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.


Author: Jessica Johnson

Editor: Travis May

Photo: Used with permission, courtesy of Eva Fuze

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Jess Dec 11, 2015 9:03am

I am so happy to read this as I can definitely relate. It didn't make any sense to me before, as we are taught that mindfulness reduces anxiety but you raise some very good points. I will definitely be trying your suggestions!

Cathy Dec 11, 2015 6:34am

Noticing the anxious habitual response to your object of meditation will in and of itself lessen the anxiety in the long run. The practice is called mindfulness/awareness practice and they occur simultaneously . Group practice and a meditation instructor could prove helpful as well

Jenny Dec 10, 2015 11:29am

Excellent conversation! The word "mindfulness" was the word of 2015, so it's important we discuss what that means and the various qualities that we can experience when practicing mindfulness. I can definitely see how we can become over sensitized, hyper focused, and how this can increase anxiety. However, as was mentioned in the article, we don't need to place judgement about these feelings of being anxious. Might I also add that initially when practicing mindfulness, there may come a subtle (or sometimes overt) feeling of attachment. It can manifest as wanting to hang on to a sense perception, feeling, or even the thought of maintaining a state of mind, which are possible indications of resistance and I think it is within this juncture that anxiety begins to churn. We can practice being mindful by noticing a short glimpse of awareness, but we don't need to hang on to it. I myself could not imagine practicing mindfulness in daily life without some formal meditation practice to anchor me. I often wonder if our society is wanting the "sound bites" of mindfulness and missing the deep connection of earthiness that a formal practice offers. Building the roots of a steady practice may serve us greatly when we feel flooded by this highly overstimulated culture.

What a rich topic!! One that is much appreciated by this therapist and yoga instructor. Thank you!

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Jessica Johnson

Jessica Johnson is a Virginia-based certified yoga teacher and physician-in-training passionate about incorporating the East with the West to foster true healing. When she began medical school a few years ago she developed a yoga & meditation program for her campus community in an effort to promote balance & self-care and to expose current & future healthcare providers to the benefits of yoga. Currently in her 3rd year now, she’s maintained this sense of balance by splitting time between the hospital and the local pier where she teaches dynamic vinyasa sunset yoga classes with the entirely donation-based pop-up yoga collective she co-founded earlier this year, The “Bhav Brigade.” She is a tireless promoter of self-care, lover of cooking (eating!), mom to an adorable two-year-old Samoyed puppy, River, and eternal student who champions the life motto “always remain teach-able.” Catch up with her on Instagram, Facebook or on her blog, Living Soulfull.