How to Overcome Fear, Anxiety and Panic using Mindfulness Meditation.

 

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All of us will experience fear on occasions. It is a normal healthy biological reaction warning us of perceived threat or danger. However, some people experience fear more frequently, some even on a daily basis, perhaps manifesting as generalised anxiety or in the form of panic attacks.

Often people cope with fear by ignoring such feelings when they surface or by denying them. Many people try to push the feelings away, because they don’t like them and are not prepared to accept them, while others engage in wrestling and battling them as if they were the very threat itself, instead of the messenger.

What I am going to suggest, which might seem a little radical when all you want to do us get rid of these feelings, is to “make friends with your fear.” You see, the problem is, the more you try to battle, ignore or push these feelings away, the more they will surface. When you try to banish them to the deepest, darkest dungeon in your castle, no matter how hard you try, you will still hear them calling you. The harder you try to get rid of them, the more you will experience them. Why? Because you are focusing your energy on them and when you do this, rather like trying not to think about an annoying song or a tune that goes round and round in your head, it will simply magnify your experience.

The first thing I want you to know is that these symptoms cannot harm you. I will say it again, these symptoms cannot harm you. You will not have a heart attack, stop breathing, you will not faint and you will not lose control or lose your mind. Fear simply mobilises your body to be ready to fight off a real or imagined foe.

I will show you how, using a technique called mindfulness, you can achieve what you desire, that is, not to be overwhelmed by your fear and instead to bring about a new relationship with your fear. So, instead of viewing fear as something that should be suppressed or eliminated, we will be using mindfulness to bring about acceptance.

“The way of mindfulness,” says best selling author and mindfulness master Jon Kabat-Zinn,” is to accept ourselves right now, as we are, symptoms or no symptoms, pain or no pain, fear or no fear. Instead of rejecting our experience as undesirable, we ask, “What is the symptom saying, what is it telling me about my body and my mind right now?”

What he is suggesting is that we listen, take a closer look and get acquainted, instead of reaching for the diazepam, rescue remedy or whatever it is we grab in our  immediate desire to make it go away.

Using mindfulness and harnessing quiet gentle breathing we begin to make friends with our fear. As Jon Kabat-Zinn suggests, “We allow ourselves, for a moment at least, to go right into the full-blown feeling of the symptom. This takes a certain amount of courage…dip your toe in…and move a little closer for a clearer look.”

We begin to approach our symptoms “as we would a shy animal sunning itself  on a grassy bank.” Ever so gently, becoming aware of our feelings about the symptoms as they appear. Perhaps we feel anger, frustration, anxiety or despair. We may say to ourselves, “Why now, not again or oh no, I cannot bear this again.” The key is to look as dispassionately as possible, with a non-judging mind. We need to accept that whatever we are feeling, it is here now. It is already with us, already part of our experience in this moment. The key is to accept our feelings as they are, opening to the fear in a kindly way rather than continually trying to block it out and overcome it.

When you experience symptoms simply observe and watch as they unfold. Try not to react, responding as if the symptoms were a wild animal out to get you. Instead, calm, tame them by making friends. Observe your moment-by-moment experience and view it as a “process” instead of getting caught up in the “content.” As you do so, you will discover that there is a “flow” of changing sensations and responses. Allow yourself to be curious, interested in a dispassionate way in the quality of the sensations and your experience, rather than get caught up in the distorted imaginations you tell yourself. These fantasies about what may or may not happen simply fuel fear, anxiety and despair.

It won’t be easy, as resistance will re-emerge many times and your first response will be to block it out, but with practice you can learn to resist this habitual behaviour and you will learn to interrupt the cycle of tension, reaction and suffering and replace it with peace, awareness and kindness.

As you become intimately acquainted with the nuances of your experience you will gently tame that which you wish to banish. You will find that instead of visiting you regularly, stirring up terror and suffering, the occasions of fear will change, they will no longer be completely overwhelming; the intensity and duration will diminish, and you will be able to smile instead of tensing rigidly. You will begin to break free from that which bound you.

Here is a simple befriending mindfulness exercise:

Make yourself comfortable in your body. Spend a moment loosening or adjusting your posture. Whether you are standing, sitting or lying down.

Now place your attention on your breathing. Notice the in-breath, notice where the breath enters your body, the nostrils… Notice how at the end of the in-breath the breath naturally starts to subside; follow the breath. Try to find that momentary pause between the in and the out-breath, the out and the in-breath; a moment of stillness and space. Notice how without having to do anything, the breath rises and falls naturally.

Encourage a tender, gentle awareness to permeate the breath, so the breath softens any resistance and with full intention, breathe in kindness and compassion, breathe out tension and fear.

When we are aware that what we are feeling is fear, we make friends by saying:

“Breathing in – fear I know you are there.”

“Breathing out – I accept you, I will take care of you.”

