Recovery: Anxiety
I have been thinking a lot about anxiety recently. I recently read the wonderful Claire Weekes' book Hope and Help for Your Nerves. Ironically I was anxiously blocked to read the book; I had it on my shelf for almost two full months, I picked it up and started it two times before putting it back down again. Third time's the charm, I read it cover to cover.
How could I be anxious about reading a book on anxiety? I believe that anxiety, as a coping mechanism, is strongly defended and rationalized by the mind: at a certain point, I'd prefer to remain anxious and blocked than face my fears and move forward. Claire Weekes, with simple and penetrating insight, fully reveals anxiety as the emperor without clothes; my psychological defenses ramped up to prevent this realization from bubbling up, sending the very fear response I'm seeking to face to overwhelm me and cause an avoidance behavior.
Anxiety as bewilderment
Claire Weekes does a great job at listing the various ailments that anxiety sufferers face. I made several new connections myself; while I had been aware of the more obvious symptoms like body tension, shortness of breath, and susceptibility to illness, I saw how episodes of low blood sugar leads to weakness and panic, my bowels are thoroughly permeated with anxiety, and most poignantly that avoidance is an anxiety response. The anxiety sufferer begins with bewilderment of such symptoms, worrying if they've become the victim of some terrible disease like cancer. Health anxiety and internet doomscrolling has been my bread and butter for ages; ordering random supplements and convincing myself I must have some terrible condition lurking within me.
That so many of my health symptoms can be plausibly traced to anxiety seems obvious in hindsight. The Myth of Normal by Gabor Mate is relevant here, with its thorough accounting of the various ailments affecting trauma and anxiety sufferers. The story that sticks with me is of the doctor's office that noted its patients tended to be the most pleasant people, in other words people pleasers. The behavior tendency to suppress one's emotions, especially the most challenging like guilt, shame, fear, and pain, is directly linked to rare disorders of the body. As a wake up call, I took home the critical importance of continuing on my healing journey and seeking out safe loving communities.
Anxiety as avoidance
Avoidance is maybe the most subtle symptom of anxiety for me. Through rationalization and denial I am typically not even aware I am avoiding some task, person or feeling of which I am afraid. One clear example is addressing health issues promptly. I've had my share of bodily injuries, but what sets me apart is waiting weeks, months, or even years to seek treatment, all the while convincing myself that I am definitely taking care of myself! Once I do seek treatment, any bump in the road sets me back on the path of avoidance. When I injured my foot, a podiatrist told me that they had no idea what was wrong and good luck. Instead of seeking a second opinion, I took this to heart and continued suffering in silence for many more months before taking another positive step forward. I now make a conscientious effort to address health issues promptly, and encourage others to do the same. So much suffering is avoidable just by taking the first few positive actions.
Another major area for avoidance for me is relationships. Growing up in a dysfunctional family, I learned that speaking up for myself was dangerous and liable to be responded to with shame, guilt, neglect and abandonment. As an adult, I've swallowed my feelings, my wants and needs, my interests, my complaints, out of fear. But it was so second nature that I wasn't even aware of it, I rationalized my behavior as normal, if not outright heroism: here I am taking the high road by putting someone else first! I'm not going to turn out like my parents, explosive and selfish and rageful. Lo and behold, as the ancient Greeks said, the very steps I took to avoid my fate led me directly to it. I was thoroughly dysfunctional myself, just in the inverted, codependent-dominant way.
It took many painful friendships, relationships, and jobs to see my role in my unhappiness. It took recovery for codependence for me to see how I was sabotaging myself by not speaking up for myself, setting boundaries, and ending unhealthy relationships promptly rather than sticking around and trying to fix them. It took years after starting to put new behaviors in practice for me to begin to see how deep-rooted the fear is within me, how I've been running from that ancient, primordial fear of abandonment my entire life.
Other avoidance strategies that I employ are not getting mail from my mailbox for weeks (and then leaving the mail unopened on my table); using "safe" chores like dishes, laundry, cleaning to fill in empty time; running errands to businesses unnecessarily far away to add extra driving time; picking up my phone or alt tabbing to the browser to doomscroll social media and the news. Like I said, it's pervasive in my life.
I rank avoidance as one of the harder symptoms of anxiety to resolve, because the mind is so capable of hiding it. I'm putting into practice new mindful approaches to how I spend my time, in order to seek out, explore and understand my avoidant behaviors. One of my favorite avoidant strategies is constant busy-ness, so I'm optimistic that casting a compassionate eye on my time management will reveal underlying fears and let me face them with love and compassion.
