12 April 2018

Accepting Anxiety

The Tetons and the Snake River (1942)
Grand Teton National Park, Wyoming, USA
(Ansel Adams)

I thought that I would share something a little different on the blog today.

For those who do not know, I am currently on the recovery path from severe anxiety and agoraphobia stemming from long-term physical health issues. Well I say “recovering”, but I am not entirely sure what “recovered” really means in this context. Anxiety is something that I have grappled with at various levels for the entirety of my adult life - from being unable to get within a few steps of the front door of my home, to living a fully functional life without anybody even knowing I had any health issues at all. My goal is to be able to live an independent and functional life again. Admittedly what that means varies from person to person. For me the recovery process has been about tackling my self-limiting beliefs and behaviours. Easier said than done I know, but then pushing at the limits of our comfort zones is how we continue to grow throughout our lives.

One of the most common images I come across when reading about dealing with anxiety is actually a mindfulness technique that I often employ during meditation. You watch your thoughts come and go like clouds in the sky or leaves floating down a stream. Whether good thoughts, bad thoughts, exciting thoughts, or uncomfortable thoughts, you simply allow them to pop into your head and watch them go. Rather than getting carried away with the narrative of those thoughts, you try to observe them and allow them to be. It is about cultivating acceptance and the ability to ground yourself, through which you come to realise that thoughts are not facts. I have seen this type of metaphor employed numerous times for anxiety, where a writer will tell you to allow the anxiety to wash over you like a wave. To observe it and allow it to pass.

In my experience this works wonderfully for meditation and general thoughts racing around your mind. It teaches you to become more mindful. But when it comes to anxiety, it is pretty useless. The problem I find is that anxiety does not allow you to simply watch it flow past, especially when you have had anxiety for a long time, because it has become an ingrained habit that is always present. Anxiety refuses to budge, and when you do try, it will go kicking and screaming the entire way until you give up because you no longer have the energy to fight it. In my case it is one of the most well-trodden neural pathways I have, it has become an unfortunate habit, and so it is where my brain defaults to. It takes great effort to consciously rewrite those automatic anxious thoughts and slowly build new pathways, but we know that it is most certainly possible thanks to the wonders of neuroplasticity.

I would like to offer a different metaphor that I thought about while half-reading the Tao Te Ching as I watched people jogging along the River Thames. To my mind anxiety is like a giant boulder blocking your pathway as you move forward. It is huge and deeply embedded into the soil, and so, as far as you can tell, entirely blocks your route.

The sympathetic nervous system provides the body with the fight or flight response, wherein anxiety is played out as a physical response from a psychological trigger (or vice versa to be honest, because I often find myself misreading unrelated bodily symptoms as anxiety). The symptoms are ones I am sure most will be aware of - your jaw, shoulders and fists may clench, your blood rushes to your vital organs and so your fingers and toes may get cold, adrenaline surges through your body and you may get skittish, your breathing may become quick and shallow, etc. In response to anxiety arising from your thoughts about this boulder, your body is ready for fight or flight. Either you tense up and resist the boulder, going at it with a hellbent fury, trying to Hulk smash it out of your way. Or you start sweating and trembling and run back the way you came because the thought of trying to get past the boulder is entirely overwhelming (hello agoraphobia).

To my mind both reactions are misplaced. Trying to smash the boulder and resisting against it just leads to exhaustion, tension and frustration. On the other hand, running away from the boulder means that you are unable to get to where you want to go, and indeed the next time you try to come down this path, you will likely turn back long before getting anywhere near the boulder. Both instances have an effect on the body, and serve to maintain and increase the anxiety. In your mind it becomes something monumental blocking your path, which you think that you will never get past. You build it up more and more, because it is either too large to break down by yourself, or too scary to get close to in the first place. Thus that anxiety festers and begins to poison the ground around it.

Anxiety for me is not a leaf that I can watch float past, but that giant boulder blocking my path. The conclusion I have come to sounds simple, but is difficult to embody when the very notion feels alien to you - try to be like water (shout out to Bruce Lee). Water adapts to any shape, water is patient, water finds a way to keep flowing, water is humble (it flows down to the sea, which is lower than most water on land), water is adaptable (it becomes steam when hot, ice when cold, but can always return to fluid). The idea is to accept the boulder in front of you, and rather than trying to resist it or run away from it, trying to accept things as they are in the moment as exactly the way they need to be. In being able to accept, you are able to adapt, and adaptation is the name of the game. You learn to flow past it or flow over it. With patience and persistent work (doing beats knowing) you either come to erode that boulder down little by little, or you sweep it away in a surge. And so you find a way to keep going down your path even though that boulder is there. After all, bravery is not the absence of fear, but the ability to continue even while experiencing that fear.

