Updated: 4 days ago
The causes of chronic anxiety are complex, so its management necessitates a holistic, or whole-being approach.
With that in mind, different approaches will target issues that arise from each dimension of Being, from gross to subtle. Those are body, mind, emotions and consciousness*
* In simple terms, consciousness can be thought of as the capacity to be aware or to witness one’s internal processes with detachment. It is also the dimension of Being where we can experience ourselves as connected to something larger than the personal self.
Classical forms of psychotherapy are focused primarily on the mind and emotions, while more contemporary forms recognize the importance of integrating the body and consciousness in treating dis-ease. Without the foundation of a healthy body, internal practices and psychotherapeutic work will be harder, and their effect diminished. Once these are in place, psychological factors such as early life trauma and attachment wounding can be effectively isolated. Such a linear approach is an ideal, however, and some form of psychological support or holding may need to be in place first.
Body Optimizing lifestyle factors is the low-hanging fruit of anxiety management in the sense that it involves practical steps that one can take to significantly reduce symptoms in a relatively short period of time. This is about forming new habits and will require some sustained effort and a degree of refinement before they establish their own momentum.
The importance of fundamentals such as diet, sleep, exercise and breath cannot be over-stated.
They are often ignored in favour of exploring potential psychological factors. Conveniently, this allows us to continue avoiding the kind of intimacy with our own bodies that will actually help. Whatever supports grounding attention in the body will alleviate symptoms of anxiety.
An optimal diet will be unique to you and your particular food sensitivities, and it might even depend on your ancestral heritage. A willingness to experiment and to listen carefully to the body’s feedback is key here.
There are, however, some universals that will apply to all of us.
Known colloquially as the gut-brain, the enteric nervous system has a huge impact on our mental health. Consumption of sugar and refined carbs cause insulin spikes, mood instability and contribute to leaky gut (A condition whereby food toxins pass through the damaged gut-lining and into the blood stream causing an array of health complications).
Swapping out ultra processed foods for whole foods is a good place to start; as a general rule, try to avoid anything with a long list of flavourings and preservatives.
There is good evidence to suggest that incorporating fermented foods into your diet supports overall digestive health, which in turn, will improve your mental health.
If you can, limit your drug and alcohol consumption and make giving up smoking a priority - a highly effective method for this is Allen Carr’s Easy Way to stop smoking.
Do whatever you can to get enough restful sleep. We now know that sleep deprivation is carcinogenic, probably due to the increase in cortisol which causes stress and irritability. Furthermore, poor sleep makes us less able to resist unhealthy foods, or to register signals of satiety (being full).
Alcohol consumption and excessive screen-time will negatively impact the end and the beginning of the sleep cycle, respectively. Together, they burn the candle at both ends.
A little-known fact states that our core body temperature falls as we get ready for sleep. If you have ever struggled with insomnia, you might have noticed that your extremities, i.e. hands and feet, become uncomfortably hot. This is a sign that your core body temperature is too high. Having a hot shower before sleep will actually help lower your core body temperature as it encourages the pores to open, allowing heat to escape.
Incorporate some form of exercise into your daily routine. Anything that gets your body moving and increases your heart rate will do. Picking something that you enjoy is obviously essential for sustainability, but resistance training is ideal (i.e. bodyweight exercises or lifting weights). Building and maintaining muscle mass is correlated with longevity and better health outcomes in general. This will have the added benefit of helping you to feel more connected to, and grounded in, your body. If you can’t manage this, a brisk walk every day is a good start.
Pay attention to your breath when feeling anxious. You will notice that it is both shallow and rapid. Force yourself to take 10 long, slow, deep breaths, fully inhaling and fully exhaling. Notice the effect this has on your anxiety. Learning to breath mindfully when anxiety is present is undeniably hard, but will help to ground attention and relax tension.
The dimensions of emotion, mind and consciousness might be best addressed with the guidance of a suitably informed therapist.
Among other things, the therapeutic relationship can be an opportunity to experience a healthy attachment. Attachment traumas can originate early in life when our primary attachment figure (usually Mother) is experienced as unavailable, inconsistent, or smothering, or later in response to insecure adult partners. This can result in a chronic and persistent sense of insecurity which we carry into subsequent relationships. Instead of a secure base*, we internalize a feeling of being unwanted or uncertain that care and support will be available when needed.
*British Psychiatrist, John Bowlby, coined the term 'secure base' to describe how the primary attachment figure symbolizes, for the infant, a place of security. This secure base gives the infant confidence to explore the world, safe in the knowledge that the caregiver will be consistently available to meet their needs when they return.
