Randy Kamen

Behind the Therapy Door


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and perhaps become curious about each feeling state as it comes and goes. As you become aware of your emotions, practice naming each feeling, such as “joy,” “anger,” or “frustration,” in a steady and relaxed way. Then deepen your breath and notice what happens. Perhaps you will sense your emotions building, peaking, or easing and the wave becoming less pronounced. Paying attention to your feelings, rather than simply reacting to them, can reveal much about your inner world and liberate you from the potential storms of emotion and physical sensation.

      In contrast, avoiding your feelings delays the process of moving through them successfully. For example, when you numb yourself to the pain of loss or hurt, the associated feelings cannot successfully resolve in your conscious or unconscious mind. Painful feelings, when examined, can become magnified before they quiet down. However, when people allow themselves to observe, feel, and move through their pain, the intensity of their emotions subsides and they gain a greater sense of personal empowerment and resilience.

      My goal was to help Anne develop the internal resources needed to allow her complicated and uncomfortable feelings to surface and to learn to tolerate her pain. In this way, she could eventually move beyond the old demons. I knew that if she were able to do this, she would find greater inner peace. Therefore, teaching her a basic approach to use to practice observing and being present with her difficult feelings was an important place to continue our work.

      Strategy for Tolerating Painful Feelings

       Notice the feeling as it arises in your mind and body.

       Give it a name, such as anger, sadness, shame, or remorse.

       Take a few deep breaths.

       Observe how the feeling moves through you.

       Remind yourself that you can handle this feeling and that it will subside.

       Pay attention as the feeling begins to pass through and quiet down.

      Mindfulness

      I explained to Anne that the above technique was not only a way to control her anxiety but also a way to become more mindful, and that increased mindfulness would help her in all facets of her life.

      Mindfulness means deliberately paying attention to, and seeing clearly, what is happening in our lives in the present moment, without judgment. It does not eliminate life’s stressors, but it can help us respond to them in a calmer manner that also benefits the heart, mind, and body. It helps us to recognize and step away from habitual patterns of behavior, which are often unconscious emotional and physical reactions to everyday events. For example, being mindful helps us make more thoughtful decisions about food, exercise, rest, and perhaps even our relationships.

      Our minds have a tendency to wander through all kinds of thoughts and emotions. Some of these are positive, while others may include feelings of unexpressed anger, anxiety, cravings, guilt, and shame. When we indulge ourselves in these negative thoughts, we make them stronger. We do not want to stop thoughts and emotions from entering our minds, as they deepen self-awareness and guide future life choices. Instead, the idea is to notice and observe our feeling states without embellishing them in our minds. It is important to understand that whatever we focus on in our minds becomes stronger. As a result, it behooves us to focus on thoughts that are positive and support our best intentions.

      When we pay attention in the present, we are not dwelling in the past or the future. We are anchoring ourselves in the moment, creating a space where peace and contentment can grow and flourish.

      Mindfulness also means being consciously nonjudgmental. This gives us a chance to be kinder and more compassionate with ourselves and in our relationships with others. Rather than being judgmental, we can perhaps become more curious about our own behaviors and those of others. We can be aware that an experience, interaction, or feeling is either pleasant or unpleasant, but when we are mindful, we learn to observe rather than judge.

      For example, Anne could bring herself into the present moment and be curious about the dynamics with Justin and within herself rather than be critical. This would help her to be more open-minded and positive. Mindfulness is not about creating balance and happiness, although these are often residual benefits. It is about being awake to our lives and finding peace within.

      Mindfulness improves our physical and psychological well-being. It heightens our capacity for creativity, intuition, and wisdom. We can train our brains to be more present and less judgmental, to better care for ourselves, to create healthier relationships, and to make better life choices.

      The most basic vehicle to mindfulness is the conscious focus on and deepening of the breath through abdominal breathing. From the first time I met Anne, I noticed her breathing was shallow and rapid. I knew that teaching her abdominal breathing so she could learn a simple and effective way to control her anxiety with immediate results would open up Anne to a greater sense of calm and vitality. The regular practice of abdominal breathing and other relaxation techniques are excellent strategies for self-regulating.

      Abdominal Breathing

      I asked Anne to remember how her children had breathed as babies, their bellies expanding and contracting with each new breath. I said, “Think about the full and rhythmical way in which they breathed. Somewhere along the way, most of us stop doing this and our stress levels increase. When elevated stress levels become consistent, the ongoing state of arousal can begin to seem normal.”

      Most of us are unaware of the importance of breathing properly and use only a small fraction of our full breathing capacity. Stress, poor posture, long hours in front of a desk or computer, and the wish for a flat stomach promote shallow chest breathing. When we restrict our natural breathing pattern, as we do automatically when we are stressed, the oxygen flow to the brain and body is reduced and we become more anxious. This perpetuates the experience of anxiety and pain within the mind and body.

      However, when we deeply expand and contract the breath, oxygenated blood circulates throughout the body and deactivates the autonomic nervous system’s stress response. As a result, there is a boost to the immune system, muscles relax, heart rate and blood pressure lower, digestion improves, bone repair and growth occur, and the whole body moves toward a greater state of relaxation. Most important, abdominal breathing evokes a feeling of emotional control along with a sense of mental and physical well-being.

      I explained to Anne that abdominal breathing, also known as “belly” or “diaphragmatic” breathing, is the fastest way to change one’s physiology, triggering a state of relaxation. I told her, “Relaxation and anxiety are incompatible responses that cannot coexist, because they are two distinct physiological responses. When you practice and internalize the feeling of relaxation, you eventually learn to override the effects of stress and anxiety. Abdominal breathing is the antidote to anxiety and panic.”

      The method I described was as follows: “Sit in a comfortable position with arms and legs uncrossed. Place one or both hands on the abdomen just below the navel and watch the rise and fall of the low belly. Breathe through the nostrils slowly and deeply. Expand the low belly as you inhale and contract the low belly as you exhale. Allow the exhalation to take twice as long as the inhalation. The relaxation occurs as you breathe out. Practice this for five to ten breaths a session and notice the effects. Abdominal breathing can greatly enhance your breathing capacity. It calms the mind and body and induces a feeling of relaxed attentiveness, which is at the root of mindfulness.”

      This basic breathing exercise can be practiced anytime you need to relax or to reduce anxiety, stress, or pain. The use of the hands on the chest and abdomen is only needed when you are training yourself to breathe abdominally. Once comfortable with your ability to breathe into the low belly, release the hands and keep them on the lap or to your sides. Go back to using your hands if you want the added reminder to breathe into the belly and keep the chest relatively still.

      Anne seemed curious. I told her, “Abdominal breathing requires practice and thought,