Book review: The Mindful Way Through Anxiety: Break Free from Chronic Worry and Reclaim Your Life, by Susan M. Orsillo, Ph.D., and Lizabeth Roemer, Ph.D.

Mindful Way Through Anxiety
A book review by Lisa Anyan Smith

We live in a stressful world.  Anxiety is a part of the human condition.

Many people complain of feelings of anxiousness, ranging from occasional mild worrying to full-blown anxiety disorders such as Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, Social Phobia, or a specific Phobia.

Although anxiety is a normal human emotion, we find feelings of anxiety unpleasant and typically try to avoid experiencing them.  Attempts to avoid  anxious feelings may include overeating, drinking alcohol, watching TV, taking prescription medications, or staying away from situations or people that may trigger anxiety. In their new book, “The Mindful Way Through Anxiety: Break Free from Chronic Worry and Reclaim Your Life,” Orsillo and Roemer propose that avoiding anxiety or attempting to control it does not ease pain and suffering.  Rather, avoidance brings its own costs.  The authors suggest that to break free from anxiety, instead of avoiding anxious feelings, we practice coping strategies that allow us to turn toward and pay close attention to anxiety.  Turning toward something that we would usually avoid and taking a fresh look at habitual responses are crucial components of mindfulness.

Before exploring how mindfulness can help us break free from the grip of anxiety, let’s look at an example of what anxiety is.

Jody recently moved to New York City from Alabama to start a new job.  Heading into a corporate meeting, she notices that most of her coworkers are already seated and chatting with one another.  She takes a chair between two groups already engaged in conversation and begins shuffling through her papers.  She feels her anxiety rising.  Some of the thoughts that go through her mind include, “I don’t fit in here,” “My clothes are all wrong,” and “They must think I’m an idiot.”  She feels her face flushing, palms sweating, and pulse quickening.  Thinking of the friends she left behind at her former job, she feels a wave of sadness and regret.  She despairs as she thinks about the years ahead of her, just knowing that she will always feel alone.  For the duration of the meeting, she keeps her eyes downcast, contributing nothing to the discussion.

As this story illustrates, components of anxiety include thoughts, emotions, physical sensations, and behaviors.  Evolutionarily, humans are hardwired to feel fear.  Fear is actually a helpful warning that alerts us to potentially dangerous situations.  When we perceive a threat, the fight-or-flight response kicks in to ready us to combat or escape from harm.  The physical symptoms we experience when this response occurs (increased heart rate, rapid breathing, adrenaline rush, etc.) are merely side effects of the body getting ready to fight or flee.

Compared to fear, anxiety is a more subtle but chronic state.  Whereas fear is an automatic response to a threat we perceive as immediate, anxiety includes thinking about or imagining some possible threat we may come up against in the future.

Orsillo and Roemer’s research indicates that our struggle with fear and anxiety does not come from any actual harm caused by the physical sensations of these emotions.  Rather, it arises from our reactions to these emotions and the thoughts, sensations, and images that accompany them.  Criticizing ourselves for feeling fear or anxiety is what hurts us, not the fear and anxiety themselves.  This is where the turning inward is helpful.  Mindfulness can help us replace self-criticism with compassion.

Simply put, mindfulness is a specific way of paying attention.  It involves “purposefully expanding your attention to take in both what you are experiencing inside – your thoughts, feelings, and physical sensations – and what is happening around you.” (p. 81)  The key concepts of mindfulness include 1) Noticing – becoming fully aware of the thoughts, feelings, physical sensations, and images that you experience, as well as the details of your environment; 2) Curiosity – approaching experiences with openness; and 3) Self-Compassion – acknowledging that the reactions we have are part of being human, accepting what cannot be controlled, and treating yourself with kindness and care.

The authors provide a series of exercises progressing from a 5 minute breath exercise through a number of informal and formal techniques to practice mindfulness.  Readers are also encouraged to download audio recordings from the book’s website to listen to while practicing or to record their own scripts.

