Staying in the Here and Now

Stressful situations can make the most balanced people act in crazy ways.  A few weeks ago, I received an email from a friend who is worried about her relationship with her long-term partner.  She told me she’s been feeling very anxious.  She wrote:

I’m not really eating and sleeping is bad and sometimes talking…helps, but otherwise all I’ve got is that prayer from Alcoholics Anonymous.

I responded with some suggestions about how to manage anxiety, and with her approval, I would like to share them with you.  Here is what I wrote to her:

It sounds like you're dealing with some pretty hefty classic anxiety symptoms here (which are not inherently pathological - everyone in extreme situations has symptoms of anxiety) and like you said, you could really use some good coping skills. 

The best definition of anxiety I've ever heard is that it's any time you leave the present. In other words, if you're worrying about the future or trying to reinvent the past, you're going to feel anxious, but unless you're being chased by a bear, staying in the present very rarely induces that kind of fear-based response. So the best thing you can do to decrease your anxiety is stuff oriented towards keeping you grounded in the present.

A few suggestions:

1. Remind yourself about what's going on in the here and now. One very simple way to do this is to say about a hundred sentences beginning with the phrase "I am aware..." For example, I might say, "I am aware of the noise of the keyboard as I type. I am aware that my cat is trying to figure out how to get into a paper bag. I am aware that there is a mug of three-day-old tea on my desk. I am aware that the garbage can is overflowing. I am aware that my heart is beating faster than it normally does. I am aware of a tension behind my eyes." These should be concrete things that you notice about the here and now, rather than stuff about how you're feeling or what you believe, so not, "I am aware that my partner is a big jerk for making me feel this way. I am aware that I'm panicking about what’s going to happen the next time I pick up the phone."

The other important piece of this is to suspend self-judgment.  Notice that in my list, I didn’t say “I am aware that there is a mug of three-day-old tea on my desk.  That’s really gross, I don’t know why I let that happen and I really need to be better about housekeeping” or “I am aware that my heart is being faster than it normally does.  I wonder why that is – do I feel anxious or scared?  What do I feel anxious or scared about?”  This isn’t about observing and trying to solve new problems; it’s about anchoring you.

2. Mindfulness meditation is pretty awesome. For a while, I wrote it off as hokey, new-age silliness, but recently it's something I'm trying to integrate into my life more because its positive effects have been well-documented for all kinds of things. For example, in addition to helping control anxiety by - you guessed it - keeping you in the present, it's the only thing that has been clinically proven to generate new synapses in the brain in adulthood. It's also a core piece of Dialectical Behavioral Therapy, which is the only thing shown to help people with Borderline Personality Disorder, a pervasive disorder characterized by inability to control extreme emotions in response to minor triggers.

Mindfulness meditation is easy to do - at least in theory. One of the things that always made me skeptical of meditation is that as someone who’s pretty down-to-earth, I don't really want to envision my spirit animal accompanying me on a journey through a dark forest. It just doesn’t resonate with me.  

Mindfulness can be done with guided meditation, but the way I practice it - and probably the easiest way for you to practice it is as follows: Find a comfortable position to sit in. Close your eyes and focus on your breathing. This is easiest to do, especially if you're new to this, by either placing your hand on your belly and feeling it get bigger and smaller as you breathe or by noticing the movement of air into and out of your nostrils. If you can, breathe from your diaphragm - though one of the problems with anxiety is that it can impair your ability to do that. If that's the case, no worries - just breathe as deeply as you can. Set an alarm for a period of time - maybe start with 5 minutes (I do 10 minutes per day) and focus on your breathing.  Don't admonish yourself for not doing it right, or for not being able to get as deep a breath as you'd like - just focus on your breathing.

At some point, you will start to feel your mind start to wander. When that happens, don't judge it - just gently bring yourself back to focusing on your breathing. In other words, if I'm doing mindfulness and I think "oh, crap, I meant to stop for milk," I don't follow that with, "dumb Jennie, you're supposed to be focusing and here you are thinking about groceries!" Instead, I think, "my mind wandered. I'm noticing that. Now I'm coming back to focusing on my breathing."

3. Aside from those two things, the best coping skills are the things you know have worked well for you in the past. If you’re a writer, maybe journaling will help - not online or even in a word document, but actual pen-to-paper journaling. There's something visceral about the act of writing, and something that allows you to be more honest with yourself when you’re writing things down than when you're talking about them. None of what you write is stuff to be shared with anyone else in your life, or even to be reread by you, but rather just to get the stuff out of your head... if it stays in your head, it will continue to drive you crazy. If you put it on paper, it no longer has to live exclusively in your head. If you write something really deep or significant, you *can* share it, but don't write with that purpose in mind.

And then lastly, do things that make you feel good. Go for a walk, have dinner with friends, read a good book, take a bath. When I'm upset, I sing so hard I feel like my face might come flying off - whatever your thing is, that's what you should do. Unless your thing is to worry, in which case I refer you to the preceding body of this email.