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A  bumper sticker popular around fifteen years ago proclaimed “If you’re not angry, you’re not  paying attention.”  Mine would read “If you’re not anxious you’re not paying attention.” In 2017 anxiety disorders surpassed all others as the most frequently diagnosed malady in the U.S., surpassing depression for the first time.  As a clinical psychologist, I track this increase with concern and, well, a little anxiety.

Last month I saw a  talented young man grown nearly debilitated with anxiety after intensively researching climate change and global warming.   This young student at one of the top engineering schools in the country could barely get out of bed, face other people, or make it to class.   The word “apocalyptic” is being thrown around this year in the aftermath of natural and unnatural disasters which are occurring at such  alarming rates many of them fail to make the front pages of our major newspapers.

Fires in California devastating hundreds of  thousands of acres from San Diego to Mendocino, snowstorms shutting down the East coast for days, hurricanes and flooding ripping apart Puerto Rico, Texas, and Florida, and mass shootings occurring 9 out of every 10 days are such occurrences that should shock us with their magnitude  but are becoming almost commonplace. The daily news provides plenty of fodder for all of us to worry, go numb, get depressed  about or live in a constant state of over-arousal.

“What if…. what if…. what if….”  runs the anxious mind,  feeding anxiety with thoughts of things going wrong and catastrophes resulting. Near the end of his days  Mark Twain said, “I am an old man and have known a great many troubles, but most of them never happened.”  What then, is the point of worrying?  People often tell me that if they prepare for something bad (with worry)  if it  happens then they will be better able to deal with “it.”  This is what I call “rehearsal” for catastrophe.  In actuality,  this rehearsal not only doesn’t help one to cope with difficult events,  it also taints the present by sending the same toxic bio-chemicals coursing through the body-mind system as if misfortune were actually occurring right now.

What is anxiety, actually?  Etymologically, anxiety traces back to the Latin Angere “to choke, squeeze tight.”  When I ask my patients where do they feel this they often point to their throats, to their chests.  I ask what does it feel like?  A squeezing, a vice grip, something heavy and oppressive sitting on one’s chest, a tightening in one’s throat.  Then there is dread.  The sense of the other shoe about to fall, but you never know when. Author Molly McCloskey  describes  an episode poignantly: “I dreaded getting up in the mornings, half believing that if only I could sleep long enough, I might sleep through it, whatever it was.”

Anxiety lives in the past or, more commonly, in the future.  In William Blake’s epic poem “Milton,” there is one time of day that the devil cannot be found.  That, I would argue, is the present moment.  I tell my patients to come into this present moment, into the embodied experience of now.  But what if now is so full of dread that they simply cannot get a breath?

 Among the many methods of managing anxiety, most involve trying to get away from  it. Distraction is one often effective for relief in the short term.  It involves finding a more compelling stimulus to capture the mind’s attention for a time and sort of pretend anxiety is not there, or at least not front and center stage. Some distractions, such as a really good film, a conversation with a friend,  or a musical experience can also result in changing perspective so that the anxiety actually lessons when the stimulus ends.  But most distractions like bingeing on TV,  Facebook, drinking, drugs, gambling, compulsive sex , shopping and over-eating compound the anxiety with additional problems.  

Avoidance,  similar to distraction, involves a variety of ways to try to get away from the feelings of anxiety.  Some very positive habits can develop from this strategy including habitual exercise.  Running, swimming, lifting weights, any kind of movement can temporarily alleviate tension and focus the mind.  These habits can have very positive side effects and also help to settle the bodily symptoms down.  But patients often report feeling as if they are merely trying to outrun the dread, and it is always waiting for them once the music stops.

Rather than ignore, distract, or pretend  it isn’t there, what if we were to actually enter fully into it in a moment to moment way?  While it sounds fearsome, actually giving full attention to the feelings and sensations as they arise and fall can dismantle the physical aspects of anxiety, breaking them down into nameable, manageable sensations. Then this monolithic thing we call anxiety begins to crack and  crumble and we  simply witness a kaleidoscope of shifting experience moment by mind moment.  When examined closely like this, we find that within the sensation of squeezing also lies its opposite, loosening.  And within throbbing or pulsing there is a release.  Tightness also pulses, alternating pressure and its absence.   A shift of attention to these spaces in between  expands them, allowing freedom and spaciousness to emerge alongside the discomfort.   Then the contractions or intense moments become like snowflakes falling in open sky rather than a solid block of ice sitting on one’s chest.   

Similarly, we can watch the shape of things morph from a seemingly solid block to a moving ever changing pattern of sensations.  Initially, if we feel a heaviness in the chest, it might feel as though a giant is sitting there.  But if we try to discern the boundaries of the giant’s legs, they start to soften.  If we shift attention to just outside where this pressure is, then back to it, we notice that the boundary is quite slippery.  Just when we think we have nailed it down, it shifts, relaxes and may start to dissolve.  Or grow into another shape entirely.  The edges may become porous,  allowing levity alongside  the border of heaviness.

This description is  a brief exercise in mindfulness of body, the first foundation of mindfulness as taught by the Buddha.  By entering the body with full conscious attention, the anxious sensations become more manageable and, eventually, subside.  Once the body has calmed down, the mind, which has been very concentrated, is now also more relaxed and better able to think about whatever was causing the anxiety in a more rational manner.  The Buddha’s teachings went on to include mindfulness of emotion, mindfulness of mind, and mindfulness of awareness itself.  Jon Kabbot-Zin secularized the systematic training of mindfulness as Mindfulness Based Stress Awareness, or MBSR, which has been applied in numerous and various settings such as schools, hospitals and clinics, as well as psychotherapy offices throughout the world. 

Whether we give credit to the Buddha, his Hindu teachers before him, or the science based teachers that have come in the last few decades, what we know is that the practice of mindfulness and meditation can actually change the brain and make it more resilient and less prone to worry and stress. 

 Before Siddhartha Guatama became the Buddha, he was a prince leading a charmed life, protected from seeing even a wilted flower.  One day he went beyond the palace walls and was shaken to his core by seeing a very old man, a very sick man, and a corpse.  Then he saw a wandering ascetic.  These sightings are referred to as the four Heavenly Messengers because they aided in waking Siddhartha  up to reality. 

At the root of worry thoughts  is  the theme of  loss.   When we see a  gorgeous 35 year old woman worried about the lovely laugh lines just beginning to enhance and define her appearance, the first heavenly messenger is present.  When the hypochondriacal young student frets about his back pain or sore throat, the second heavenly messenger is there.  And the third, or the corpse, is at the core of all the anxieties. Death.  Loss of loved ones.  My own death. Our planet. Earthquakes, tsunamis, tornados, mass shootings.   And when an overworked professional enters her first yoga class where she  is greeted with namaste, chants OM and unites her breath and body in movement, the shadow of the mendicant moves with her.

When someone is worrying about the number of “likes” on her latest Facebook post, these messengers may seem as relevant as fairies.  But even here is fear of loss of self through losing social status as a fragile identity forms in adolescence.     If we can awaken to these truths of life and face them with “radical acceptance,” then  maybe we can greet  life in between the shaking and clenching with greater joy  and presence as well.