Simply practise this over and over, remind yourself that  these feelings will soon pass. By developing a calm, mindful relationship with your body you will learn to let go of fear, anxiety and panic.

Until next time, Steve

We would be delighted if you visit our facebook sites:

www.facebook.com/yourmentalhealthmatters

www.facebook.com/bexhillmindfulnesscentre

Steve Clifford Senior Accredited Integrative Psychotherapist.                                           Accredited Cognitive Behavioural Psychotherapist.
References:

Burch, V. (2008). “Living well with pain & illness: The mindful way to free yourself from suffering,” Piatkus.

Kabat-Zinn, J. (2004). “Full catastrophe living: How to cope with stress, pain and illness using mindfulness meditation,” Piatkus.

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Mindfulness – Learning from the breath

 

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Like everything else that requires practice, the development of mindfulness first involves learning some concepts, and some methods to practice. The methods are practiced over and over again, first only in very structured situations, eventually in all kinds of situations.Ultimately, the skills become reliable ways of responding with freedom, wisdom and kindness to a greater and greater range of human experience.

Bare attention – Attending to sensory experiences that arise with an object of attention, without distraction or thinking too much. For example, when attending to your breathing with bare attention, you just notice the sensations of breathing and nothing else. When this is occurring, many subtleties and nuances of breathing, and patterns in these, reveal themselves to you. Also, you are just noticing these sensations as they arise and pass away in the present moment – not thinking about them, not labelling them with language, not associating them with other sensations or patterns you may have experienced before.

With practice, bare attention can be applied to bodily and emotional responses, including those triggered by very painful or traumatic experiences. For example, a person might attend to the sensations in her chest, throat, and face that arise when someone raises their voice in anger and reminds her of a hurtful parent or step-parent. Focusing on emotions as bodily events while “dropping the story” of verbal thoughts, bare attending.
Labelling – Mentally applying a word or brief phrase to a particular content of experience.

Not all mindfulness meditation instructions include this practice, but many do. The idea is to help oneself simply notice something arising in your experience, without judgment, so that you can get back to observing the flow of experiences arising and passing away. This practice can also eliminate the control of particularly “sticky” thoughts and feelings over one’s attention. For example, one might use the labels “sadness” or “anger” when these emotions arise; or “planning,” “worrying,” or “remembering” when those common cognitive processes arise.

Acceptance – Accepting the reality of one’s current experience is particularly important when it comes to potentially intense negative emotional responses. Once such emotional responses have arisen in one’s current experience, neither mindlessly being carried away by them nor attempting to suppress them will be particularly helpful. Acceptance allows one to see them more clearly for what they are – unwanted and intense, but passing experiences – and choose how to respond to them, perhaps with acceptance and nothing more.

Non-reactivity – Responding to experiences, including emotions and impulses, without getting carried away by them or trying to suppress them. All organisms, including human beings, are conditioned to react automatically to most of the experiences they have. We grasp at what we want and like, and push away what we don’t want or like. Before we even know it, such conditioned responses to stimuli and emotions carry us away.

Mindfulness involves the skill of non-reactively observing split-second conditioned reactions, which provides the option of not acting out the entire chain reaction that would normally follow. This non-reactivity opens up space for new observations, reflections, learning, and freedom.

Curiosity – An attitude of interest in learning about the nature of one’s experience and mind. Through mindfulness, this quality of mind can be brought to a much greater range of experience than we ordinarily do. When it comes to experiences that we don’t want, including painful memories and emotions, we tend to just push them away and avoid them, again based on our conditioning. We tend to reserve curiosity for things and experiences that are new and at least somewhat positive. But with mindfulness, we can bring curiosity to the full range of our experience, and discover much that is new and enlightening.

Patience – Accepting a slow pace of change; bearing unwanted, difficult or painful experiences with calmness. Experiencing the breath over and over again, and repeatedly observing – with acceptance, non-reactivity, and curiosity – that one’s mind has wondered or been carried away in a chain reaction of conditioned thoughts and feelings, is a wonderful way to cultivate patience. And these experiences can translate to daily life, enabling us to become more patient with ourselves and others as we all continue to fall into habitual responses that increase our suffering.

Thoughts and feelings as events, not facts
We often respond to our thoughts and feelings as if they were facts or truths that “demand” or “justify” particular responses. However, it is also possible to understand and experience our thoughts and feelings as events that arise under certain conditions, and then pass away. This is true of all sensations, perceptions, feelings, memories, fantasies about the future, and other mental experiences.

Understanding and experiencing our thoughts and feelings in this way opens up some “space” around them. Instead of the thoughts and feelings having you, and carrying you away, you can experience yourself as having certain thoughts and feelings under certain conditions, and as having options about how you respond to them.