For my part anxiety physically leads to quick and shallow breathing, nausea, stomach problems, dizziness, sweating, shaking, muscular tension and the feeling of blood rushing to my head. Basically, it makes me feel like shit. But in learning to accept the anxiety, I can learn to adapt to the anxiety. In doing so, I am able to learn that it is something that I can work around. And yet, the more you learn to adapt, the smaller that obstacle becomes in the long run anyway. Face the fear, and eventually you learn to flow past it.

Shallow breathing leads to hyperventilating because we tend to breath in a lot, but forget to breath out. That means too much oxygen in the body, which leads to dizziness. In that instance you want to focus on your out breath - people who tell you take a deep breath have got it backwards, you want to empty your lungs all the way and let your body take control of the in breath. Your body knows what it is doing, because if you keep over-oxygenating you pass out so that your body can take over from you screwing things up. Think of it as a reset switch, which you can thankfully avoid tripping by being more aware of your breathing.

A tight stomach causes nausea because the stomach is contracting repeatedly, which also exacerbates other stomach issues. Here I find that focusing on the the rise and fall of my stomach with each breath allows me to relax my stomach at the same time as my breathing. If your stomach does not move when breathing, you are likely shallow breathing up in your chest, which is something that a lot of adults actually do. I couple this deep breathing with a conscious effort to relax my shoulders, because they tend to hunch up and get tight. For me focusing on my shoulders acts as a gateway into me relaxing the rest of my muscles (unlike many I do not clench my jaw). It is a behaviour reinforced by meditative body scan practice, where you start from the head and move down. Indeed anxiety can actually lead to chronic holding patterns beneath our conscious awareness. This means that you might have tight muscles that you have been holding for so long that you are not even aware of them. This is not a temporary issue either, most of us have muscular tension we have held for years, if not our entire adult lives. I find that using a foam roller and stretching daily helps with general muscular tension.

The shaking was something I always thought of as the point of no return, and something I could not control, but I think of it now simply as excess adrenaline. What I find helps when I start shaking is to stand up and shake out my arms and legs individually, one after another. I may even jump on the spot a little. It is much like shaking because you are excited, and all you have to do is find an outlet for that energy. I have shaken out my arms and legs on a train, and rolled my head, just as a way of getting that energy out, and I find that it most certainly does help. This also plays into instances where you get anxious about doing something, but then run away from it in fear - that anxiety is still in your body, and so you are likely to remain tense for the rest of the day, meaning that over time you develop further muscular tension.

However tackling the body without addressing the mind is not an effective approach, and so I find that a holistic approach works best. The mind and body are one, and so disturbances in one are played out in the other. Thus while focusing on the body as described, I also try to focus on the thought process leading to my anxiety in that specific instance. The idea is quite simple - look for the demand. There is always a rigid irrational demand that we are making that leads to the anxiety. An irrational demand leads to anxiety because demands do not entertain the thought of failure. Failure becomes something that is unbearable and something that would mark us out as the worst person to have ever existed. Examples of such demands are - I must not have a panic attack, she must not divorce me, I must not get fired, they must not shout at me, things must be perfect, he must not die, I must pass this exam.

Ask yourself why that must exists. Ask yourself what would happen if the opposite were to come to pass. We try and we fail. We go through horrible things that we wish we never had to. We suffer. That is part and parcel of being human, and is nothing unique to any of us. We all go through it and it is the best way to learn and grow. I try to remind myself that I have choice and the ability to exercise preference. We all have choice over our actions, even when it feels like we do not. To take an extreme example - I could choose never to eat food ever again. It would not be a good idea, because I would die, but I could most certainly do it. Thankfully most of the choices we make are nothing so major, but they can often feel like it.

To give an example - "I can choose to go into this scenario where I could potentially have a panic attack, but I do not have to. I would definitely prefer not to have a panic attack, but I understand that it could happen. If it did happen, I know that while it would feel horrible, it will not kill me and is not the end of the world. I know that this is an incredibly uncomfortable experience for me, but even if I am unable to do it comfortably, I can still choose to do it uncomfortably." In exercising choice and preference you essentially show yourself self-compassion. You can choose to stay with the anxiety and learn to flow around that boulder instead of tensing up or running away. Accept and adapt, because in time that boulder becomes nothing more than another pebble on the riverbed.

One last thing that I always try to keep in mind - talk to yourself in that moment like you would to a loved one or friend going through the exact same thing. I think that for most of us, we are kinder to others going through hardship than we are to ourselves when going through that same hardship. But yes, rather than watching the leaf flow past, I prefer to be the water flowing over the boulder. After all, life is not about standing still. Wherever you go, there you are.

xxxx

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