The effort to suppress grief related to this contributes to our anxiety. With the support of a trusted therapist and the psychological holding they can offer, we can finally explore and process what has been too scary or painful to face, including the memories and feelings associated with all kinds of traumatic experience.
Learning to identify the full spectrum of emotional tone, encourages us to feel, express and ultimately process emotion that otherwise remains trapped in the musculature of the body. Unprocessed emotion can express itself in numerous ways such as illness, muscle tension and pain, poor posture, and breathing difficulties.
Helpful practices here might involve journaling and/or a technique called focusing - This involves bringing focused attention to where in the body emotions are registered. We can think of our attention as the beam of a spotlight that is usually directed outward, or on the contents of the mind. Gently, direct the spotlight of attention down and in toward the felt experience of the body, and try to describe any emotion you notice in terms of descriptive words. Ask yourself - is there a shape, colour, sound, image or movement associated with this feeling? Stay with the raw sensations and try to ignore the verbal chattering of the mind. Trust the fleeting images that you notice, even if they appear silly or irrelevant.
Occasionally, there may even be a significant memory that arises in relation to specific emotions.
You might want to record the image in a journal and explore what it could mean to you. What does it symbolize or represent? A playful attitude of curiosity and exploration is advisable here.
Feelings may increase or decrease in intensity, so allow yourself to express the emotion in whatever way feels appropriate. There may be tears, laughing, shouting or even growling! The trick here is not to judge however the body reacts. Trust that the body knows instinctively how to process what the mind doesn't understand.
Regardless of what you notice, such focused attention will allow you to process emotion, relax tension and often generate important insight.
Internal practices focusing on the dimensions of mind and consciousness involve the harnessing and refinement of attentional capacities and/or cognitive reframing of limitations.
Cognitive behavioural therapy, or CBT, is the gold standard for ‘evidence-based’ psychotherapy and is the often-recommended modality for treating anxiety and depression. It is specifically focused on thought processes, unconscious beliefs and errors of cognition that drive and maintain negative emotional states and behavioural compulsions. Because of the nature of CBT focused therapy, it is often delivered in a structured and goal-focused fashion. This can be reassuring to clients, but can also have limited depth in comparison to more exploratory approaches.
Anxiety resulting from unconscious thought processes can be addressed using CBT to examine our internal monologue. Developing an attitude of scepticism towards the mind’s habitual narratives is essential for good mental health.
For many of us, the relationship between suffering and pain is unconscious.
To a large degree, suffering is created and maintained by resisting the inevitable pain of human life. Sometimes, by avoiding pain we are choosing the long-term, chronic suffering of disempowering narratives over the short-term, acute pain of taking responsibility for meeting the challenges that life presents us with. In this instance, chronic anxiety is the nagging feeling that we are not doing what we know we must.
These familiar, and oddly comforting, stories can involve comparison with others, a fixation with a victim mentality, a sense of entitlement, or a nihilistic outlook on life. Importantly, they all serve the same function of allowing us to avoid acute discomfort, and generate the same negative emotions of anxiety, bitterness, resentment and envy.
Conversely, our willingness to consciously face and work with (not against) the inherent limitations of life frequently generates gratitude and compassion for self and other.
It is vitally important that we become aware of what kinds of narratives we entertain and what purpose they serve. Sometimes, it's hard for us to let go of these limiting stories because we are addicted to the negative feelings they arouse in us. A literally sobering fact that's worth your contemplation!
Using a journal in a question and answer format is useful here.
Some questions to start with might be –
What do I believe about myself, life and other people? How do these beliefs make me feel and behave?
For each belief –
Is this true? How do I know it’s true? Can I really be sure? Is there evidence to the contrary? Given the evidence, are there other interpretations of this event, person, situation that might also be valid?
Experimenting with opposite statements can reveal what might be unconscious.
For example, a belief such as people are judgemental can become I am judgemental.
How would different beliefs about life, myself and others make me feel and behave?
Take a moment to inhabit these different beliefs in your imagination and experience their effect on you.
Along with this kind of cognitive re-framing, we can identify and take practical steps to alleviate anxiety. Once appropriate action and cognitive re-framing steps have been taken, give yourself permission to let the anxiety go.
With enough practice, we can begin to identify the mind’s habitual negative distortions before they lead us into catastrophic thought loops.
