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December 8, 2015

The Downside of Mindfulness for the Anxious Mind (& What to Do About It).

Jessica Johnson

This morning, in-between seeing patients on rounds with the neurology team, we were discussing the potential for psychological disturbances to manifest themselves as physical symptoms.

The mind body connection is strong, so much stronger than we may ever fully realize. (I find it so encouraging that a topic such as the mind-body connection is being discussed among the medical community on morning rounds, but that’s beside the point.)

Our brain constantly receives input from millions of sensory nerves delivering tactile, noxious, thermal, proprioceptive, visual, auditory, olfactory or gustatory information from every micrometer of our body. Typically, our brain is adept at filtering these sensations in order to hone in on those that are most relevant and acute so that we may give our full attention to what matters most.

Mindfulness elevates our perception of these inputs so that we may become more aware of any number of these sensations at a given time. For the most part, this is a very good thing. It allows us to become more intentional—to live life with a little more presence and to avoid missing out on the little things that we often later find out were the big things.

This can be particularly helpful in the setting of medical conditions that involve perception as a key component, such as Attention-Deficit-Hyperactivity-Disorder (ADHD), phobias, anxiety, and chronic pain. Ironically, in the same way that mindfulness has the potential to help manage anxiety, it can also make it worse.

The key problem with anxiety is the underlying maladaptive tendency to perceive the world as inherently dangerous and uncontrollable. Mindfulness, though potentially therapeutic, can rewire our brains to be able to bring any number of sensations into the realm of conscious thought at a given time. These sensations, which would previously have gone unnoticed by the less mindful person, now give the anxious mind more material to distort from benign into potentially threatening.

For example, focusing on the breath can create sensations of having difficulty breathing, focusing on swallowing can create the sensation of difficulty swallowing or the presence of a foreign body—a condition known as “globus hystericus.” Many times, I have been told by people who admittedly struggle with anxiety that being told to focus on the breath in a yoga class—a presumably calming activity for most people—is enough to tip their latent anxiety over the edge. Normally, these transiently worrisome thoughts can be redirected, but when we start to become intensely aware of every sensory input, the anxious mind may magnify them to the point of causing an acute exacerbation of the anxiety or even a panic attack.

The idea behind mindfulness is, of course, to observe these sensations from a non-judgmental neutral space without acting on them (the potentially therapeutic effect), but sometimes we’re not able to get to that point. Particularly anxious people (myself included) may only get to the noticing part of the practice, which then sends them into a tailspin of anxious thinking—one anxious thought leading to the next.

This is not to say that we all shouldn’t practice mindfulness. The practice of mindfulness most certainly can unlock the door to freedom for people struggling with various medical conditions and can help even those who don’t to get more out of their lives. It can help us to live with more ease and less struggle—to cultivate an impenetrable sense of peace and contentment unaffected by the fluctuations of our surroundings. Rather, I write this to suggest that for some of us it may get worse before it gets better. And, in true mindful fashion, we should try not to judge ourselves if this is the case.

Now, what to do about it?

If the little voice inside your head is screaming, “Hey! That’s me! She’s talking about me!” as you’re reading this, or if you’ve just never been able to buy into the whole meditating-on-the-breath-thing, don’t lose hope just yet. Rather than giving up on the practice of mindfulness altogether, simply try switching the focus of your attention from a somatic sensation—one that is malleable and, depending on who you are, can be distorted into something potentially threatening—to one that is invariably neutral and disconnected from your perception of self.

Whether the problem is anxiety or that you simply find it difficult to focus on the breath or any other bodily sensation (I experience both), shifting attention to something more tangible may help unlock the door to the benefits of mindfulness. The object of your attention can be anything you’d like—a candle flame, your favorite mantra, mala beads, your surroundings as you take a walk outside, tonight’s dinner—the list is endless.

The breath is an obvious choice for mindfulness meditation because it’s free, permanent, and is inevitably always with us, but it’s far from the only one.

BONUS VIDEO: Contemplation Practice: The Four Reminders that Turn the Mind Towards the Dharma

Relephant Favorite:

How Mindfulness Helped My Fear of Public Speaking.

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Author: Jessica Johnson

Editor: Travis May

Photo: Used with permission, courtesy of Eva Fuze

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