Shane trembled as she waited her turn to stand behind the podium and deliver her speech.  She had agreed months ago to make a presentation before her colleagues at the real estate convention, even though she was terrified of public speaking.  As the previous speaker was concluding his remarks, Shane felt her stomach churn.  Her neck felt tight and sore, she felt the blood rushing to her face as she blushed, and she began sweating profusely.  “Why, oh why did I ever agree to this?” she thought.  She recalled the incident in high school when she had forgotten her lines in the school play, and now she relived those old feelings of embarrassment.  “It will be just like in high school!”  “These people will think I’m so stupid.”  “No one will ever refer any business to me again, ever!”

Orsillo and Roemer would say that Shane is experiencing “muddy” emotions.  This occurs when we bring in memories of past events – and conjecture about future possibilities – into the current moment.  If Shane were to take a moment to be mindful of the immediate challenge, she would realize that she is muddying her current anxiety by worrying about “what if” rather than focusing on “what is.”

The authors write in a style that is easy to follow and offer many vignettes to provide examples.  They also address the questions that many readers may be asking:

But isn’t mindfulness a Buddhist principle?  Is it a new age fad? What if I have different spiritual beliefs?  

The term mindfulness indeed originated with Buddhism, but the idea has recently been included in research and therapeutic settings.  In fact, mindfulness practice has been shown to decrease anxiety, insomnia, stress, risk of coronary heart disease, substance use, chronic pain, and fibromyalgia, and increase attention, sexual functioning, quality of life, and immune system functioning.  The book does not focus on the religious aspect of mindfulness.

How can I find the time to practice mindfulness?

While research suggests that more practice is associated with greater benefit, the authors offer a variety of techniques including exercises that only take 5 minutes a day.  They also point out activities that you can do mindfully, such as eating, walking, washing dishes, folding laundry, petting your dog, cooking, listening to music, or hugging a friend.

How can mindfulness help with anxiety? 

By this time you may be thinking, “Gee, thanks, but no thanks.  I’m already acutely aware of my anxiety.  Why on earth would I want to focus on it more?”  Yes, it is seemingly counterintuitive, but mindfulness can actually help us notice what we are experiencing and make choices about how we want to respond, rather than automatically reacting in ways that hold us back from fully engaging in our lives.  Let’s look at one more example that illustrates the value of mindfulness:

Sam was on a third date with Chris.  He had been single for a long time and knew that he wanted to develop an intimate relationship.  He was quite fond of Chris, and was getting signals that the feeling was mutual.  As the talk turned more personal, he felt his pulse quicken, his chest tighten, and his mouth get dry.  He felt the urge to change the subject so he wouldn’t risk feeling vulnerable and getting hurt.  He watched Chris for cues, and thought he saw a frown of displeasure when Sam talked about a low point in his life.   What Sam really wanted to do was excuse himself, pretend to go to the bathroom, and run like hell out the back door of the restaurant.  However, he really wanted to build a connection with Chris, so he chose to remain in the situation.

Often the things that really matter to us, like loving people, forming emotional connections, taking on challenging tasks, or caring for those in pain and suffering, bring with them emotional pain.  In these cases, living a fulfilling life means that we notice the pain and allow it, rather than trying to make it go away.  Mindfulness can help us to embrace our entire range of emotional experiences, making it easier to make these choices and enrich our lives.

 

Additional Reading:
Boyce, Barry (Ed.). The Mindfulness Revolution. Shambhala Publications,  Inc., 2011.
Germer, Christopher. The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions. Guilford Press,  2009.
Matheny, Kenneth B. & Riordan, Richard J. Stress and Strategies for Lifestyle Management. Georgia State University Press, 1992.
Nhat Hanh, Thich. Peace is Every Step: The Path of Mindfulness in Everyday Life. Bantam Books, 1992.
Siegel, Ronald. The Mindfulness Solution: Everyday Practice for Everyday Problems. Guilford Press, 2010.
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