Stimulus or trigger -bodily discomfort (feelings of fear/vulnerability) – contraction and avoidant behaviour- negative self-talk – more fear/vulnerability & shame – deeper contraction -
Firstly, a caveat - some of the practices suggested below may seem innocuous but they are also potent catalysts for transformation, so are necessarily destabilizing. Consequently, if you are feeling suicidal, have had psychotic episodes, or have a family history of schizophrenia/psychosis they should be avoided, or at least approached with great care.
At a certain point, we might need to delve much deeper to address anxiety that arises in response to important dilemmas or questions that want our attention. Often these conflicts can be existential (related to the fundamental facts of existence) or transpersonal in nature (related to spiritual intuitions) and so can feel insurmountable.
Unanswered questions about our own mortality, the burden of freedom and the quest for meaning can haunt us in our quiet moments and drive all kinds of unhealthy avoidant behaviours. Until we find our own satisfactory answers to these questions, we cannot rest at a deep level, but instead might feel a sense of impending doom or intuit a disturbing void at the core of our being.
Such questions to ask yourself might be –
What is my anxiety trying to tell me about my relationship to myself/to life?
How do I feel about the facts of impermanence and mortality? Are these facts something I work hard to avoid acknowledging? How might they affect important change if I were to let them in on a frequent basis?
Do I feel my life is meaningful? If not, what do I yearn for that I'm not allowing myself to pursue?
Does my anxiety have a greater meaning? Is it in the service of some larger purpose that is asking me to surrender? Self-growth, spiritual development, character formation, responsibility of freedom etc?
Where and who was I before I was born, and where and who will I be after death? --
Try to bring an attitude of healthy scepticism to bear on your automatic response to this important question. Whether you're an unquestioning atheist or true-believer, ask yourself to whom you have outsourced your authority in this most important of subjects. Maybe its your family, the local priest, a shaman, a teacher, or some Nobel prize-winning scientist. Regardless of the answer, belief as it relates to this question, in either the positive or negative sense, often masks unresolved anxiety around uncertainty. Engaging with that uncertainty consciously, and allowing your curiosity to motivate you will have a positive effect on death-anxiety.
Being related to fundamentals, these questions inevitably lead us back to the nature of the ‘self’ and identity. The first step is to take the questions seriously, to allow them to motivate us in constructive ways and to inform our character such that we become conscious of our own depths. Although satisfactory answers can be found, relief will often come as a by-product of our simple and genuine engagement with the questions. That engagement will propel us along a path that will be unique to us, so courage, curiosity and experimentation are vital.
Specific practices here will be contemplative in nature. Some form of daily meditation along with self-enquiry is a good starting point. Meditation can start with 5-10 minutes a day simply sitting and training attention to remain focused or one-pointed. Any object of focus will do, such as an image, a word/phrase or sensation, but the in-out movement of the breath is often recommended. The trick here is not to try to empty the mind, but simply watch the breath and note all the sensations that accompany it. When attention gets caught in the mind, gently, and without recrimination, bring it back to the breath; rinse and repeat. Slowly build up to longer periods of sitting.
Time in meditation is time spent undermining the compulsive grasping at thought that feeds anxiety, so it offers some immediate relief. However, the long-term goal here is to train and strengthen attention such that it becomes powerful and penetrating enough, not only to recognize thoughts as objects in awareness, but also to grasp its own source. To the degree that much suffering is self-created in the maintenance and defence of identity, waking-up to what we are at the most foundational level, prior to identity, is the antidote.
Self-enquiry is as straight-forward as the term suggests. It is enquiring into the nature of self; sitting with simple questions such as what/who am I? and witnessing what emerges into consciousness. For every definition that the mind offers up, note it as another object arising within awareness and repeat the question. Like meditation, the ultimate goal here is to sit with the questions until awareness begins to spontaneously fold back on itself so it can cognize its own free-standing nature. The catch here is that awareness is transparent and thus not a perceptible object. It is too intimate to be seen directly; it is knowing through being, rather than perceiving.
If you've managed to arrive at this point, you might be feeling a little overwhelmed by the array of suggested practices. If this is the case, I don't blame you! My advise would be to start by focusing on one section at a time, for a month, and note any changes. A sensible order in which to do this would reflect the structure of this essay - body, emotions, mind and consciousness. This will not be a one and done kind of thing, nor so linear in reality. However, by familiarizing yourself with the practices in this kind of deliberate and structured way, they will eventually be integrated into your life.
A useful analogy here might be that of learning chords on a guitar, or colour theory in painting. Once the basic principles are learned, you can employ them in a spontaneous, creative, and intuitive fashion.