Anxiety in the body
When I started anxiety recovery, I was completely numb to my body. I was aware of intense sensations, like sharp pain or orgasm, but numb to the every day average sensations that comprise the vast bulk. What helped me to start to get in touch with my body was emotional recovery through program, consistent meditation practice, and finally yoga. The timeline was incredibly slow, more like evolutionary punctuated equilibrium than steady progressive gains over time. The fits and starts have been meaningful, and revelatory over time, but I'm far from fully in tune with myself, I only just became aware of my consistent chest tension (thanks Claire Weekes!).
The first bodily sensations I noticed were tendonitis, as they were chronic and loud. I developed some tendonitis in my forearm (tennis elbow) after over-doing it at the gym, but I rank the real underlying cause to be my unhealthy relationship to work. Showing up at the computer with my hands and forearms taut with stress for hours every day for work, followed by extra hours of personal use, with breaks to use my phone.. yeah, repetitive strain is all but guaranteed.
Next was my back and shoulders. I began to notice my back when I started going for massages - the masseuses exclaimed shock at how knotted my back was. I was aware without their surprise, as their hands punished me and I called it quits when it was too much (quick comparison to today when a back massage is deeply relaxing and soothing). Yoga has helped me tremendously at unlocking the tension stored in my back and shoulders, and helping to keep that stress moving in and through me rather than accumulating.
Next was my breathing. This has come in fits and starts, at first I became aware during some meditations that I'd go through cycles of not breathing and then gasping for air. Learning and practicing paced breathing methods like resonance breathing (5 seconds in no hold 5 seconds out no hold repeat), 4-7-8 (4 seconds in hold 7 seconds 8 seconds out no hold repeat) and box breathing (equal 4 seconds each in, hold, out, hold) has helped me tremendously in this area. A breakthrough for me was that a good meditation does not require sitting with intense anxiety for long stretches; instead, I learned that calming is part of the practice, and sitting with guided resonance breathing for twenty to thirty minutes is superior to the same duration gasping for air.
One marker of my growth in this area came during my recent 5k training. I started training when on a no-tech week, so I ran without phone or music. I enjoyed the time with myself and my body enough that I kept at it through the entire training and race. It was great practice to check in with myself, to observe how my calves felt at the start, middle, and end of a race; to be fully present with my breathing; to notice how my body started to unwind itself and stretch out. Writing this now I am blushing as I recognize my perfectionism showing up; this is what it's like to be present with my body, to be aware of myself.
Anxiety as a positive feedback loop
The last topic I want to share on today is the stressor-fear-stressor cycle of anxiety and panic:
otherwise known as the first and second fears, or the two arrows in Buddhism. I find it meaningful that many different cultures came up with the same understanding of how fear works.
The basic process is as follows: some stressor triggers an automatic fear response within me, which causes some set of body and mind sensations, which generates more fear, cycling adding more fear until I'm in a state of panic and collapse. The wise or skillful approach is to catch myself, at any point in this cycle, and respond without fear. In the best case, this leads the cycle to fizzle out, as without more fear added the stress will naturally fade away (how hard it is to remember this in the moment!). Typically, the fear lingers or even continues to grow, but this does not reflect poorly on me, as the panic cycle is well worn and deeply grooved within me; it takes significant repetition and practice to train the mind to respond differently.
This is an example of a positive feedback loop, which despite the name is not so positive when experienced as a panic attack. The classic example of this process is two telephones on call together held next to each other, where the sound from one is amplified by the other, then received back and amplified further, cycling and amplifying more and more. It may also be thought of as an interest bearing account, where the interest is reinvested as capital, leading to more interest, leading to more capital, and so on.
Two pillars of recovery
Understanding the feedback loop dynamic completes the picture of my systems thinking of anxiety recovery, which I define with two main features. The first is the stored anxiety, pain, grief, trauma, etc., that inflames reactions towards the extreme. Emotional recovery, in the form of 12 step, trauma informed therapy, etc., thaws and processes these stored emotions to reduce the kindling for future emotional eruptions. The second feature is reducing the amount of new emotions bottled up. This means regular emotional processing of current events through journaling, intimate conversations, therapy, somatic work, etc. It also means interjecting new behaviors into the fear cycle by reacting differently in the moment, for example through Claire Weekes' face/accept/float/let time pass method.
Put together, this leads to a state of baseline calm and less reactivity. In other words, nerves that have adapted to be calm and return to calm more readily. It takes enormous effort to do this work and make these changes, but I can't see any other way to live at this point.