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50 Tools for Panic and Anxiety -- page 10
by Monica A. Frank, Ph.D.

Advanced mindfulness training builds on the skills taught in initial relaxation training. It is important to have a strong foundation prior to the advanced training.

Index to 50 Tools

Listen to 50 Tools

Advanced Mindfulness (cont.)

Suggestion 27: Let Yourself Grieve

You may question why I have included grieving among the techniques for advanced mindfulness. If you have read much of my material you may understand that I believe the ability to grieve is a critical aspect of coping with life. You will not avoid loss in your life. Some loss will be devastating such as the death of a loved one. Some loss will be bitter-sweet and necessary such as leaving a beloved job for a better opportunity. Or, a child growing up and not needing you in the same way. But loss will be present in life. No one escapes it.

However, we have been given the ability to grieve which is a healing process built into our systems. As I have discussed earlier, people don't want to feel discomfort so instead of allowing this natural process to occur they often use various means to try to avoid it. Unfortunately, as a result, they prevent healing. Instead, the grief is ever raw and pervasive. It may even present indirectly as increased anxiety.

I believe that mindfulness is to be fully present and aware with whatever emotional experience we have. By doing so, we allow our body to function as it is meant to. We allow the natural healing process to occur. This process, however, does not feel pleasant. I think of it as similar to the medical procedure of wound debridement which is removing the dead tissue from wounds so the healthy tissue can heal. I understand it is a very painful, but necessary, process.

The same is true of grief. Feeling grief fully can be very emotionally painful. However, it is a healing process created within us to help us cope with the loss we will experience in life. Mindful grieving means recognizing that the emotions of grief, sadness, anger, hurt, are a part of our present experience.

However, it also means recognizing that certain thoughts distract us from the grief process and can cause us to become stuck in grief. For instance, thoughts of self-blame are often irrational and can prevent the healing process. These thoughts can be about the event itself such as “I should have known” or it can be about the grief such as “I should just get past this.” Either way, self-blame is usually a distraction from the full experience of the grief.

Too often, you might find that others want to diminish your grief because they are uncomfortable with the emotion themselves. Although this can generally make people question these normal emotions, in particular I am concerned about the medical profession medicating grief. By doing so, I believe they not only prevent the natural healing process from occurring but also contribute to the belief that we should always feel good which, as I indicated previously, is detrimental to managing life problems.

The mindful practice of grieving means to experience your emotions without judgment. Your emotions may be intense, angry and raw, but they are not abnormal. Let your emotions be what they are and trust in the grief process to heal you. When thoughts come into your mind, let them be while gently refocusing yourself back to your present emotions.

One caveat, however, is to recognize that when grieving, your present experience involves more than the grief. That is why people can laugh at funerals when remembering certain events involving their loved one. Grief involves the full experience of emotion including feelings of happiness. In addition, grief does not have to be experienced 100% of the time because there are many other aspects to your present experience as well.

Suggestion 28: Mindful Grounding Technique

A technique that has been used a long time to help people who have intense anxiety, panic, or flashbacks to trauma is called “grounding.” This technique is highly related to mindfulness in that it involves drawing the attention in a very concrete way to the immediate experience.

For instance, many people when having a panic attack have symptoms of “depersonalization” or “derealization.” Depersonalization means that the person does not feel connected with his or her body. Derealization is when a person perceives the immediate environment as “unreal.” These symptoms come about because the individual is caught up in the internal sensations and symptoms of the anxiety. For instance, someone who is experiencing flashbacks to trauma is focused on internal images and emotionally re-experiencing the event.

Mindful grounding is a technique to refocus the awareness externally. In this situation the person very deliberately focuses on the immediate surroundings. This may even involve physically touching things in the environment such as the chair they are sitting on or the wall they are near. Or, it may involve looking deliberately at the items in the environment such as the color of the wall or the objects on a table. Or, it could be focusing and identifying nearby sounds. By doing so, they bring themselves back to the present external experience and away from the internal sensations.

Although this technique can be quite effective, some people need more practice than others. In particular, it can be difficult to remember when in the midst of a panic attack or flashback. Therefore, some people might wear a reminder such as a bracelet or they may have a friend remind them to focus on their immediate surroundings. Again, don't expect this technique to work without general mindfulness practice.

Suggestion 29: Acceptance of Yourself

Many people with anxiety disorders are critical of themselves for having the disorder and expect others to be critical or dismissive as well. Unfortunately, this attitude is complicated by the prevalence of misunderstandings about anxiety. People have often been seen as weak or blamed for their anxiety. They may be viewed as not being able to cope with normal life problems.

Although such a view is inaccurate, you can't change the attitudes of others. But you can change the attitude you have towards yourself. I have often seen that by changing how you feel about yourself, others will respond differently. For instance, if you approach people apologetically about your anxiety, they may be more likely to respond in a negative way. If, however, you assertively and confidently explain “I'm not comfortable with that” you might find greater understanding. And if some people don't understand, recognizing that it is their problem, not yours, helps you to be less critical of yourself.

Acceptance of yourself helps to reduce anxiety because it removes an additional demand upon you. The more that you believe that you have to get rid of the anxiety to be acceptable, the more anxiety you are likely to experience due to this unreasonable expectation.

A good technique that comes from the psychological Buddhist practice is Loving Kindness Meditation. This technique involves developing an attitude of loving-kindness towards yourself and others. By doing so you remove the stress of demands and can more gently focus on learning to manage your anxiety.

Suggestion 30: Practice Mindfulness with Discomfort

To enhance your ability to tolerate discomfort, deliberately practice mindfulness in uncomfortable situations. Most people can experience mindful states under certain conditions. Some situations tend to naturally enhance the mindful experience. For instance, observing a beautiful sunset is often experienced mindfully.

However, the true practice of mindfulness means bringing this experience into all aspects of our lives. Of course, no one can be perfectly mindful all the time, unless they are perhaps a guru on a mountaintop (and even that might be difficult). Yet, the more you practice mindfulness, the more frequently you can experience it in the various aspects of your life.

The more advanced mindful practice involves being mindful during discomfort. For instance, the natural inclination when you have an itch is to scratch. But what if, instead, you allowed yourself to be fully aware of the experience of the itch? As you focus on the different sensations, without judgment, you may find a greater ability to tolerate the itch.

Focusing on discomfort means learning to observe from a distance. Instead of being emotionally involved in the experience, you allow yourself to observe the experience. What I mean is with the above example of an itch, instead of focusing on “I can't stand this!” you focus on the actual sensation. Where do you feel it? Where does it start and stop? Does the intensity of it vary or stay the same? Can you make it increase?

Interestingly, it is often found that by developing this more observant approach, the sensation becomes more tolerable. Not only that but once the sensation is more tolerable, the perception is that it does not feel as bad. Yet, nothing about the experience itself changed but the way you focus on it and perceive it.

Excel At Life offers a number of mindfulness practice audios and transcripts that focus specifically on awareness of unpleasant situations. At first you may practice mindfulness in physically uncomfortable situations but eventually expand your practice to emotionally uncomfortable situations. Practicing mindfulness in these situations can increase your ability to tolerate discomfort. READ MORE: page 11

Kindle Books by
Dr. Monica Frank

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