerned with worrying, but it also decreased activity in the part of the brain associated with emotion. Even more strikingly, anxiety levels were measured to have decreased by up to 39% after the participants had undergone the mindfulness training.
“Mindfulness is premised on sustaining attention in the present moment and controlling the way we react to daily thoughts and feelings,” study researcher Fadel Zeidan said. “Interestingly, the present findings reveal that the brain regions associated with meditation-related anxiety relief are remarkably consistent with the principles of being mindful.”
There are now a host of studies which show how mindfulness and meditation affect our bodies and our minds including:
- Increased “folding” (known as gyrification in the world of science) in the brain.
- Larger amounts of grey matter in the right orbito-frontal cortex which controls emotions and responses.
- A different composition of metabolites linked to anxiety and depression.
- A decrease in “mind-wandering”.
- Structural changes in the parts of the brain associated with sensory, cognitive and emotional processing.
But the most comprehensive study was a 2014 University of Montreal study of 209 separate pieces of research covering more than 12,000 people and which determined that mindfulness was “especially effective for reducing anxiety, depression and stress”.
Of course that’s not surprising to the millions of people worldwide who already practice meditation as part of their spirituality, but for those of us who live in the fast-paced, consumer-obsessed world, it can help to offer a practical path to a quiet appreciation of our anxieties.
Kyle MacDonald and I’m aRegistered Psychotherapist with over 15 years clinical experiencehelping people change behaviours and manage social anxiety, social phobias and shyness.
His experience in treating social anxiety along with an intense interest in social media to reach people online, has drawn me to develop an online-based therapy treatment approach for people from all around the world struggling with social anxiety, social phobia and shyness.
For more see: www.overcomingsocialanxiety.com