Attending to process vs. attending to content.
Most of the time, most of us are lost in the contents of what is running through our minds. Though fears, cravings and various emotions drive our thought processes, we tend to get lost in the specifics and details of our thoughts and memories. Mindfulness meditation teaches us how to observe the processes of our minds and how they work.

For example, when we are experiencing a pain in our body, or a painful memory, we tend to focus on the content of the pain experience and relate to it as something solid and unchanging. When that happens, the pain or memory is experienced the same way we always experience it, with the same predictable results. However, if we truly attend to the process by which sensations of pain or aspects of remembering arise and change from moment to moment, the experience tends to lose its grip over our awareness and become more tolerable and workable.

When we can attend to a painful memory as a process that arises and plays out in our mind, we notice how the images, thoughts, feelings and bodily experiences change from moment to moment, and that experience of remembering involves new learning and opportunities for healing. Repeatedly attending to the processes of one’s mind in daily meditation practice, one can become more mindful and more skilled at noticing the processes of experiences in daily life – and choosing not to get lost in the contents of experiences.

The transformative and healing power of this shift in how we attend to our experience really is amazing, though it does take practice and discipline. Most important, this is a skill that truly can only be experienced directly, and only hinted at with words and concepts like these.

Until next time, Steve

We would be delighted if you visit our facebook sites:

www.facebook.com/yourmentalhealthmatters

www.facebook.com/bexhillmindfulnesscentre

Steve Clifford Senior Accredited Integrative Psychotherapist.                                           Accredited Cognitive Behavioural Psychotherapist.
This blog post is largely an abridged version of “Mindfulness and Kindness; inner sources of freedom and happiness,” by Jim Hopper, PhD – http://www.jimhopper.com [Accessed 18/02/15]

Image: By Michael Coghlan from Adelaide, Australia [CC BY-SA 2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons

Beds – there is a problem but the main solutions lie outside hospital

Thanks Paul, excellent, well thought out blog post addressing some of the real challenges of this very complex area, Steve

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No controversy rages more fiercely in healthcare, and in particular mental health care, than that of whether there are enough beds.   Although it is 20 years since the closure of the last long stay mental health hospital, the number of beds still holds significant sway as the working currency of psychiatric care.  The debate is a philosophical one as well as a practical one.  One side of the debate sees beds as the epitome of oppressive medically dominated care, in some cases arguing that with the right community resources there may be no need for beds at all, or at least not for what we currently define as psychiatric inpatient beds.  Others see the gradual erosion of inpatient beds as a big mistake and cites the undoubted pressure on resources in some parts of the country as proof of the urgent need for new capacity to be opened.

Pressure there…

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Have you ever considered Skype therapy?

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These days when you need to talk to someone about your problems you can do so from the comfort of your armchair. The benefits of on-line therapy mean that you can access therapy anywhere in the world at a time that suits you. No more having to miss time off work, arrange for child care or spend half an hour each way travelling. Many people now enjoy the convenience of talking to their personal therapist and getting support in their own homes and offices where they feel most comfortable.

For mental health difficulties such as depression, anxiety and panic; or conditions such as agoraphobia, Skype can offer that first step to getting help. In my own practice I have been providing Skype therapy to people all over the world for some time. Over time little glitches like time delay have been ironed out and with a delivery system close to traditional therapy, Skype can afford all the intimacy of the consulting room with the bonus of internet flexibility.

For the on the move business person where “time is money,” cutting out the journey to and from the consulting room can mean an hour or so, is not wasted travelling. For those in far off countries without access to therapy, Skype really comes into its own. Internet therapy or Skypeotherapy as it is also known, has really hit it off with the younger generation. To be able to talk to your therapist on your mobile in the privacy of your bedroom with no one asking you where you are off to and pay on-line has many advantages. Many men, who traditionally have avoided talking about their problems are nowadays much more likely to access this type of help.

If you would like to learn more about Skypeotherapy or book up an introductory taster session why not contact me via my website: www.stevecliffordcbt.com

Until next time, Steve

We would be delighted if you visit our facebook sites:

www.facebook.com/yourmentalhealthmatters

www.facebook.com/bexhillmindfulnesscentre

Steve Clifford Senior Accredited Integrative Psychotherapist.                                           Accredited Cognitive Behavioural Psychotherapist.

 

Ref: “Depressed patients turn to the internet for Skypotherapy” The Telegraph, 24/12/14

Should I see a therapist?

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Well, that really depends on why you want to see a therapist. If you are going to see them with the hope that they will solve your problems, then perhaps not. If, however, you are going to them with the hope that they will help you to solve your problems, then that’s another matter. You see, the job of a therapist is not to “fix,” but instead to help you to mobilise your resources. A good therapist does not solve your problems, but helps you to develop the capacity to solve your own problems.

People often look to have therapy when they have a major life crisis, such as a death, the end of a relationship or the loss of a job. Sometimes people feel empty or inadequate inside, or they may feel that life is not going right and they may feel unfulfilled.

