The AWARE Approach to Anxiety

Have you ever experienced anxiety, and have friends and family tried to help you out by telling you to “calm down” or to “stop thinking about it”? Have they tried to reason with you, pointing out that your fears seem exaggerated or unrealistic? Has either of that helped? I’m sure it hasn’t. There is no arguing with the anxious part in us and no just trying to ignore it. Anxiety persists and gets even stronger when we do that.

We live in a time where depression and anxiety are both on the rise. Mood and anxiety disorders are among the most common types of mental disorders in Canada and have a major impact on the daily lives of those suffering from it and on their loved ones, who often are support people. According to Statistics Canada, three million Canadians (11.6%) aged 18 years or older suffered with a mood and/or anxiety disorder in 2013. It is important that we learn to understand what can be done to address anxiety.

A person with an anxiety disorder comes to treat their anxious feelings not just as a symptom of nervousness, but behaves as if there is a threat. The mark of a chronic anxiety disorder is that a person feels afraid and defensive when they are not presently in danger. A part of us takes over that wants to protect us. We are left with our instinctive three responses to enemies: fight, flight or freeze. All these are very useful when there is real danger. These instinctive reactions allow us to act without conscious thought and to either fight, run away, or play dead when confronted with a dangerous enemy. These responses, however, are extremely unhelpful when we are caught up in “What if…” thoughts or worries about a future that hasn’t yet happened, and is most likely not even going to happen the way we fear.

What we have to keep in mind is that anxiety is not about being in a dangerous situation. Therefore, the first two questions to ask according to anxiety expert David A. Carbonell are:

  1. Does the problem I am afraid of exist right now in the present moment?
  2. If so, what can I do to address the situation? If not, I am dealing with severe discomfort, but not acute danger.

 

When a bus is driving towards us, we are busy jumping out of the way instead of distracting ourselves. Or if a dog is attacking us, we are busy fighting the dog off rather than distracting ourselves. So, when you feel the urge to distract yourself from the fear, that is a powerful reminder that you are not in present danger.

For some people, the fear of fainting during a panic attack is an issue. If that is one of your worries, let’s examine what happens in the body for us to faint. What causes a person to faint is a sudden and significant drop in blood pressure. Because the brain is at the top of our body it has difficulty getting an adequate supply of blood. Fainting brings the brain down to the floor to guarantee the blood supply. However, during an anxiety episode or panic attack, the blood pressure is doing the opposite, it is going up, not down. Carbonell mentions in his book “Outsmart Your Anxious Brain” that in thirty years of seeing anxiety clients, exactly five clients have fainted and that was due to a rare condition called POTS, which less than 1% off the population has. If you had that condition, you would know because you would have a history of fainting frequently.

Once having determined that there is no acute and present danger, rather than trying to argue with the fear, or trying to distract ourselves from it, or going into fight, flight or freeze, what is most useful is to relax, be with the fear and give it time to pass.

In my article “Hello, Old Pal Anxiety!” I mentioned greeting the anxiety like an old friend, “Hello, my friend. I know you. You are my old pal fear. Welcome back.” While we are simply watching the physical sensations, we use deep belly breathing.

Taking a deep breath can be tricky when we are tensed, so start with a deep sigh or two, exhaling with an open mouth before you take your first deep belly breath. You can place one hand on your belly (to feel it filling up with air) and the other one on your upper chest (for comfort). As you inhale through your nose, let your belly come out and fill up with air. Take a short pause, and then exhale through your mouth and let your belly become smaller again. Continue this way of breathing while you remind yourself that every anxiety episode has an end.

In his book “Outsmart Your Anxious Brain”, David A. Carbonell outlines five simple steps to address anxiety.

Accept

Resistance to the part in us which is coming up with warnings is futile. The fearful part will only make itself heard more loudly. In the end, we feel worse when we resist or argue with the anxious part. The opposite of resistance is acceptance. Simply decide to accept that it is there. Welcome it. It is there for a reason. There is some deep wisdom behind this part showing up, even though it seems like it is trying to make life harder for you.

Watch

Watch the sensations and observe your symptoms without judgement. Carbonell suggests keeping a symptom journal, because it keeps our mind in the present moment. Watch how this part makes you feel physically and listen to what is has to say with open curiosity.

Act

This does not mean trying to stop the anxiety. That is not your job when you are experiencing fear! The anxiety will last as long as it lasts, no matter what we do to stop it. Acting means to see if you can feel a little more comfortable while you wait for it to end. One main way of acting is the deep belly breathing I described above.

You could also communicate with the part in you that is trying to protect you with “What If…” thoughts. Do not argue with it. What we resist persists.  Instead remember that there is a part in you that has the best intentions. This part is separate from you. It is trying to protect you. Humour it. Listen to it. Let it know you understand what it is trying to do for you. Let it know that it makes sense to you that it would feel it has to give you anxiety symptoms to warn you. Let it know how very grateful you are for what it is trying to do for you.