It can take courage to go and see a therapist, after all, firstly the person has to admit they have needs and then they have to face them. Fear of facing painful feelings can prevent people seeking help and many turn to work, alcohol or other coping strategies to push thoughts and feelings out of their consciousness. Therapy does require a commitment from you, but it is worthwhile and talking about difficult emotions in a safe space can be very liberating. Expressing your thoughts and feelings in such a way as to clarify your own situation, come to terms with painful emotions and see your difficulties with greater objectivity can really be helpful.

It is the therapist job to provide you with a space where you can talk without fear of judgement. In other words, a confidential place where you can feel held, secure and safe. For many, the therapy room is a refuge, a sanctuary. I like to think of it as your room, your space within my world. A place where you can return to at any time in your life should you need.

A good therapist will make you feel at ease, they may even feel more like a friend than a professional therapist, someone with whom you may feel you can tell anything. Whilst friendship and friendliness may be an important ingredient, along with warmth, genuineness and congruence they can never be a friend as such. You are seeking their help as a professional not as a chum, buddy, lover or any other relationship.  It is precisely because of the uniqueness of this relationship where warmth and friendship in the therapy space combined with professional integrity come together in the service of your difficulties. Next time you are telling a friend something notice how they will often come back and try to tell you a worse story, or perhaps they will tell you what to do or simply rubbish what you say. A good therapist won’t do this. Of course, there may be a value in the therapist sharing or disclosing something of themselves, they will only do so really if it is deemed to be helpful and supports the therapeutic endeavour. You can be sure of one thing though, unlike a friend or acquaintance, a good therapist won’t dump their garbage on your shoulders!

The term psychotherapist is one that I really like. Not because it is a lovely grandiose title… but because of the original Greek meaning of the word. Here the word therapist literally means “attendant” and the word psyche literally means “spirit” or “soul.” So a psychotherapist is literally a “Soul Attendant.”

One of the problems when deciding that you want to take up therapy is to find the right type of therapy for you. The problem is that there are just so many different types of therapy to choose from. Therapies vary from analytical laying on the couch type therapy, to body therapy, cognitive behavioural, transpersonal to neurolinguistic programming. The list is seemingly endless. I suggest you go to a good bookshop and look for books on therapy in the psychology section, alternatively contact a few therapists and ask them to tell you more about their particular approach.

Probably the best way to find a therapist is through personal recommendation. This may be from your doctor or a friend. The key thing is that the therapists approach has to feel right for you.

These days a lot is spoken about a type of therapy know as cognitive behavioural therapy or CBT, which is my own speciality. This is an action-oriented as well as word-oriented therapy. It helps people understand what is happening and what they can do to change the way they feel and react. CBT looks at the way thoughts (cognitions) and beliefs affect our emotions and the meaning we give to events. This affects our emotions and our reactions (behaviours). Unlike some other approaches, CBT is a relatively short term psychotherapeutic approach. The length of therapy tends to depend on the complexity of the presenting problem. A block of sessions ( usually six) may often be enough for a noticeable difference to emerge. Improvement to “quality of life” is often the best measure of success. The goal of CBT could be said, to enable the client to learn ways to address problems and difficulties in order to become their own therapist.

If somebody asked me what do you do? I would reply that I do many things, but one of the most important things is”tilting the mirror.” In other words. Reflecting back in such a way as enable the client to glimpse a slightly different perspective. Helping the client gain insight and understanding. This may be helping the client to see how unhelpful thinking traits, such as catastrophizing mind reading, black and white thinking distort their view of reality. We may look at the meaning they give to events creates a huge emotional upheaval and how stepping back and distancing can help. Then together we look at the problem area and the way it impacts on the person’s life. We consider how life would be different if the problem was resolved. We look at what may need to happen or change, then we look at the emotions arising out of the event or situation and talk about them. Together we identify what needs to happen to bring about resolution of the problem area. Then we identify strategies and goals (or aspirations) to aim for. Working within a specific time frame, using measures and behavioural experiments to help us. Through the course of therapy the client and therapist walk “shoulder to shoulder,” addressing the difficulties In a collaborative way.

Some people say, “I felt worse after my first session,” for others, getting it out in the open can be a great relief. Problems rarely resolve themselves without action, and if they do so, it may not be in the way we desire. Having the opportunity to explore them with another person may help a great deal.

Don’t expect miracles, but don’t dismiss the possibility that resolution of difficulties can feel like a miracle. Therapists are not “miracle workers” and if they present themselves that way, don’t go anywhere near them! The therapist is there to guide you to achieve your goals, not to do the work for you or “make” you feel better. Every session you attend is one step closer to feeling better.

Until next time, Steve Clifford, Cognitive Behavioural Psychotherapist.

visit us @ www.stevecliffordcbt.com
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