Carbonell suggests using the “Yes, and…” rule of improvisational theatre. Agree with what this part has to say and add to it in a humorous way. He gives the example of a man who is anxious about his next job evaluation: “Chris might respond to his frequent thought, ‘What if the boss gives me a poor evaluation?’ By replying, ‘Yes, and he’ll probably hit on my wife too and steal her from me once I’ve been fired!’”

Repeat

The “R” in the AWARE method stands for “repeat”. You simply continue to repeat the accepting, watching and breathing or talking to the “What-If” part. Practice is key for addressing anxiety.

End

Have you ever had an anxiety episode that did not end? They all end, no matter what you do or don’t do. Remind yourself of the fact that it ends as you accept, watch and breathe.

The AWARE method outlines clear steps to respond to anxiety rearing its head. Carbonell also suggests making daily ten-minute appointments to worry out loud in front of a mirror, just letting one what-if thought after the next flow. People find that by giving the anxious part room in that way, that the rest of the time they feel less anxious.

To practice the AWARE method and to learn other techniques to embrace yourself with your anxiety, reach out for a free phone consultation.

Angelika

905-286-9466

greendoorrelaxation@yahoo.ca

Steps to a Happy Healthy Heart

How do we keep our heart healthy? In this latest episode of my podcast “Discover the Hidden Potential of Your Mind”, I am interviewing my colleague naturopathic doctor Felicia Assenza about this topic.

Join us for a 30 minute podcast episode about heart health.

Or you can also read her article below.

Steps to a Happy Healthy Heart

BY FELICIA ASSENZA, ND

February is heart month and with heart disease being the leading cause of death worldwide, it makes sense that we would dedicate a whole month to bringing awareness around the heart. What can you do for your beautiful, hard-working heart? It’s not easy pumping all that blood around day-in and day-out! Here are just a few things you can do that your heart will thank you for.

 

Say thank you!

What Felicia!? You want me to thank my heart? You may be thinking this sounds a little hokey but before you stop reading, hear me out! If you’re a well practiced yogi or someone who’s familiar with chakras or mind-body medicine, then you probably don’t think this sounds strange at all. Gratitude is good for the heart! For those of you who may be a little more skeptical, I have evidence. Not only has having an attitude of gratitude shown to be an amazing motivator for making positive lifestyle changes but being grateful actually lowers your heart rate, results in fewer deaths from heart failure, lowers inflammation, and helps balance emotions1, 2. All that just for saying thank you! So thank your heart for working so hard, thank the people in your life, thank God or whoever who believe in, just be grateful and at the end of the day, your heart will thank YOU for it.

Exercise

Most people already know that exercise is good for the heart so I won’t spend too much time on this one. One thing I will say though is find a way to get moving that is fun. If you hate running, don’t plan to run every day because you heard that it’s good for you. Find an activity you love and can get excited about and work that into your action plan to get moving.

Make healthy food choices

This is a hard one. There is always so much propaganda around diets, each one making amazing claims until the next one comes along. I think this is an area where it helps to have someone (like your local Naturopathic Doctor) who has a solid understanding of nutrition to work with you to figure out the best food choices for you and your body. I will, however, dare to make a generalization for three heart healthy food choices: 1) Eat lots of vegetables, 2) Eat healthy fats (mono- and polyunsaturated), and 3) Avoid processed foods.

Connect

Did you know that social isolation or loneliness has the same risk as smoking for heart disease. Connection is good for the heart! Find events in your community that you’re interested in. Call that friend or family member you’ve been meaning to catch up with. Head to a public library or cafe to catch up on work or reading. Don’t like connecting with humans? Get a pet. Go for a forest walk. Do whatever you have to do to connect with the people and world around you.

Want to work together on your health journey? Send us an email, give us a call, or book a free 15 minute consult.

Dr. Felicia Assenza can be reached by e-mail:

felicia.assenza@gmail.com

or through the

Awakening Health Clinic in Burlington

Sources

  1. Kyeong, Sunghyon, et al. “Effects of Gratitude Meditation on Neural Network Functional Connectivity and Brain-Heart Coupling.” Scientific Reports, vol. 7, no. 1, Nov. 2017, doi:10.1038/s41598-017-05520-9.

  2. Redwine, Laura S., et al. “Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability and Inflammatory Biomarkers in Patients With Stage B Heart Failure.” Psychosomatic Medicine, vol. 78, no. 6, 2016, pp. 667–676., doi:10.1097/psy.0000000000000316.

  3. Publishing, Harvard Health. “Loneliness Has Same Risk as Smoking for Heart Disease.”Harvard Health, www.health.harvard.edu/staying-healthy/loneliness-has-same-risk-as-smoking-for-heart-disease.